Q. My father, Steve, is a retired Marine who is recently widowed. My mother used to provide care for him full-time until she passed away suddenly. My brothers and sister live far away, and my father needs assistance now. He has Parkinson’s Disease, post-traumatic stress disorder, and is depressed over the loss of my mom. I reduced my hours last week to become his live-in caregiver, and I really don’t know what to expect, and how to deal with challenges as they arise. (I have no experience with caregiving, whatsoever.) Do you have any suggestions?
A. More than five million caregivers assist veterans in need with activities of daily living, including bathing, dressing, feeding, toileting, and walking or using a wheelchair. They often provide care continuously, day and night, and put the well-being of their loved ones before their own.
These caregivers also provide emotional support and help their loved ones manage mental health problems, such as Post Traumatic Brain Disorder (PTSD) and depression. Data from the U.S. Department of Defense and studies of mental health problems suggest 30.3% of those deployed meet criteria for PTSD or depression. Therefore, caregivers play a significant role in balancing their loved one’s emotional stability.
Caregiver needs are many; however, there are resources available that can help. It is a good idea to be proactive (as you are doing) and make note of some of the challenges military caregivers face, and strategies/resources to overcome them.
Challenge: Complex Medical Tasks
Advances in medical technology now require family caregivers to handle medical procedures that used to be performed by trained nurses in hospitals.
Strategy: There are some training resources that could help. For instance, the Rosalynn Carter Institute for Caregiving recently released free training webinars on all aspects of caregiving. In addition, the Family Caregiver Alliance has posted instructional caregiving videos on YouTube, and major medical centers are also producing print and video instruction for caregivers. If the medical tasks become more than you can bear, you should consider hiring an aide to come in and assist you or find alternate arrangements for your father, such as assisted living or a skilled nursing facility.
Challenge: Mental and Emotional Distress
Caregivers commonly experience grief as they adjust to their new roles. They grieve what they thought their lives would be, and they miss the people their loved ones were.
Depression is an emotional state common to military caregivers, with studies reporting that 40 -70% of them experience it, a much higher percentage than non-caregivers. What’s more, military family caregivers who care for service members/veterans with PTSD are at greater risk of becoming depressed sometime during their caregiving journeys than other military family caregivers.
Strategy: Take time for yourself. Respite can be as simple as having one of your father’s friends come over to watch a movie or sporting event or to take him fishing. It can mean taking your father to an adult day care program for a short period of time. Your first reaction may be that you can never get away from being a caregiver, which is not true. You can always find ways to lessen your caregiving burdens by turning them over to others for a short period of time, or indefinitely. The VA Family Caregiver Program offers respite services. Learn more here. You can also find details about respite services on the Fairfax County Website, Montgomery County Website, and DC Respite Website.
In addition, if you suffer from depression, please know that it is a treatable medical condition, and caregivers who experience signs of it should seek medical help. These are resources that can help military caregivers experiencing depression:
The Defense Centers of Excellence: Provides 24/7 help for psychological health issues.
Military One Source: Provides non-medical counseling services online, via telephone, or in-person, as well as access to other mental health resources.
Military Pathways: Provides free, anonymous mental health and alcohol self-assessments for family members and service personnel in all branches including the National Guard and Reserve, as well as referral information provided through the Department of Defense (DoD) and Veterans Affairs (VA).
Challenge: Stress and Apathy
All caregivers experience stress during their caregiving journeys. Unfortunately, in many cases, caregivers do not take care of themselves, or do not seek medical help until crises arise. Military family caregivers are twice as likely to report having a chronic health condition and to have higher mortality rates than non-caregivers.
Strategy: A high proportion of military caregivers (68%) consider their situation highly stressful. The good news is that the Veterans Administration now offers a comprehensive program for assistance, thanks to the Caregivers and Veterans Omnibus Health Services Act of 2010. However, only about 22,000 are receiving this extensive assistance, because the eligibility criteria are very limiting. Read more about it here. Luckily, there are other resources that can help.
Peer Forums
The Military Caregiver PEER Forum Initiative utilizes Military Family Life Counselors to organize and conduct forums that provide non-medical counseling opportunities for military caregivers on topics such as managing stress, nutrition, financial wellness, and more. Military caregivers may join their peers virtually in an online forum on the fourth Thursday of every month to discuss topics that they choose, share their expertise, and network with others who are experiencing similar challenges.
Therapeutic Pets
Therapeutic pets can be helpful for veterans with PTSD and their caregivers. Paws for Purple Hearts is one of four experimental programs nationwide that pair veterans afflicted by PTSD with Labrador and Golden Retrievers. Read our blog post, Lending a Paw for Veterans, for more details.
Additional Resources
The Caregiver Resource Directory is designed to help empower military caregivers with information about national-level resources and programs specifically for them. Topics include: helplines, advocacy and benefit information, military caregiver support, and more. You can download the CRD online or request hard copy print versions.
Challenge: The Potential Length of the Caregiving Journey
43% of caregivers caring for veterans expect to provide care for the long term. In general, estimates show that military family caregivers provide care for much longer periods of time than other populations of caregivers of adults.
Strategy: Most people want to stay in their home for as long as possible. However, if the time comes that living at home is a strain for your father and your duties as a caregiver are much more than you can handle, it may be time to consider other alternatives.
Whether the outcome is in-home care, assisted living, or nursing home care in the future, it is always wise to work with an experienced Elder Law Attorney such as myself. Life Care Planning and Medicaid Asset Protection is the process of protecting assets from having to be spent down in connection with entry into assisted living or nursing home care, while also helping ensure that your loved ones get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home.
Veteran’s Aid and Attendance
Your father may qualify for a special pension benefit called Veteran’s Aid and Attendance. As an Accredited Attorney with the U.S. Dept. of Veterans Affairs, I understand both the Aid and Attendance Benefit and the Medicaid program and the interaction between both benefit programs. The Veterans Aid and Attendance benefit can provide more than $25,000 annually for an eligible married veteran, more than $21,000 annually for a single veteran, and almost $14,000 annually for the surviving spouse of a qualified veteran.
Eligibility criteria includes:
• Those over 65 do not have to be disabled; veterans under 65 must be 100% disabled. The veteran or spouse must be in need of regular aid and attendance due to inability to dress oneself, feed oneself, loss of coordination or other conditions, as described on our website, and there must be actual ongoing caregiving services being received from someone else.
• You or your spouse must have served on active duty for at least 90 days, at least one day of which occurred during a period designated as wartime (see our website). There must have been a non-dishonorable discharge as well. Single surviving spouses of such veterans are also eligible.
For more details about Veteran’s Aid and Attendance and other veterans’ benefits, please sign up to receive my Aid & Attendance 4-Part Mini Series here.
Keep in mind that a 3-year look-back is soon going to be imposed on transfers of assets, including gifts to persons, trusts, or purchases of annuities. Benefits could be denied for up to 10 years due to transfers. All gifts in the look-back period will be presumed to have been made to qualify for benefits. And, there will be no allowance to give away money to your church, for a wedding gift to a grandchild, etc. I just taught a 90 minute continuing legal education class to attorneys around the country on this topic yesterday. Read more about this new rule change here.
Applying for Veteran’s Benefits
Applying for veteran’s benefits, such as Veteran’s Aid and Attendance, is always a confusing and arduous task, fraught with perils along the way. Here at the Farr Law Firm, we work with veterans and their spouses to evaluate whether they qualify for the Veterans Aid and Attendance Benefit and/or Medicaid, and we take care of all the paperwork. If you are a veteran or the surviving spouse of a veteran, and are worried about the need for long-term care in the future, please contact us as soon as possible to make an appointment for a consultation:
Fairfax Veteran’s Attorney: 703-691-1888
Fredericksburg Veteran’s Attorney: 540-479-1435
Rockville Veteran’s Attorney: 301-519-8041
DC Veteran’s Attorney: 202-587-2797
P.S. Another benefit of being a veteran is a 10% discount off all services at the Farr Law Firm. We hope to see your family soon!
About Evan H Farr, CELA, CAP
