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Hospice Program Comforts Dying Veterans

Michelle Faust
Palmer Gaetano, 92-year old hospice patient, tells Jaqueline Coates, nurse practitioner for Visiting Nurse Service of Rochester, about his tours of duty in Europe with the army during World War II.

Palmer Gaetano served in the army in France and Belgium World during War II. The 92-year old now lives in a hospice facility in Spencerport, near his daughter and her family.  He proudly points to an American flag quilt and pin, and two plaques, now hanging on the walls which he received during a private ceremony held in his honor shortly after he entered hospice in late 2014. A group called We Honor Veterans presented each of these items to him. “It was quite a day for me,” he says.

Gaetano is one of more than 9 million American military veterans over the age of 65, according to 2013 census bureau figures.  There are 1,800 veteran deaths each day, including  vets from Vietnam, Korea, and World War II, and this aging population has an increased need for end-of-life care.

We Honor Veterans serves that need. The program began in 2010 as a partnership between the Veterans Administration and the National Hospice and Palliative Care Organization. The initiative connects terminally ill vets with end of life services, including financial help covering some of their physical and mental health needs.  It now enlists more than 3,500 hospice and community partners nationwide.

“Veterans often have some special needs at end of life that make them unique,” says Jacqueline Coates, nurse practitioner for Visiting Nurse Service of Rochester—the We Honor Veterans partner that oversees Gaetano’s care.

The VA estimates 85 percent of veterans don’t receive medical care through their health system and most vets are not dying at VA facilities. Coates says nurses and volunteers with We Honor Veterans are specially trained to understand these patients.

Often our older population of veterans have PTSD that was never truly diagnosed and we start to see symptoms and presentations that may be suggestive of a history of Post-Traumatic Stress Disorder. So, we also train our staff to recognize these symptoms and how we deal with them and help the family through this difficult time,” Coates explains.

Sometimes, PTSD lies dormant and symptoms, such as nightmares and agitation, only begin to show when a person gets dementia. Coates says her program looks to ease these symptoms and give patients peace in their final days.

Gaetano’s Nurse, Marcia Chiaponne says after many years of being ignored, veterans are delighted to have their service acknowledged, “Some of them you talk to them about that and they open up and they tell you wonderful stories. Because they're so proud of what they’ve done and to be recognized finally they just open up like a rose blossoming you know. It's kind of neat.”

Gaetano sits in a recliner with the quilt in his lap, his plaques are displayed proudly on the wall, and he wears a smile on his face. For the elderly vet, it was the recognition ceremony that most surprised him. “I never expected it. It was a wonderful feeling. It was a good experience. It’s a good way to end my life.”

Michelle Faust, MA, is a reporter/ producer whose work focuses strongly on issues related to health and health policy. She joined the WXXI newsroom in February 2014, and in short time became the lead producer on the Understanding the Affordable Care Act series. Michelle is a reporter with Side Effects and regularly contributes to The Innovation Trail. Working across media, she also produces packages for WXXI-TV’s weekly news magazine Need to Know.