SLEEP DISORDERS

Sleeplessness is one of the more frustrating symptoms of PTSD.  It leaves you feeling sluggish during the day, and, at least in my own situation, angry that I can’t sleep when I’m tired and want to sleep. Oh, I’ve read all the reports on that things you can do to help yourself get through insomnia, and none of them work with the exception of one: surrendering to it.  I have found that if I don’t fight sleeplessness, I can at least live with it.

My night generally goes like this: I am exhausted and want to go to bed fairly early since I didn’t get enough sleep the night before.  I average about 5 hours per night, if I’m lucky.  So, around 9:00 pm, I want to crawl into bed and go to sleep. When I do, I’ll be fortunate if I can actually get three to four hours of sleep.   It’s more likely I’ll wake by midnight or slightly before with my mind racing, sometimes drenched in sweat and trying to fight my way out of a nightmare.

Interestingly, what I’ve found helps the most is to not fight it.  I simply get up when I wake up, whatever time it is, and I stay up for several hours until I’m tired again.  I have several books by the bed, some crossword puzzles, and my ipad is handy.  I can play some games, listen to music, work a few puzzles and relax, or I can lie there and curse my misfortune at being awake.  Seems like a no-brainer to me!

I am fortunate in having several little dogs to keep me company, and since they sleep around 20 hours a day, they don’t mind getting up in the night to be scratched and told how wonderful they are.  It makes it feel less alone and I find I go back to sleep much more quickly than if I fight it.

Next time you find yourself awake in the middle of the night, think about how you could use your time more productively.  I am lucky in that I can sleep in the next morning if I want.  I also acknowledge that, for me at least, it’s ok to get by on 5 hours of sleep per night.  While I’d like more, I am comfortable during the day most of the time.  Instead of fighting your sleeplessness, try working with it.  It reminds me of the poster I once saw that said, “The best way out is through.”  That’s true here; it doesn’t help to get mad and rage against the dark.  Chill out, enjoy the extra time.  It sure beats getting worked up over something that I can’t change.

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DEALING WITH ANGER

Unfortunately, those of us who suffer with PTSD often find we have anger issues too.  The symptoms of PTSD can cause so much frustration; anger is one of the more common areas our frustrations can be vented.  Learning ways to appropriately handle that anger requires commitment, but it’s worth it in the long run.  No one wants to be around someone with an explosive temper.

Use a time-out when necessary.  Well, it’s not quit the same thing as the time-out you impose on your children, it’s just a way of backing off for a few minutes to allow yourself to cool down.  As soon as you notice your anger is beginning to boil, step back from the situation and give yourself a moment to think.  This gives you time to consider all your options, and that can make the difference between venting your anger on others, and finding a more appropriate way of dealing with it.

Discussing your anger with a trusted friend or family member allows them to help coach you through it.  They can often offer a different point of view about why you are getting angry and help you look more objectively at how your anger is affecting those you care about.

Practice relaxation exercises when you’re feeling angry.  It is physically impossible to be angry and relaxed at the same time.  Relaxing cancels out your anger.  Try deep breathing or muscle relaxation techniques.

Challenge your negative self-talk.  Anger seems to inflame your thoughts, so you blow things out of proportion.  Take the time to think about what’s making you so angry before you react.  Stop those negative though patterns before they get out of control.

Part of winning the war against PTSD is managing your symptoms instead of letting them manage you!

HOUSING GRANTS FOR DISABLED VETERANS

The VA has grants for Servicemembers and Veterans with certain permanent and total service-connected disabilities to help purchase or construct an adapted home, or to modify an existing home to accommodate a disability. Two grant programs exist; the Specially Adapted Housing (SAH) grant and the Special Housing Adaptation (SHA) grant.

The Specially Adapted Housing Grant help vets with certain service-connected disabilities live independently in a barrier-free environment. These grants may be used to build an adapted home on land you’re planning to purchase; build a home on land already owned if it is suitable for specially adapted housing; or to remodel an existing home if it can be made suitable for specially adapted housing. You may also apply the grant against the unpaid principal mortgage of an adapted home already acquired without the assistance of a VA grant.

The Special Housing Adaptation Grant helps vets with certain service-connected disabilities adapt or purchase a home to accommodate the disability. You can use the SHA grants to adapt an existing home that you or a family member already owns in which you live; or to adapt a home you or a family member intends to purchase in which you will live; or to help you purchase a home already adapted in which you’ll live.

The SAH and SHA benefit amount is set by law, but may be adjusted upward annually based on a cost-of-construction index. The maximum dollar amount allowable for SAH grants in fiscal year 2014 is $13,511. No individual may use the grant benefit more than three times up to the maximum dollar amount allowable.

A temporary grant may be available to SAH/SHA eligible Veterans and Servicemembers who are or will be temporarily residing in a home owned by a family member. The maximum amount available to adapt a family member’s home for the SAH grant is $5,295.

To apply, you must complete and submit a VA Form 26-4555. You can find this form on line at www.ebenefits.va.gov or by calling the VA at 1-800-827-1000.

THE RIGHT PRINCIPLES

The VA has identified 4 principles that govern the mental health care they provide to veterans.  Those principles are:

  1. Focus on Recovery – VA is committed to a recovery-oriented approach to mental health care. Recovery empowers the Veteran to take charge of his/her treatment and live a full and meaningful life. This approach focuses on the individual’s strengths and gives respect, honor, and hope to our nation’s heroes and their families. The concepts underlying a recovery-oriented approach to care are very much in line with VA’s commitment to provide patient-centered care.
  2. Coordinated Care for the Whole Person – VA health care providers coordinate with each other to provide safe and effective treatment for the whole person—head to toe. Many Veterans begin mental health care with their VA primary care provider. VA believes Veterans can continue to be treated for many mental illnesses in primary care or referred for more intensive treatment to specialty mental health care. Also, most VAs have chaplains available to help Veterans with their spiritual or religious wellbeing. Having a healthy body, satisfying work, and supportive family and friends, along with getting appropriate nutrition and exercising regularly, are just as important to mental health as to physical health.
  3. Mental Health Treatment in Primary Care – Primary Care clinics use Patient Aligned Care Teams (PACTs) to provide the Veteran’s healthcare. A PACT is a medical team that includes mental health experts. Like a quarterback, the primary care provider directs the Veteran’s overall care by coordinating services among a team of providers. If you are experiencing mental health problems, talking to your primary care provider is a good place to start. Many times your mental health problem can be evaluated and treated by your primary care provider, with extra help from a mental health clinician who can stay in close contact with you. There are also mental health providers on primary care teams to offer guidance to your primary care provider when needed. When more complex or intensive care is needed, your primary care provider will refer you to a specialized mental health program for further treatment. Veterans receiving care in specialty mental health clinics will still have their primary care closely coordinated with the PACT team.
  4. Mental Health Treatment Coordinator – Veterans who receive specialty mental health care have a Mental Health Treatment Coordinator (MHTC). The MHTC helps to ensure that each Veteran has continuity through his/her mental health care and transitions. The MHTC’s job is to understand the overall mental health goals of the Veteran. Having a MHTC assigned ensures that each Veteran can have a lasting relationship with a mental health provider who can serve as a point of contact, especially during times of care transitions. Once assigned, the MHTC usually continues to be the mental health point of contact for the Veteran as long as the Veteran receives mental health services within VHA.

The ideas that govern these principles are sound: allowing the veteran to choose his or her treatment plan and focusing on strengths, looking at providing care for the whole person, creating teams of professionals to offer guidance on treatment options, and assigning a treatment coordinator who ensures continuity across all the programs used in treatment are all excellent steps in providing the best possible care for veterans.

Now that the formula is in place, let’s hold the VA accountable for following its’ own policies and principles!  Our veterans deserve no less than the best possible care that can be provided.  The VA has the right idea…now they only need implement it.

VETERAN HOMELESSNESS

Veteran homelessness is down 47% since 2010, 17% in the past year.  That equates to less than 40,000 Veterans that experienced homelessness on a given night in January, 2016. While those figures are commendable, it is still horrendous to think that almost 40,000 individuals are homeless. While progress is definitely being made, there is still much to do.

Ten strategies developed by those interested in ending veteran homelessness include the following:

  1. Getting local leaders to support helping veterans locate and utilize needed community resources.
  2. Removing as many barriers to housing services as possible.
  3. Developing a coordinated entry system that matches veterans to appropriate housing opportunities and services.
  4. Developing a plan to effectively utilize all available resources.
  5. Improving transitional housing opportunities.
  6. Development of partnerships with landlords to fully utilize local, state and federal subsidies.
  7. Identifying all homeless veterans and tracking progress toward permanent housing.
  8. Engage in coordinated and creative outreach efforts.
  9. Increasing connections to employment programs.
  10. Coordinating with legal service organizations to resolve legal issues.

While it is laudable that homelessness in the veteran population is down, knowing that almost 40,000 veterans are still homeless should energize us toward putting an end to the problem once and for all.