Many veterans deal with back pain on a daily basis. Whether the problem is caused by injury, or from carrying a heavy pack while hiking, the result can be life-long suffering.  Now there is new evidence that physical therapy, spinal manipulation and yoga can be as helpful as surgery or drugs, while posing far fewer risks.  In a Consumer Reports survey, 3,562 individuals with back pain were surveyed, with 80% of those who had tried yoga, tai chi, massage therapy, chiropractic intervention, or physical therapy finding the treatment helped reduce their pain.

In the past, these types of treatments were considered fluff in comparison to conventional treatment which usually consisted of drugs to mask the pain or surgery. Now, it is evident that a combination of supportive alternative therapies can be just as effective.  Tai chi and physical therapy strengthens muscles that support the back, while improving balance and flexibility.  Chiropractic intervention can realign the spine and improve posture and balance as well.  Massage therapy helps muscles relax, and reduces inflammation.  A combination of these alternative therapies can bring relief when traditional methods fail.

In the past, alternative therapies were not regarded as viable treatment options. Now they are taking their place as legitimate treatments and are being recognized by medical professionals as valued forms of treatment.

Advertisements

USING TELEMEDICINE IN TREATING PTSD

Telemedicine is the newest trend in treating PTSD. Video teleconferencing (VTC) allows a single person or group of individuals in one location and a clinician in a different location to see and hear each other in real time.

Telemedicine allows veterans living in remote areas to access treatment services they otherwise would have to travel miles to reach. Telemedicine services may include clinical assessment, individual or group psychotherapy, educational interventions, cognitive testing, and general psychiatry. The major benefit is that these services eliminate travel expense that may be disruptive or overly expensive.

Research comparing VTC and real-time methods of PTSD assessment has shown the methods yield comparable results. While providing treatment using telemedicine may need more research, it does provide an alternative for individuals who have difficulty accessing treatment even though they live in remote areas.

Telemedicine appears to offer a more convenient and economical way to provide or supplement PTSD care services. For patients that live remote distances from VA Med Centers, this is one way to make treatment for PTSD accessible.

THE LATEST GLITCH: VETERANS BEING FORCED TO REPAY SIGNING BONUSES

I read an article today that said that in 2006, when the wars in Iraq and Afghanistan were going full swing, apparently the California National Guard came up with an idea to attract individuals to enlist.  They would offer a $20,000 bonus to get people to sign up.  It worked, of course.  Only now, some ten years later, it’s been decided this was illegal to begin with and the government wants its’ money back.  So, they are demanding veterans who received the bonus repay it.

Now those veterans who received the bonus are struggling to pay it back; in some cases the payments are hundreds of dollars per month.  In response to public outrage, the Pentagon has declared they are suspending the debt collection program.  The only problem is, no one seems to know what that means or if they will not look for other ways of reclaiming the funds.

At this point, anything being said by the government is vague at best.  While I understand that the government is caught between its’ obligations to veterans versus those of taxpayers, it is not the fault of the vets that this decision was made in the first place.

I am hoping that the government will come up with a solution that recognizes our veterans are not responsible for repayment of these funds.  I guess at this point, we all need to monitor the progress of the situation and watch to see that our veterans aren’t forced to repay the bonus at the expense of their current standard of living.

MESOTHELIOMA IN THE VETERAN POPULATION

For years, asbestos was widely used for its’ heat and fire resistant properties.  Unfortunately, as time went on, we learned that asbestos exposure lead to Mesothelioma, an aggressive form of cancer caused by exposure to asbestos.

It has been estimated that veterans account for 30% of all mesothelioma cases.  Ten thousand veterans die annually from asbestos-related deaths.  The peak years of military use were 1935 through 1975 when it was commonly used to insulate pipes.  Engine and boiler rooms of ships were prime locations for asbestos use, but it was used in other areas too, including sleeping quarters and the mess hall.   About 3,000 new cases are diagnosed each year, with symptoms appearing 10 to 15 years after exposure.

Veterans who have been diagnosed with mesothelioma can request benefits from the Veterans Administration if they can prove their disease is asbestos-related and occurred during their military service.  They may qualify for special financial benefits from the VA including disability compensation, special monthly compensation and service-connected death benefits for surviving family members.   They may also be due compensation from asbestos manufacturers.  If you are a veteran who has been diagnosed with mesothelioma, contact your VA Medical Center to determine whether you qualify for benefits.  Also, contact the Mesothelioma Foundation to find out if you qualify for assistance.

CAREGIVERS OF VETERANS

In a national study of those who provided caregiver services to veterans, the following statistics were gathered. This information is from a study published in 2010.

Caregivers were asked what health condition the veteran to whom they provide care had. The response:

  • Mental illness was reported by 70%.3
  • Post-traumatic stress disorder (PTSD) (60%)
  • Traumatic brain injury (TBI) (29%)
  • Diabetes (28%)
  • Injuries to bones, joints, or limbs (24%)

The presence of diabetes or cancer is increasingly reported by caregivers of older veterans and those serving in Vietnam or earlier. [Depression/anxiety, PTSD, and spinal cord injuries are more common among younger veterans, particularly those who served in Vietnam or later).

Most caregivers say the veteran they care for is their spouse or partner (70%)

Only 16%, say they are caring for a parent or parent‑in‑law

About one in ten indicate that they are caring for their son or daughter (9%) (These relationships differ from caregivers in general; nationally, only 6% of caregivers are providing care to a spouse or partner).  Of note, not all family caregivers of veterans are actual family members; they may be friends, neighbors, or other non‑relatives.

Only 29% of caregivers of veterans feel they had a choice in taking on the responsibility of caring for their loved one. By comparison, nationally 57% of caregivers do.

Caregivers of veterans who feel, for whatever reason, they did not have a choice in becoming a caregiver are more likely to report impacts on their lives in terms of emotional stress, isolation, physical strain, financial hardship, children’s emotional problems, and work impacts. They are also far less likely to say the experience is fulfilling for them or that the knowledge and skills they are gaining give them a sense of reward. These effects are evident even though their burden of care appears to be equivalent to those who feel they did have a choice.

Most caregivers of veterans (69%) report typically spending at least 21 hours per week helping the veteran.  This includes 43% who spend more than 40 hours per week—three times the share of caregivers nationally who do (12%). 

Caregivers whose veteran has paralysis or diabetes are nearly twice as likely as their counterparts to spend more than 80 hours per week providing care.

Those providing care to a spouse/partner are in the most time‑intensive situations—half (50%) spend more than 40 hours per week, compared to 32% of those providing care to their child and 24% of those who have some other relationship to the veteran.

The long-term nature of the care being provided creates a situation where caregivers are at great risk of burnout.  The importance of providing support for the caregivers of veterans is evident.

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.