VA Geriatrics and Extended Care Services
According to a Census report, approximately half of all U.S. veterans are 65 years or older. This implies that over the next two decades, there will be a rising demand for geriatric care, services, and benefits.
The Department of Veterans Affairs offers a range of programs for qualifying veterans under the “umbrella” of Geriatrics and Extended Care (GEC), including services to help veterans maintain their independence and quality of life.
These options are not services for “end-of-life care” situations. VA GEC options are available to those with a chronic or life-limiting illness.
Eligibility is determined by the need for ongoing treatment and assistance, not necessarily their prognosis. The core qualifications relate to the complexity of a veteran’s health conditions and how those challenges affect their daily life.
VA Geriatrics and Extended Care (GEC) Mission
The mission of the VA when providing GEC services is to help veterans keep their independence as they face aging, disability, or illness.
According to the VA official site, “As you age, we offer a range of medical and support services to help you stay as healthy, active, and independent as possible. We also offer help to family members and caregivers who may support you.”
Geriatrics and Extended Care options from the VA include living centers, adult day care, home-based primary care, telehealth, and nursing home services.
Veterans with complex needs may be assigned to a Geriatric Patient Aligned Care Team (GeriPACT). This provides primary care and facilitates the coordination of services for older vets who have multiple chronic diseases, declining physical abilities, or challenges with memory.
Care Planning Tools for Veterans
Patient Priorities Care (Shared Decision-Making)
The VA emphasizes a collaborative process in which veterans, along with their family caregivers and healthcare team, work together. This approach, also known as “Shared Decision-Making,” helps veterans identify what matters most to them in terms of care.
Advance Care Planning
This is a crucial process for all adults, enabling patients to clarify their values and healthcare choices for a future time when they may not be able to make decisions for themselves.
Through an advance directive, a veteran can state the types of treatments they do or do not want and legally appoint someone to make health care decisions on their behalf. The VA provides resources to help patients, their families, and caregivers navigate this important planning process.
Who Is Eligible for GeriPACT?
GeriPACT is designed for veterans enrolled in VA health care who are facing challenges from:
- Multiple chronic medical conditions.
- Dementia, memory loss, or other declines in cognitive abilities.
- “Geriatric syndromes” such as frequent falls, significant functional decline, or issues arising from taking multiple medications.
According to the VA, GeriPACT may not be suitable for those with untreated substance abuse issues.
Services Offered Through Geriatrics and Extended Care
The VA offers a comprehensive range of long-term care services across various settings. A veteran’s care plan is always tailored to their individual clinical needs and personal goals. Options may include:
Home and Community-Based Services:
- Home-Based Primary Care: A team provides primary care services in the veteran’s home.
- Homemaker and Home Health Aide Care: Assistance with daily activities like bathing, dressing, and preparing meals.
- Skilled Home Health Care: In-home nursing, physical therapy, or other skilled services.
- Adult Day Health Care: A program providing social activities, companionship, and recreation during the day.
- Respite Care: Short-term care to give a family caregiver a break.
- Remote Monitoring: Using technology to monitor a veteran’s health from home.
Residential Settings and Nursing Homes:
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- Community Living Centers (VA Nursing Homes): Facilities providing 24/7 skilled nursing and medical care.
- Community Nursing Homes: Private nursing homes that are contracted with the VA.
- State Veterans Homes: Facilities run by individual states that provide nursing home and other long-term care.
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Inpatient and End-of-Life Care:
- Geriatric Evaluation: Inpatient assessments to create a comprehensive care plan.
- Palliative Care: Focused on providing comfort and relief.
- Hospice Care: Comfort care for veterans with a terminal condition.
Care for Specific Conditions
While GEC assists with many conditions, there is a focus on age-related cognitive issues like dementia, Alzheimer’s disease, and delirium.
Delirium, for example, is a sudden state of confusion that is treated as a serious medical issue, potentially indicating an underlying problem. The VA urges caregivers and family members to contact a doctor immediately if a veteran shows symptoms like difficulty focusing, mumbling, or sudden changes in behavior, as prompt treatment is essential. Care for these issues is an important part of the VA program.
The VA official site notes, “Depending on the Veteran’s needs, services may include Home Based Primary Care, Homemaker and Home Health Aide, Respite Care, Palliative Care, or Hospice Care. Caregiver Support is also an essential part of these services.”
Signing Up For VA Geriatrics and Extended Care
To learn more about GEC services and eligibility, call the VA’s main information line at 1-800-MyVA411 (1-800-698-2411) or contact the social work department at your nearest VA medical center.
Paying for Geriatric and Extended Care
A veteran’s eligibility for long-term care is based on their clinical need and the availability of the service in their area. Other factors, such as service-connected disability status, income level, and private insurance coverage, determine whether a copay is required.
Many services are part of the standard VA medical benefits package. For long-term care, copays are typically not charged for the first 21 days of care in a 12-month period. Hospice care may be provided at no cost to the veteran.
The VA is also required to bill any private health insurance a veteran may have for non-service-connected conditions.
Non-VA Options
The VA official site directs users to a program called PACE, also known as the Program of All-Inclusive Care for the Elderly (PACE. This provides “comprehensive medical and social services to certain frail, community-dwelling elderly individuals, most of whom are dually eligible for Medicare and Medicaid benefits,” according to the PACE official site.
“For most participants, the comprehensive service package enables them to remain in the community rather than receive care in a nursing home.”
This is not an option run by the Department of Veterans Affairs; PACE is a national organization that is funded by offering services under Medicare. “The PACE program becomes the sole source of Medicaid and Medicare benefits for PACE participants.”
“The PACE model of care is established as a provider in the Medicare program, and it enables states to provide PACE services to Medicaid beneficiaries as a state option.”
PACE Eligibility
Applicants may qualify for PACE if they meet the following conditions:
- 55 or older
- Live in the service area of a PACE organization
- Eligible for nursing home care
- Be able to live safely in the community
See the PACE official site to learn more or sign up for the program.
20 Frequently Asked Questions about VA Geriatrics and Extended Care
1. What are VA Geriatrics and Extended Care (GEC) services?
GEC services are a range of long-term care and support options provided by the Department of Veterans Affairs. They are designed to help those with complex, chronic, or disabling conditions. The goal is to promote health and independence for aging and disabled veterans.
2. Who is eligible for these long-term care services?
Eligibility is based on a clinical need for the service and enrollment in the VA health care system. Other factors, such as a service-connected disability rating, financial status, and the availability of specific services in your area, also play a role in determining access and potential costs.
3. Do I need a service-connected disability to qualify?
No, a service-connected disability is not always required. While veterans with high-level service-connected disabilities often have priority and may face fewer copayments, many other enrolled veterans with a demonstrated clinical need can qualify for various GEC services.
4. How does the VA determine my need for long-term care?
A VA clinical team, which may include a doctor, social worker, and other specialists, will conduct a comprehensive geriatric evaluation. This assessment reviews your physical health, mental condition, ability to perform daily activities, and social support system to determine the appropriate level of care.
5. What types of care settings are available?
The VA offers care in multiple settings to match a veteran’s needs. These include care at home, in the community through various programs, and in residential settings like VA Community Living Centers (CLCs) or contracted community nursing homes.
6. What are VA Community Living Centers (CLCs)?
CLCs are VA-operated nursing home facilities. They are designed to feel more like a home than an institution, providing skilled nursing, restorative care, and assistance with daily activities. They offer both short-term rehabilitation and long-term care for patients with significant health needs.
7. Does the VA pay for care in a private community nursing home?
Yes, under specific circumstances. The VA partners with community nursing homes to provide care for eligible veterans. This is often used for those who need short-term care after a hospital stay, have a service-connected disability rated at 70% or higher, or require nursing home care for a qualifying service-connected condition.
8. What Home and Community-Based Services does the VA offer?
These services are designed to help vets live independently in their own homes for as long as possible. Programs include in-home health aides, skilled nursing and therapy, meal delivery, and specialized programs like Veteran Directed Care.
9. Can I receive skilled medical care in my own home?
Yes. Through the Skilled Home Health Care (SHHC) program, the VA can provide services from a nurse, physical therapist, occupational therapist, or speech pathologist in your home. This care is typically short-term and ordered by your VA physician.
10. What is the Veteran Directed Care program?
This program provides a flexible budget for patients to hire their own personal care aides. It allows veterans who need assistance with daily living activities to have more control over who provides their care and when that care is delivered.
11. What are Medical Foster Homes?
A Medical Foster Home is a private residence where a caregiver serves a small group of veterans. The VA inspects and approves these homes, which offer a long-term, family-style living arrangement for those who cannot live alone safely.
12. Is there support available for family caregivers?
The VA offers extensive support for caregivers through its Program of Comprehensive Assistance for Family Caregivers and its Program of General Caregiver Support Services. These programs provide education, resources, peer support, a telephone support line, and, for some, a monthly stipend and access to health care benefits.
13. What is VA respite care?
Respite care provides temporary breaks for a family caregiver. A veteran can receive care up to 30 days per year in a VA Community Living Center, a community nursing home, or at home. This service helps prevent caregiver burnout.
14. Does the VA offer hospice care?
Yes. When a veteran is diagnosed with a terminal condition, the VA provides hospice care focused on comfort and quality of life. This care addresses physical, emotional, and spiritual needs and can be provided at home, in an outpatient setting, or in a VA or community facility.
15. Is there a difference between palliative care and hospice care?
Palliative care is focused of relief from the symptoms of a serious illness. This may be provided at any stage of the illness. Hospice care is a type of care for patients approaching the end of life.
16. Are there special programs for Veterans with dementia?
Yes, the VA provides specialized care for veterans with varying types of dementia, including Alzheimer’s disease. This includes diagnosis, disease management, and services like home-based care, adult day health care, and placement in facilities with dedicated dementia care units.
17. What is the Gerofit program?
Gerofit is a supervised exercise and health promotion program for older veterans. It is designed to improve strength, balance, flexibility, and overall health. The program is led by kinesiologists and physical therapists and is available at various VA medical centers.
18. Are GEC services free for all eligible Veterans?
Not always. While care for service-connected conditions is free, veterans may be required to pay a copayment for other long-term care services. The amount of the copay is determined by income, assets, and other factors. Some Veterans may qualify for a full or partial waiver of copayments.
19. How do I start the process of applying for GEC services?
The first step is to speak with your VA primary care provider or a VA social worker. They can assess your needs and make a referral for a geriatric evaluation, which will formally determine your eligibility and help create a care plan.
20. Where can I find more information about GEC programs near me?
You can contact the GEC team or the social work service at your nearest VA medical center. Additionally, the official VA website provides detailed information and a locator tool to find services in your specific region.
About the author
Editor-in-Chief Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter/editor for Air Force Television News and the Pentagon Channel. His freelance work includes contract work for Motorola, VALoans.com, and Credit Karma. He is co-founder of Dim Art House in Springfield, Illinois, and spends his non-writing time as an abstract painter, independent publisher, and occasional filmmaker.
