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Trauma-Informed Practice with Older Adults
Putting it into Practice with Veterans
Laura Taylor, MSW, LSCSW
National Director, Social Work
U.S. Department of Veterans Affairs
Session Objectives
• Identify the number of older Veterans served by the Veterans Health Administration (VHA);
• Explore the importance of screening clients to learn of military status;
• Identify one best practice being implemented by VHA;
• Identify at least one resource to get more information about serving older Veterans.
©2017 National Association of Social Workers. All Rights Reserved. 3
Did you know?
4
Of Veterans served by VHA, half - almost 11 million Veterans - are 65 or older.
Veterans over age 80 are the fastest growing cohort VHA serves
©2017 National Association of Social Workers. All Rights Reserved. 5
A little bit about you…
• Are you a Veteran or Servicemember?
• Are you a family member of a Veteran or Servicemember?
• Do you work with Veterans, their families, or caregivers in your practice?
• Do you ask the clients you serve if they have served in the military?
©2017 National Association of Social Workers. All Rights Reserved. 6
Military Health History Questions
• "Have you or a loved one served in the military?"
• Would it be ok if I talked with you about your
military experience?
– When and where did you/do you serve and in what branch?
– What type of work did you/do you do while in the service?
– Did you have any illnesses or injuries while in the service?
https://www.va.gov/oaa/pocketcard/
©2017 National Association of Social Workers. All Rights Reserved. 7
Posttraumatic Stress Disorder (PTSD) and the Military
• The number of Veterans with PTSD varies by service era:
– Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF): About 11-20 out of every 100 Veterans (or between 11-20%) have PTSD in a given year.
– Gulf War (Desert Storm): About 12 out of every 100 Gulf War Veterans (or 12%) have PTSD in a given year.
– Vietnam War: About 15 out of every 100 Vietnam Veterans (or 15%) were diagnosed with PTSD at the time of the most recent study* in the late 1980s. It is estimated that about 30 out of every 100 (or 30%) of Vietnam Veterans have had PTSD in their lifetime.
©2017 National Association of Social Workers. All Rights Reserved. 8
*National Vietnam Veterans Readjustment Study (NVVRS)
Development of a Best Practice • Began in October 2012 at the VA in Little Rock, Arkansas • Used lean methods, primarily Plan, Do, Study, Act (PDSA) process
improvement cycles • Funded by Geriatrics and Extended Care and Office of Rural Health • Office of Rural Health Promising Practice in 2015 • VHA Under Secretary for Health’s Diffusion of Excellence Initiative
Semi-Finalist, Finalist and Gold Best Practice in 2016
Advance Care Planning Groups
• Discussions are
conducted in groups – Primary Care and other clinics
– Mental Health
– Vet Centers
• Led by Master of Social
Work
• Length: 45-60 minutes
• Veterans are asked to set a SMART goal
• Telephone follow-up at 2 weeks
Long Term Services and Supports
• Programs focus on:
– facilitating Veteran independence
– enhancing quality of life
– supporting family members and caregivers of Veterans
• There are four categories:
– Home and Community-Based Care
– Residential Settings
– Nursing Homes
– Geriatric Services
©2017 National Association of Social Workers. All Rights Reserved. 11
Need to Learn More about Military Culture?
• VA Community Provider Toolkit
– https://www.mentalhealth.va.gov/communityproviders/
• Military Culture Course Modules
– http://deploymentpsych.org/military-culture
• Bridging Military and Community Service Systems
– http://www.aheconnect.com/citizensoldier/courses.asp
• National Center for PTSD
– https://www.ptsd.va.gov/
©2017 National Association of Social Workers. All Rights Reserved. 12
QUESTIONS?
©2017 National Association of Social Workers. All Rights Reserved. 13
