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• W142810867 abstract "A person in the community takes a dependent veteran into their private home and serves as a caregiver, providing daily supervision and personal assistance. The Department of Veterans Affairs (VA) Home-based primary care model is evidence of an ongoing revolution within the VA system. The commitment of the VA leadership to a shift to non-institutional care, along with a strong commitment to the use of electronic medical records, has led to innovations in primary care for the veterans whom we serve. The convergence of homebased primary care (HBPC), electronic medical records, and a growing population of veterans with chronic disabling conditions led to the creation of another VA innovation, the VA Medical Foster Home (MFH) program. The MFH program began in Little Rock, Arkansas, through two social workers: one who was running a VA community residential care program and another who was running a VA HBPC program. They discussed some of their most challenging patients, particularly those who initially did very well in their program but eventually declined and were no longer safe living alone. The social workers might say to the veteran, put in grab bars and handrails in your bathroom. We've built a ramp so that you can manage getting in and out of your home in a wheelchair. We've brought in home health aides in addition to our comprehensive interdisciplinary homecare team. But this is no longer enough. It's just not safe for you to be at home alone anymore. It's time for a nursing Often these fiercely independent veterans would say, No thank you. I understand my risks. I'll take my risks. I understand that I might die here. But I want to stay in my own home. I'm not going to a nursing This creates a dilemma, and pits ethical principles against each other-autonomy and beneficence. These two social workers got together and developed the concept of merging the strengths of their mutual programs. They wondered, if we find someone in the community who is willing to take a veteran into their home and provide twenty-four-hour supervision and personal assistance? What if we then bring the comprehensive interdisciplinary homecare program to the veteran in this new home? Discussions between the founding social workers led to the MFH concept becoming a pilot project in 1999. By early 2002, the program staff presented their outcomes and reported positive results across the board. As the National Program Director for Home and Community- Based Care, I was also very excited, but cautiously optimistic. While I could see the many benefits of this MFH program, I had concerns about the risks. We were asking the community if anyone would be willing to take a veteran into his or her home for about $2,000 a month-a veteran who is so frail and vulnerable that he or she might not be able to make a telephone call if encountering abuse or neglect. Concerned about the vulnerability of these veterans, I flew to Little Rock and made unannounced visits to twentythree of the twenty-eight veterans in these medical foster homes. After these visits, I was astounded and totally convinced that this remarkable program needed to expand. The veterans were receiving exceptional care, and every one of them was pleased with their new home. Their caregivers were wonderful: clearly their hearts were in this work; they were very proud and fulfilled to be providing this care. The homecare teams were exuberant with the care that was being delivered and that these veterans were able to remain in a home environment. For those veterans who had family, the family members also praised the MFH program. Being highly convinced about the merits of the MFH program and wanting to expand it to a national scale, I needed to know how these caregivers were selected in order to alleviate my concerns about risk to these vulnerable veterans. After extensive discussions with the social worker who was the coordinator, it became clear that the requisite devotion, scrutiny, and attentive advocacy were evident in the social workers and foster families. …" @default.
• W142810867 created "2016-06-24" @default.
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• W142810867 date "2010-07-01" @default.
• W142810867 modified "2023-09-23" @default.
• W142810867 title "The VA's Medical Foster Home Program" @default.
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