Evaluation of the Department of Veterans Affairs Mental Health Services


Book Description

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.




Long-term Outcomes of Military Service


Book Description

Using data compiled from longitudinal studies of World War II, Korean War, and Vietnam War veterans, contributors to this groundbreaking book examine the effects of military service across the lifespan. The US spends over 100 billion dollars annually on healthcare for more than 30 million active military and veterans. The prevalence of negative trauma and post-traumatic stress disorder (PTSD) among military veterans is well-known. But other more subtle effects of military service--particularly on health and well-being in later life--are less well-understood, among researchers as well as medical and mental health professionals who care for veterans. Chapters in this book give us crucial insights into the impact of military service, including the surprising finding that service can serve as a protective factor in some contexts, throughout the aging process. Topic areas include the effects of combat and stress on longevity and brain functioning; the use of memory, cognition, and ego development at various points in life; the relationship between experiences of discrimination and the later development of PTSD; marriage longevity; employment; and the way notions of patriotism and nationalism among service personnel and their families may change over time.




Families Caring for an Aging America


Book Description

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.




Retooling for an Aging America


Book Description

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.













Veteran-Centered Care in Education and Practice


Book Description

Veteran-Centered Care in Education and Practice: An Essential Guide for Nursing Faculty addresses the mandate to improve veteran healthcare as a national priority, highlighting the tremendous impact nurses can make on improving veteran health. It provides guidance on how faculty can integrate veteran-centered care into nursing curricula, ultimately improving veteran-centered care at the bedside and in the community. The expert authors utilize a holistic approach to veteran needs, beginning with an overview of the importance of veteran health in nursing education and a primer of military culture and lifestyle, and transitions. A wide range of veteran-specific healthcare issues are addressed, including occupational and environmental exposures, common physical-related issues, mental-health issues, and special topics such as women's health and military sexual trauma, gender issues, and end-of-life concerns. ; This book offers innovative teaching and learning strategies to build a base of knowledge related to nursing prioritization of veteran health care needs, filling a notable gap in nursing literature. It includes teaching strategies for the classroom and clinical setting that graduate/undergraduate nurse educators may employ to integrate veteran content into existing courses or to build a Veteran Health elective or topics course. It outlines key competencies and essential knowledge faculty and students need to teach and provide basic veteran-centered care. Also covered are the expansion of Veteran-to-BSN programs, current research on veterans transitioning to the classroom, and strategies to enhance learning within this student population and maximize their skills and leadership abilities. Key Features: Discusses national and organizational efforts to improve veteran-centered care Guides nursing faculty on how to address the multifaceted nature of veteran health needs in existing nursing courses and curricula at all educational levels Outlines key competencies and essential knowledge faculty and students need to teach and provide basic veteran-centered care Includes evidence-based instructional strategies and resources to incorporate into classroom and clinical settings Features learning activities to enhance knowledge acquisition Details the unique needs of the veteran student population, as well as strategies to enhance their learning, while maximizing their skills and leadership abilities




Aging Veterans with Disabilities


Book Description

The number of older war veterans receiving disability benefits is steadily growing and is predicted to rise in the next decade. This book provides comprehensive knowledge about health and psychosocial concerns of veterans aging with disabilities and unmet needs and compares policy in three countries that have been involved in massive warfare in the 20th century––the United Kingdom (UK), the United States (US), and Israel. Using a cross-national comparative study of the policies, legislation and services provided by these three countries, which have significant numbers of aging disabled military veterans, this book provides evidence-based knowledge on the trajectories and attendant mental-health and psychosocial problems this sub-group faces when aging with a disability. It sheds light on the paradox in which most veterans with disabilities in the UK, USA and Israel are older, while the current legislation and budget target younger veterans with disabilities. The book reflects the current debate regarding the desired policy toward older veterans with disabilities in these countries and whether to provide them with proactive health services prior to retirement to prevent "accelerated aging". It also evaluates the dilemma of whether to serve aging veterans separately as a unique population or to provide them with the same services used by the general population. This book will be of interest to all academics and students working in disability studies, rehabilitation studies, gerontology, psychology, sociology, social work, social policy, and law more broadly.




The Role of Telehealth in an Evolving Health Care Environment


Book Description

In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.