End-of-Life Care for WW II, Korea, and Vietnam-Era Veterans

Military Veterans' End of Life: Supporting Them in Their Last Deployment

More than 600,000 U.S. Veterans die from illness each year. Clinicians in civilian settings are increasingly providing care to Veterans at end of life. Veteran care should be distinctive and individualized to meet their unique needs. There is limited information to guide civilian clinicians in providing care to Veterans at end of life. This article provides bio-psycho-social information to holistically guide Veteran healthcare and assist them with solace, respect, and serenity at end of life. Various options for end-of-life care are discussed, as well as specific concerns of women, lesbian, gay, bisexual, and transgender Veterans. Some end-of-life entitlements for all Veterans and sometimes their spouses/children are included.

Above and Beyond the Call of Duty: Rural Home Care and Hospice Nurses' Experiences Caring for Veterans

Approximately 4.7 million Veterans live in rural areas and face challenges receiving support and care for complex service-connected healthcare needs. The purpose of this qualitative descriptive study was to explore nurses' experiences caring for Veterans in rural home care/hospice settings. Semistructured interviews (N = 14) were conducted between August 2020 and March 2021. Content and thematic analysis resulted in three central themes: Mission readiness: Ensuring safe home environments, Partnering with Veterans: Knowing when to lead and when to follow, and It's my duty: Caring with purpose and honor. Study findings highlight the need for cultural competence in both rural and Veteran cultures. Implications for practice reinforce currently emerging national priorities, including personal safety considerations and need for further professional development associated with screening for firearms and gun safety. Other implications for home care/hospice agencies, as well as nursing education, are discussed.

Veteran Competencies in Nursing Textbooks: Implications for Educators

AIM

The aim of this study was to examine the adequacy of military/veteran-related content in nursing textbooks used in prelicensure programs.

BACKGROUND

With increased numbers of veterans receiving care in civilian settings, nurses may lack essential knowledge, skills, and attitudes outlined in competencies required to provide culturally sensitive veteran-centered care. One explanation for this may be inadequate preparation during prelicensure nursing education.

METHOD

A quantitative, descriptive study guided the analysis and rating of 32 key words in 24 textbooks across eight content areas.

RESULTS

Key words were included in most textbooks but frequently not connected to military service or veterans. The key word with the highest mean rating was posttraumatic stress disorder; the highest rated content area was psychiatric/mental health.

CONCLUSION

With limited textbook resources, nurse faculty must engage in deliberate efforts to include veteran content in nursing curricula. As competency-based education trends evolve, these findings are relevant and should be considered in curricular design and revision.

Masculinity and Military Culture in VA Hospice and Palliative Care: A Narrative Review With Clinical Recommendations

This article examines the intersection between masculinity, military culture, and hospice and palliative care (HPC). The authors conducted a narrative literature review, supplemented with clinical annotations, to identify the impact of masculinity and military culture on the following topics salient to end-of-life care with older male veterans: pain management, mental health, coping, communication, autonomy and respect, and family roles. Findings suggest that traits associated with masculinity and military culture have an influence on the end-of-life process and HPC for older male veterans. Specifically, results suggest that older male veterans may deny or minimize physical pain, decline mental health treatment, utilize maladaptive coping strategies, avoid emotional conversations, struggle to manage perceived shifts in autonomy, and experience challenges negotiating changing family roles. The authors provide clinical recommendations for providers across various disciplines to address the aforementioned concerns with older male veterans in HPC. Overall, information presented in this article may be an important contribution to the literature for building cultural competencies with older male veterans and has the potential to improve the delivery of HPC for veterans and their families.

Civilian Nurses' Experiences Caring for Military Veterans: Qualitative Data From a Mixed-Methods Study

Over nine million people living in the United States are military Veterans over the age of 65. Many utilize civilian care providers, creating a need for civilian providers to have an understanding of the unique healthcare issues of this population. This article describes the qualitative results of a mixed-methods study of nine home care nurses' experiences caring for Veterans. Three themes emerged from the data: Challenges Coordinating Care, Building a Rapport Takes More Time, and Recognizing Impact of Military Service on Patient's Worldview. As demonstrated in this study, home care nurses care for Veterans every day. Although similarities exist, nurses readily described differences in caring for Veterans compared with non-Veterans that can impact patient outcomes. It is imperative for the nursing workforce to not only assess for military/Veteran status but to also have some knowledge of military culture and Veteran-specific healthcare issues.

Civilian Nurses' Knowledge, Confidence, and Comfort Caring for Military Veterans: Survey Results of a Mixed-Methods Study

More than 20 million Veterans currently live in the United States, representing World War II, Korea, Vietnam, Iraq, and Afghanistan war eras, as well as many who served during peacetime. Little is known regarding what home care nurses know about the unique healthcare needs of this population. Using Purnell's Model for Cultural Competence, a mixed-methods study was designed to examine home care nurse's knowledge, comfort, and confidence in caring for active military, Veterans and their families. This article provides the data from a national survey of 102 home care nurses. Findings suggest that civilian home care nurses have limited experience working with active military but work with Veterans at least monthly, if not weekly. Nurses were most confident in managing pain and least confident in managing issues related to military sexual trauma. Knowledge of resources available to Veterans, war-specific exposures, and Veteran-specific health issues were the top areas nurses felt less confident in. Continued efforts need to be put in place so that 100% of all patients seeking healthcare are screened for military/Veteran status. In addition, continuing education for nurses needs to include Veteran-specific topics so evidence-based, culturally sensitive care can be provided.