Patient Care Services

Geriatrics and Extended Care Program

The shared purpose of all Geriatric and Extended Care programs is to prevent or lessen the burden of disability on older, frail, chronically ill patients and their families/caregivers, and to maximize each patient's functional independence. Because the course of chronic illness varies, the health care needs of the chronically ill patient also change, requiring the services of one, some, or all Geriatrics and Extended Care services over time. Community Residential Care, VA Community Living Centers, Community Nursing Homes, and State Veteran Homes assist Veterans who are not able to live independently. Geriatric Research Education and Clinical Centers support the advancement and integration of research, education, and clinical achievements . Geriatric Evaluation & Management, Geriatric Primary Care, and Inpatient Respite offers interdisciplinary inpatient or outpatient services to elderly patients. Hospice and Palliative Care offer a continuum of comfort-oriented and supportive services provided in the home, community, outpatient, or inpatient settings for persons with advanced illness.

The Office of Geriatrics and Extended Care advances quality care for aging and chronically ill Veterans by providing policy direction for the development, coordination, and integration of geriatrics and long-term care clinical programs, and for the advancement of geriatrics and long-term care through research, education, and evaluation of new clinical models. Geriatrics and Extended Care site

Adult Day Health Care (ADHC)

Adult Day Health Care programs provide health maintenance and rehabilitative services to Veterans in a group setting during daytime hours. VA introduced this program in 1985. In 2008, VA operated 21 programs directly and provided purchased ADHC services at 113 VA medical centers. One state home provides ADHC services.

Adult Day Health Care is an outpatient day program that provides health maintenance and rehabilitative services to frail elderly and functionally impaired veterans. These services are delivered by a team of health professionals and support staff that strives to help participants and their caregivers develop the knowledge and skills necessary to manage care in the home. Adult Day Health Care - https://www.va.gov/GERIATRICS/pages/Adult_Day_Health_Care.asp

Geriatric Research, Education and Clinical Centers (GRECC)

These centers increase the basic knowledge of aging for health care providers and improve the quality of care through the development of improved models of clinical services

and a wide variety of educational activities targeting VA staff and trainees from the full range of health disciplines. Each GRECC has an identified one or more foci of research in the basic biomedical, clinical and health services area. Begun in 1975, there are now 20 GRECCs in all but two of VA's health care networks.

Geriatric Research Education and Clinical Centers (the GRECCs) are designed for the advancement and integration of research, education, and clinical achievements in geriatrics and gerontology into the total VA healthcare system. All of the GRECCs focus on various aspects in the quality of life and care for the aging veterans and are the forefront of leading-edge research and education. GRECC site

Home-Based Primary Care

This Program (formerly Hospital Based Home Care) began in 1970 and provides long-term primary medical care to chronically ill veterans in their own homes under the coordinated care of an interdisciplinary treatment team. This program has led to guidelines for medical education in home care, use of emerging technology in home care and improved care for Veterans with dementia and their families who support them. In 2008, home-based primary care programs were located in 128 VA medical centers.

Home-Based Primary Care provides primary health care to homebound to patients that live in the community. HPBC is designed to serve the chronically ill through the months and years before death, providing primary care, palliative care, rehabilitation, disease management and coordination or care services.  Home Based Primary Care - https://www.va.gov/GERIATRICS/pages/Home_Based_Primary_Care.asp

Homemaker and Home Health Aide (H/HHA)

VA began a program in 1993 of health-related services for service-connected Veterans needing nursing home care. These services are provided in the community by public and private agencies under a system of case management provided directly by BA staff. In 1999, this program was expanded to cover all enrolled Veterans. VA purchased H/HHA services at 142 medical centers in 2008.

Provides clinical expertise in home and community coordination, provision of the continuity of care, and referral of patients to community agencies, VA programs, including skilled home health aide, and adult day health care. They also function as a liaison to community agencies, as well as monitor their services. Homemaker and Home Health Aide Care - https://www.va.gov/GERIATRICS/pages/Homemaker_and_Home_Health_Aide_Care.asp

Respite Care

Respite care temporarily relieves the spouse or other caregiver from the burden of caring for a chronically ill or disabled Veteran at home. In the past, respite care admission was limited to an institutional setting, typically a VA nursing home. The Veterans Millennium Health Care and Benefits Act expanded respite care to home and other community settings, and home respite care was provided at 122 VA medical centers in fiscal year 2008. Currently, institutional respite care programs operate in 136 VA nursing home care units. Respite care is usually limited to 30 days per year.

Respite Care provides temporary relief, assistance and support to those veterans and their primary caregiver/family who are dealing with long- term disability/chronic illness in their home. Respite can be provided in an adult day facility to provide rest to the full-time caregivers, this option should not be confused with the provision of adult day care services to veterans for therapeutic activities to enhance their physical and emotional well-being. Respite Care - https://www.va.gov/GERIATRICS/pages/Respite_Care.asp

Hospice Care - https://www.va.gov/GERIATRICS/pages/Hospice_Care.asp

Palliative Care - https://www.va.gov/GERIATRICS/pages/Palliative_Care.asp

Skilled Home Health Care - https://www.va.gov/GERIATRICS/pages/Skilled_Home_Health_Care.asp

Remote Monitoring Care - https://www.va.gov/GERIATRICS/pages/Remote_Monitoring.asp

Veteran-Directed Care - https://www.va.gov/GERIATRICS/pages/Veteran-Directed_Care.asp

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