Charlie’s health care reached a crisis about three months ago when he went six weeks without a shower. All attempts by me to get him into the shower were met with fierce resistance. His excuses were never-ending; he had one yesterday, he didn’t need one, his back hurt, he was too tired, he’d do it tomorrow. During a visit to his primary care doctor at the Department of Veterans Affairs (VA) Medical Center in White River Junction, I told the doctor I needed help.

That was all it took. Within two days, someone from the Visiting Nurse’s Association (VNA) had called and set up an appointment for an in-home evaluation. A few days later, a representative from the NH Veteran’s Independence Program (VIP) contacted me. Shortly after that, I received a call from the director of the Home Based Primary Care Program (HBPC). Within one week, a home health aid from the VNA was visiting twice weekly to give Charlie the much hated shower. She was able to accomplish what I had not. He still grumbles and insists that he doesn’t need help, but he has had a regular shower for the past two months.

After a lengthy evaluation, Charlie was approved for the VIP program. This program now provides in-home care 15 hours per week by a Licensed Nursing Assistant, giving me respite time and help with Charlie’s everyday care. We are also allowed three hours a week of housekeeping services. The budget provides a discretionary fund that can be used to help pay someone to stay with him for several days in the event I become ill or need to leave him for family time. The fund can also be used for in-home modifications to make it more handicapped accessible.

The third program (HBPC) has assigned a nurse practitioner, supervised by a geriatric specialist, who will see him once every three months, a registered nurse who will make monthly visits, and a physical therapist to assist with his ambulatory problems. Dietetic and social services are also included in the program. These people all visit Charlie in the home, significantly reducing the need for him to go to the VA hospital for his health care, including some lab tests. He will still have to make occasional trips to the clinic for specialty services; podiatry, audiology, dermatology, etc. The HBPC program is for vets living within 50 miles of a VA hospital who have difficulty getting to the facility due to physical or mental challenges, loss of a driver’s license, or who are confined to the home caring for an ill spouse.

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These collective groups of health care personnel have provided us with a Rollator, a blood pressure apparatus, bars, a raised toilet seat, various sanitary items and a medical alert system. They will oversee the timely renewal of his prescriptions, make suggestions for improving my nursing skills and advise us on possible solutions if his care becomes more than we can handle in-home. Charlie has become frustrated from time to time with all the strange people coming and going, asking him questions that he can’t answer, and fussing over him. But he seems to be handling it better than I expected. It has taken some adjusting on my part as well. I have trouble relaxing when I leave home without him; I feel like I need to hurry back to make sure everything is running smoothly. I’ve had to learn that I can leave some of the laundry and cleaning for someone else to do. I have pushed myself for so long to get everything done that I need to train my mind and body to enjoy my free time. With only 18 hours a week of help, that shouldn’t be so difficult, right? That’s not a lot of help when you are the sole caregiver for someone with Alzheimer’s or dementia, especially if they have numerous other health problems.

The help is here during the daytime hours and, like many dementia patients, the evening hours are inclined to be the most difficult. I wouldn’t say that Charlie has full-blown Sundowner’s Syndrome, but he is more difficult in the evening. I am extremely thankful for the help that the VA has provided, and I understand that as his health deteriorates, the assistance may be increased. For those of you who are wondering how we managed to get so much help from the VA while others are struggling unassisted, you should know that Charlie was career Air Force and has an 80% service-connected disability from a plane crash and Agent Orange exposure in Vietnam. I am sure that puts him near the top of the list for government assistance. But for those of you caring for disabled vets, know that there may be help available. You have to get into the system at one specific VA facility and begin asking for assistance. Good luck!