“That is Care That you Just can't fake!”: Identifying Best Practices for the Care of Vietnam Veterans at End of Life

• Published in: Journal of pain and symptom management 2021-05, Vol.61 (5), p.983-990
• Main Authors: Agha, Aneeza, Kutney-Lee, Ann, Kinder, Daniel, Shreve, Scott, Keddem, Shimrit
• Format: Article
• Language: English
• Subjects: bereaved family survey; Bereavement; Best practice; best practices; Communication; end of Life; End of life decisions; Hospice; Military hospitals; Older people; Palliative care; Patient-centered care; Patients; Polls & surveys; Relatives; Social support; Sympathy; Validity; Veterans; Vietnam Veterans; Vietnam War
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2020.09.026

We reviewed the Veterans Health Administration Bereaved Family Survey's open-ended responses to understand end-of-life (EOL) care best practices for Vietnam and pre-Vietnam Veterans. To identify 1) recommendations for improved EOL care enhancements for older Veterans, 2) a model of best practices in EOL care for Veterans, and 3) any relevant differences in best practices between Vietnam and prior war eras. We examined five years of Bereaved Family Survey data (n = 2784), collected between 2013 and 2017, from bereaved family members of Veterans focusing on 2 open-ended questions: 1) Is there anything else you would like to share about the Veteran's care during his last month of life? 2) Is there anything else you would like to share about how the care could have been improved for the Veteran? Applied thematic analysis identified successes and challenges in the experience of the bereaved of Vietnam and pre-Vietnam era Veterans. Regardless of war era and death venue, a patient-centered approach to EOL care with readily available staff who could 1) provide ongoing support, comfort, honor, and validation; 2) routinely adjust to the patient's changing needs; 3) and provide clear, honest, timely, compassionate communication was important to the bereaved. Consideration of the uniqueness of Vietnam Veterans is beneficial. Patient-centered EOL care should include assigning a point of contact that follows the patient, educates the family on expectations, ensures the patient's changing needs are met, ensures the family has appropriate support, and communicates updates to the family throughout the patient's care continuum.