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Who Receives Care in VA Medical Foster Homes?
Kate H Magid1, Chelsea Manheim1, Leah M Haverhals1
1is a Health Science Specialist; is a Research Social Worker; is a Health Research Scientist and Investigator; and is the Co-Director, all at the Rocky Mountain Regional Veterans Affairs (VA) Medical Center, Denver-Seattle Center of Innovation in Aurora, Colorado. is an Investigator at Center for Innovation in Long-Term Services and Supports at the Providence Veteran Affairs Medical Center; and an Associate Professor at the Department of Health Services, Policy & Practice, and Center for Gerontology and Health Care Research, School of Public Health, Brown University in Rhode Island. is a Physician Scientist at the Geriatric Research Education and Clinical Center and HSR Center of Innovation at the VA Greater Los Angeles Healthcare System; a Director and Professor of Medicine at the University of California Los Angeles Borun Center; and a Senior Natural Scientist at RAND. Cari Levy is a Professor in the Division of Health Care Policy and Research, School of Medicine, University of Colorado, Aurora.
Objective:
The Veterans Health Administration (VHA) Medical Foster Home (MFH) program was created to give veterans a community-based alternative to institutional long-term care (LTC). This study describes demographic, clinical, and functional characteristics of veterans in MFHs.
Methods:
Findings from in-home assessments of veterans in MFHs tied to 4 VHA medical centers for ≥ 90 days between April 2014 and December 2015 were collected. Trained nurses completed Minimum Data Set (MDS) 3.0 assessments for 92 veterans in MFHs. The assessment included demographic characteristics, cognition, behaviors, depression, pain, functional status, mobility, and morbidity.
Results:
MFH veterans were primarily male (85%), aged > 65 years (83%), cognitively impaired (55%), and had a diagnosis of depression (52%). Overall, 22% had caregiverreported aggressive behaviors and 45% self-reported pain. More than half used a wheelchair (56%). Of the 11 activities of daily living (ADLs) assessed, MFH residents were most likely to require assistance with bathing and least likely to require assistance with bed mobility and eating, although more than half required eating assistance.
Conclusions:
Veterans residing in MFHs have a wide range of care needs, including some veterans with high needs for help with ADLs and others who are completely independent in performing ADLs. These results provide insights about which veterans are staying in MFH care. Future studies should explore how VHA care providers refer veterans to LTC settings.
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