The Alzheimer's Digest: Veterans Affairs

It’s important for family Caregivers of Veterans to take care of their own health while taking care of the Veteran they love! VA offers a comprehensive health care program called the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) for family members of seriously ill or injured Veterans who meet specific criteria including Veterans who are rated permanently and totally disabled for a service-connected disability by VA. In addition, eligible Family Caregivers of eligible post 9/11 Veterans participating in VA’s Program of Comprehensive Assistance for Family Caregivers may also be eligible for CHAMPVA. For more information about CHAMPVA, please visit http://www.va.gov/hac/forbeneficiaries/champva/champva.asp. In addition, the Affordable Care Act, also known as the health care law, was created to expand access to affordable health care coverage to all Americans, lower costs, and improve quality and care coordination. Under the health care law, people will have health coverage that meets a minimum standard (called "minimum essential coverage"). The health care law designates CHAMPVA as fulfilling "minimum essential coverage". Please note that if you are not eligible for CHAMPVA and are interested in learning more about the Affordable Care Act, the deadline for enrollment for health coverage is March 31, 2014. There is information about the Affordable Care Act at http://www.va.gov/health/aca/. Please visit http://www.caregiver.va.gov/ for more information about VA's Caregiver Support Program.

Medication Reminder Notepad

Doctor's Appointment Reminder Notes Notepad

Weekly To Do List Notepad

Prescription Bottle Refill Date Stickers

Memory Ring/Keychain (Pink)

Calendar Appointment Reminder Stickers (White)

Ride Reminder Notes Memo Pad

Bathroom Routine Activity Card

Dementia Signage for the Home

Caregiving and being responsible for medications seem to go hand in hand. Veterans with chronic health problems who receive care through the VA take an average of eight different medications. This number does not include medications filled by a non-VA pharmacy or ordered by a non-VA provider, so the average number of medicines taken by a Veteran can be much higher.

The Caregiver's role in helping with medications is often thought of as making sure the Veteran takes the right amount of medicine at the right time. However, as Caregivers know, there is so much more involved: remembering to take medicines throughout the day, tracking when re-fills are needed, recognizing side effects, knowing how to recognize an emergency and how to react if one occurs, etc. Health care providers are just beginning to recognize that being responsible for a series of complex medications for another person can be an added source of Caregiver stress.

Knowledge, open communication with the health care team, and organization are the keys to making your responsibility for medications less stressful.

Care Tips: Knowledge

Start with a review of all the medicines being taken by the Veteran. Ask the Veteran’s primary care provider, pharmacist or nurse to review all the Veteran’s medications. Be sure to include those prescribed by both VA and non-VA providers, all the over-the counter medications, and herbals or vitamins the Veteran takes.
As the medications are being reviewed, ask the provider:
- Why the Veteran needs to take each medicine and it write down on the label — one or two words that will help you and the Veteran to remember the reason he/she is taking this medicine.
- How much of the medicine to take, at what time and how often each medicine should be taken each day; what to do if a dose is missed, side effects, how you and the Veteran will know if the medication is working, allergic reactions and the actions to take if the Veteran has a reaction to a medicine.
- During this review, throw out medications that are out-dated or should no longer be taken. Ask the provider about the best way to do this.
- At the end of this review, you should have a clear understanding of the when, where, how and why for all the medicines the Veteran is taking.

Open Communication with the Healthcare Team

As a Caregiver, you are a partner with the Veteran’s healthcare team in protecting his/her health and well-being. You know the Veteran best; you know when he/she has a loss of appetite, a change in sleep or mood, fever or other signs of illness. You may notice these changes, even before the Veteran does.
You are often the first person to observe the Veteran’s response to a new medication. You’ll be the first to notice if he/she is having side effects or develops signs of an allergy to the medicine. Having a plan to share your observations with a trusted member of the Veteran’s health care team will help to make sure the Veteran receives the highest quality of care.
Creating open communication with the Veteran’s healthcare team does not just happen; it is the result of actions and talks that you and the Veteran have together before, during, and after a healthcare visit.
- Before the visit: talk together and write down any questions you and the Veteran have for the healthcare team. Make a list of any changes since the Veteran’s last visit and make a list of all the medicines that the Veteran is taking prescribed by both VA and non-VA doctors and all over-the-counter medicines, herbals or vitamins.
- During the visit: be respectful of the Veteran/provider relationship but do re-state any incorrect information and add important information that the Veteran may have forgotten; discuss the recommendations with the provider; write down instructions for medications or treatments and repeat them back to the provider to assure that you and the Veteran fully understand the directions and next steps. Establish who on the healthcare team you should call if you have any questions after getting home.
- After the visit: talk about the visit together and review your notes, re-fill prescriptions, make follow-up appointments and call for test results if needed.

Organization

Maintaining an up-to-date list of all the Veteran’s medications and using a daily/weekly pill organizer are important tools for Caregivers who are responsible for helping with medications.
- Pill organizers with labeled sections for each day of the week and with multiple rows to allow for medicines taken at different times throughout the day are best.
- Many Veterans and Caregivers find that setting up electronic reminders to take medication throughout the day to be very helpful. These reminders can be phone apps or watches, key chains, etc. which can be set to sound an alarm or vibrate whenever it is time to take a medication.
- Maintaining an up-to date list of the Veteran’s medications is easiest to do by setting up and regularly updating medications in an electronic record. A Caregiver Medication Log can be found at Dementia Signage for the Home under Caregiving Management Tools.

“I am a Caregiver assisting with medication management, who can I talk to if I need assistance or more information?”

Remember that the Veteran’s primary care team is there for any questions or concerns you may have about medications. Open communication with the Veteran’s health care team and understanding the facts concerning medication management is important, it could save a life. My HealtheVet is also a good place to check out for helpful medication management resources. You do not need to be a Veteran to access My HealtheVet but you do need to register and create an account to have basic access the tools and resources available. The Medications: Play it Safe page is a great place to start. From here you can learn how you play a major role in medication review. Follow a step–by–step guide to Play it Safe with medications, get answers to frequently asked questions, and learn what actually happens in a medication review. This is the basic information to take an active role in medication review and learn how to play it safe with medications.