Take 5-Palliative Care for Armed-Services Veterans

May 19, 2011
Anne Landry

One in four Americans facing end-of-life is a veteran. Because of their traumatic experiences during combat, including experiences with death, veterans with cancer and other serious illnesses can have complex healthcare needs.

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Oncology Nursing Society 36th Annual Congress
Poster/ abstract 1052070-Palliative Care for Armed-Services Veterans: Recognition of Spiritual Distress and Unresolved Post-Traumatic Stress Disorders

Elizabeth Delaney, MS, RN, CNS, FNP-BC, OCN, ACHPN; Kathy Hayes, MS, RN, BC, CHPN; Jayne Gmeiner, MS, RN, NEA-BC

Ms. Delaney is from the Center for Nursing Excellence at The Ohio State University, James Cancer Hospital and Solove Research Institute. She is Interim Program Director of the Center for Palliative Care at OSU, Columbus, OH, and former director of the palliative care program at Miami Valley Hospital, Dayton, OH. Ms. Hayes is from the department of Hospice and Palliative Care, Dayton VA Medical Center, Dayton, OH. Ms. Gmeiner is director of the Center of Nursing Excellence and Palliative Care, Miami Valley Hospital, Dayton, OH.

One in four Americans facing end-of-life is a veteran. Because of their traumatic experiences during combat, including experiences with death, veterans with cancer and other serious illnesses can have complex healthcare needs, which may include spiritual/psychological distress and resurgence of post traumatic stress disorder (PTSD), particularly if they are facing end-of-life. In the US, however, 87% of veterans are cared for in the community setting, not in a VA medical center, so sensitivity to their special needs may be lacking.

After reviewing the Ohio Hospice Veteran Partnership recommendations, the investigators developed a bedside “pinning ceremony” at the Miami Valley Medical Center that was then replicated at OSU, to recognize and honor dying veteran patients’ service to their country.

• Following admission to the palliative care team, veterans with cancer and other serious illnesses were offered the opportunity to participate in the pinning ceremony.

• Medical staff, the patient’s family, and a veteran volunteer participated in the ceremony, and the veteran volunteer presented the veteran/patient with a pin.

• This was extended to a staff recognition ceremony acknowledging the military service of medical staff at the treatment center.

• In discussions with veteran patients during or after the pinning ceremony,  unresolved psychological and spiritual issues that the patient was experiencing often emerged, prompting nursing referral to appropriate resources to address these patients’ concerns.

The purpose of the “pinning ceremony” initiatives was to increase awareness of veterans’ specific palliative care needs and to provide an opportunity to for dying veterans to discuss their experiences, which in turn may bring a sense of catharsis and contribute to a more peaceful end-of-life for this patient population.

For more information related to this topic, visit We Honor Veterans (www.wehonorveterans.org).