This department had a veteran report for his initial visit. During his visit, they learned that his wife had passed away 6 months prior, and the Veteran was having difficulty swallowing, weight loss, low blood pressure, and hallucinations. He recently moved in with his daughter, allowing her to be his caregiver. After his initial visit, Susan offered the veteran and his daughter a VA Video Connect visit for a weight and blood pressure check. The hour-long drive to the Lebanon VA presented a challenge due to his poor health and his daughter’s work schedule. Susan committed to serving the veteran and his family, honoring the VA’s mission, knowing this visit method would be most appropriate, especially with his current health needs. With a VVC, she could accommodate their schedule and keep close contact with him. The VVC appointment was scheduled for two weeks from the date of the initial appointment, and Susan could visualize the difference and significant decline in the Veteran’s health. The nurse observed the Veteran via video lying in bed, appearing emaciated. His daughter was able to assist him in obtaining his weight, which showed a 12 lbs. weight loss in less than 2 weeks. This Veteran was visibly deteriorating. The daughter shared with Susan that he was refusing to take all his medications, and he had stopped eating for several days.

Susan exemplified integrity as she built a trusting relationship with the Veteran and his daughter through the initial visit to the PACT clinic and subsequent follow-up video visits. Through this trusting relationship, Susan was able to advocate for the Veteran through discussions with the daughter regarding hospice services available. She was able to proceed in a respectful manner, knowing this Veteran and his daughter had just gone through a similar situation with his wife/her mother a few months ago, allowing the Veteran to make the decision in line with his goals of care. The Veteran’s daughter voiced feeling grateful for Susan to approach the option of hospice, and she was relieved when she was able to visualize what they were experiencing firsthand. Susan was able to involve the geriatric PACT provider and RN, inviting them to join the video visit with the Veteran and his daughter to share concerns and develop a plan together. Consults were entered, and hospice services were in place within 24 hrs. Another VVC was scheduled a week later. During that next visit, his daughter voiced appreciation for Susan, that she was prepared and able to contact extended family, and that everyone was able to say their goodbyes. Our Veteran passed away peacefully later that evening. Having the ability to utilize video visits, Susan was able to see firsthand what families are experiencing and guide them in real time with decisions when time really is of the essence. This Veteran passed within 3 weeks of his initial visit with the geriatric PACT.

Susan strives for excellence in the care she provides her Veterans every day. Her ability to think “outside the box” and meet the Veterans where their needs are shows her unwavering dedication to her Veterans and the mission of the VA.