Geriatrics and extended care

GEC's mission is to honor our Veterans’ preferences with respect to health, independence and well-being while meeting the challenges of aging, disability or illness.

VA Community Living Center

The Boston VA’s Community Living Center is located within the Brockton Campus. The mission of the Community Living Center is to provide compassionate care to eligible Veterans with sufficient functional impairment to require the level of service and skill available in the Community Living Center (CLC). Veterans with chronic stable conditions included dementia, those requiring rehabilitation or short term specialized services, or those who need comfort and care at the end of life are served in the CLC. The CLC works collaboratively with VA medical centers in VA New England and across the nation, with community hospitals and agencies, and with the Veterans and their families. Required length of stay may be for an extended, but limited period of time.

The CLC provides innovative, cost-effective and high-quality services that preserve or improve quality of life for Veterans. As we provide these clinical services, we will emphasize the importance of educational opportunities for health professionals who are planning to care for Veterans with complex medical and psychosocial issues.

Inpatient hospice and palliative care

Learn more about our hospice and palliative care inpatient unit

Homemaker/home health aide

A homemaker or home health aide is a trained person who assists Veterans in their homes. VA Boston has agreements with community agencies to provide these services; they are not provided by VA employees.

The VA does not provide companionship services. Companionship offers company and friendship such as playing games and taking walks.

Services provided by homemakers/home health aides include...

Examples of homemaker services include:

Meal preparation
Light housekeeping
Light shopping
Laundry

Examples of home health aide services include:

Bathing
Dressing
Shaving/brushing teeth
Toileting
Walking
Eating
Verbal medication reminders
Light housekeeping

Admission criteria:

Enrolled in the VA Boston Healthcare System
Homemaker services may only be provided in conjunction with home health aide services
Clinical judgement from provider noting the Veteran would require nursing home care without home and community based services
- Three or more activities of daily living (ADL) dependencies
  - Bathing
  - Dressing
  - Grooming
  - Transferring
  - Walking
  - Toileting
  - Eating
- Significant cognitive impairment
- Requires H/HHA services as an adjunct care to community hospice services
- Two ADL dependencies, and two or more of the following conditions:
  - Has dependency in three or more IADLs
  - Has been recently discharged from a nursing facility
  - Has an upcoming nursing home discharge plan contingent on receipt of home care services
  - Is seventy-five years old, or older
  - Has high use of medical services defined as three or more hospitalizations in the past year
  - Has high use of medical services defined as outpatient clinics or emergency evaluations 12 or more times in the past year
  - Has been diagnosed with clinical depression
  - Lives alone in the community
  - Maintains appointments with VA PCP on at least an annual basis

Referral/consultation process:

A referral can be placed by a VA Primary Care social worker, or designee with documented approval of an attending physician or licensed practitioner
The person entering the consult is responsible to make a request for a specific number of homemaking and home health aide hours per week

Community Nursing Home Program

The Community Nursing Home (CNH) program may authorize placement for eligible Veterans who require short-term rehabilitative services, long-term care or hospice services. VA has established agreements and care contracts with a myriad of community nursing homes in order to meet the clinical needs of Veterans who require 24-hour care as well as skilled services. Community nursing homes are private facilities that provide 24/7 care, assistance with ADL’s and various rehab services (PT, OT, ST) to Veterans. The Community Nursing Home Program has established agreements and care contracts with nursing homes in numerous geographic areas in order to better service our geriatric Veterans. Of note, Veterans are eligible for this program if they have a Service-Connected status of 70-100%, or 60% with a designation of unemployability, and require skilled care or are dependent upon others for their ADLs.

How services are being provided:

Community nursing homes are accepting patients for admission when the facility determines that they can meet the needs of the referred Veteran. The VA community nursing home team provides monthly oversight visits to monitor each Veteran and ensure their needs are being appropriately met.

Referral/consultation process:

A referral can be placed by a VA Primary Care social worker, or designee with documented approval of an attending physician or licensed practitioner

CNH Coordinator: Rebekah Larocque, LICSW

COR: Joan Morley, LICSW

Contract adult day health care

Contract Adult Day Health Care
The Contract Adult Day Health Care (CADHC) program is made up of community-based facilities that provide health maintenance services to elderly and disabled Veterans. The program helps keep these Veterans in the community and provides caregivers with respite.

Services Provided By CADHC*

Medical and nursing services
- Medication management in collaboration with the patient's physician
- Ongoing health assessment and care of medical and mental health conditions
- Incontinence care
- Proper nutrition (therapeutic diets available)
- Personal care
Activities program
- Social interaction
- Cognitively stimulating activities
- Arts and crafts
- Entertainment
- Exercises
- Quiet area for relaxation
- Supervised outings
Social services
- Counseling and support for patients and their families
- Support groups for caregivers
- Referrals for community services
- Assistance determining eligibility for various services and benefits
  
  Please note not all services listed are offered at each CADHC program
  
  *Adapted from Massachusetts Adult Day Health Services Association

Admission criteria:

All Veterans who are enrolled at the VA Boston Healthcare System and currently receiving treatment from VA Boston Primary Care Provider are eligible to be considered for CADHC
Co-payment may be required for CADHC services
Please complete 10-10EC
If Veteran is deemed Catastrophically disabled, they are exempt from CADHC co-payment

Referral/consultation process:

A referral can be placed by a VA Primary Care social worker, or designee with documented approval of an attending physician or licensed practitioner

Outpatient Geriatrics

As you age, we offer a range of medical and support services to help you stay as healthy, active and independent as possible. We also offer help to family members and caregivers who may support you. Common conditions may include memory problems, sleep problems, falls, bone loss and weight loss.

Available at these locations

We assess your situation and condition to decide which outpatient geriatric services are right for you or a senior Veteran in your care, and coordinate that care. Our team of specialists provides geriatric services that include:

Functional status assessment
Cognitive impairment assessment
Medication review
Medicine and nursing
Psychology, psychiatry and social work
Physical and occupational therapy
Caregiver education and support

To access care, ask your primary care provider for a referral.

Please bring all medication bottles and pillboxes, a photo ID (such as your Veteran’s ID card or a driver’s license) and your health insurance information with you to your first Geriatrics appointment. We encourage you to bring a family member or caregiver, if applicable. If you are transferring from a health care provider outside the VA, it is helpful if you bring your medical records with you.