Tuesday, February 4, 2020

Let's Renew Together

Caregiving Goes On – Even if VA Information Does Not     

It’s February, and the realization that VeteranCaregiver has postponed creating new videos to support, educate, and even possibly sometimes inspire you hit me hard today.  Creating videos, and voicing thoughts you’ve had and wish you could have gives me joy and purpose.  So, today, we asked you what you want to hear?

Year ago, we began short, personal videos on medical conditions, how to better navigate the VA biosphere (little air in there…), manage the day to day, and the daily fatigue, frustrations, complications, and facts.  The realization that so many are confounded (us too!), that little to no information is forthcoming, and that background turmoil continues and has for so long is disheartening.

So, please share what you’d like to hear about – even if it’s silly, a life-skill like communicating better, or a serious issue that needs addressing, please tell us.  Like you, each day feels better with distinct purpose rather than responding to emails in a vacuum.  😊

It’s time to renew.  Let’s do it together!

Linda Kreter and the VeteranCaregiver Team

Thursday, January 31, 2019

Calm is a Superpower

So many times we wait for answers, decisions, and choices OTHERS will make.  In the meantime, we have choices: recognize the choices are not ours, surrender the control we'd like to make to influence them, and wait before responding to the parts of the answer that affect us.  That's the calm way and the least exhausting way.

Other times, our choice is to overthink.  To ponder the worst, anticipate how it will affect twenty different things in our lives, and to make ourselves miserable, both day and night.  Sleep doesn't come easily when we're spiraling, food either becomes an enemy or absent, and we're not much fun to be around.

Remember the video on the Waste of Worry? (https://www.youtube.com/watch?v=naN4PfT-jQs&t=3s)  Do you want to waste your one precious day today on fruitful thinking or worry?  It's a choice and it is also tiring to actively push the negative or wasteful thoughts away, but it gets easier with practice.

Picture credit:  LordsOfHustle
Calm is a Superpower, and within your grasp.  Like everything else, breaking poor habits and building new ones takes practice.  Perhaps you need to inwardly rant for an hour - go ahead!  That can release some angst and you've affected only yourself.  BUT, if you're able to look inside and PAUSE to realize your efforts to hasten a decision or to influence a decision is not serving you well, you've achieved a breakthrough!

Here's to knowing we can only control our own responses to life's situations, and that we have kind friends who will help us when we reach out to them.  If you don't, work on finding/making friends, and don't underestimate the power of a pet!

Blessings and care,

Linda Kreter and the VeteranCaregiver.com Team

Friday, January 4, 2019

Failure, Helplessness, New Hope, and Growth

It may have been a hard week, month, year for you.  You’ve stepped mightily into each challenge with hope, optimism, and sound strategy.  Yet, each time, you find yourself plunged a little more into bewilderment, sadness, and anxiety.  Standing up strongly, you know you have that little bit more within you to take another step – but it’s a hard step to take.

This is not about mistakes you’ve made, or choices made.  It’s about those times when you’re absolutely not in charge of the outcome despite your best efforts.  Despite your insanely wonderful capabilities, and personal drive.  It’s when logic does not prevail that brings on that feeling of helplessness.  Sometimes, it’s only a mere step to hopelessness, and that’s to be avoided.  If it can’t, professional help may be needed, and seek it. 

So, what do you do?  Maybe it’s time to hit the PAUSE button.  Slow down and think about the steps you’ve taken and those you haven’t. Take time to look closely at the situation and slowly remove emotion from the equation.  Mostly let’s talk about this with relationships, professional and personal. 

 We all know we cannot change other people, but only ourselves.  Looking at situations from a different perspective, and looking at the possible priorities of others may provide a glimmer of understanding.  Those times when you’ve revealed that your plans and hopes were hampered by others either afraid of change, or because of power or ego show you valuable lessons.  

Why?  Because you aren’t likely to make those fears go away (hint:  they are not your fears), and those who misuse power with inflated egos usually show a pattern of behavior, also not likely to change.  Bottom line:  only YOU can change the course. And, YOU are creative and innovative, strong and strategic.  Trust this.

Possible steps:
1.      Look at options.  Could you alter your timing, your approach, find alternatives, or refine your goal?  If so, explore those opportunities as a new approach to achieve the same goal.
2.     Scrap your plans.  This is a severe but possible response.  For example, if you’ve been trying to achieve change with many approaches and failed often due to others’ actions or behavior, it may be time to walk away.  Staying too long at anything just because you invested time in it seldom works out. However, if you scrap your plans, insert a new plan to take its place, even if that plan is to pause.  Nature will fill a vacuum; make it YOUR choice to do so.
3.     Use the Pause Button to explore an entirely new path you may not have considered because SURELY one of your previous explorations would have worked.  Now that it didn’t, let your mind walk down different paths.
4.     You are NOT alone.  Talk with trusted friends and advisors.  Talking things through with someone who really "hears" you is invaluable
5.  Nurture your confidence.  You are only in this temporary helplessness place BECAUSE YOU TRIED.  Those who don’t try may not know the feeling of failure, but it’s often failure that leads to fresh ideas and renewed optimism.

Stay within the realm of hope, consider how strong you’ve been to persist, and take the time to ponder your new path.  Often, the failures of the past lead to growth and plans you might have missed – failure is grounding for options, opportunities, learning, and even gratitude.  Do we LIKE this experience?  Of course not.  Yet, look at each life experience from all angles, and grow in wisdom, creativity, and confidence you’ll achieve your goals.  It’s just around the corner!

Linda Kreter and the VeteranCaregiver Team

Monday, October 29, 2018

Protect Your Family with a Disaster Plan

Have you ever considered what you would do if a disaster struck you and your family? Would you know what to do? Would you take the right step to take to protect your life and that of your family? Many of us assume that disasters only happen rarely and to other people. But unpredictable weather can affect any area of the country, and recently we've witnessed wildfires, tornadoes, floods and other natural disasters in places we least expected.

Although natural disasters can cause catastrophic loss of property and injuries, you can reduce their effect through careful planning and preparation.

The first step to planning a disaster response is to be informed. Especially if you’re new to an area, you should become familiar with its frequent natural disasters. Identify the known risks such as earthquakes, flood zones and frequency of extreme weather. Some information about the area can help you understand some of the initial responses to include in your plan. For example, if you live close to the water, you'll likely want to have a well-thought out plan in the event of a flood. 

Tornadoes are another example. As HomeAdvisor explains, “Although they are mostly associated with the Midwest and “Tornado Alley”, no state is immune to tornadoes. Even sunny California experienced seven of them in 2014. Therefore, it only makes sense to take some precautions and have procedures in place in the event of a tornado.”

After acquiring information about your particular disaster likelihood, the next steps to developing a plan is to consider these four questions with your family and friends:

How will emergency alerts and warnings be transmitted? What is your shelter plan? What is your evacuation route? What is your communication plan?

When answering all these questions, consider any particular needs of your family. Small children, seniors, people with special needs and even pets can all affect how you develop and execute your plan.

Next, consider what sort of supplies you should need if there is a disaster. Creating an emergency preparedness kit is simple, and although you hopefully will never have to use it, it’ll be the best investment you've ever made in the event disaster strikes. Having the following basic supplies can make a life or death difference:

-       Water - 1 gallon per person per day
-       Nonperishable food, such as canned goods
-       Flashlight
-       Battery-operated or hand crank radio and/or phone charger
-       Extra batteries
-       Medications
-       Personal hygiene items

And if disaster strikes, be ready to put your plan into effect. None of these preparations are useful in a state of chaos, so your plan should include designating someone to be in control.

And if a natural disaster hits, consider the impact on your pets as well. Contact your local emergency management office or Humane Society to see if a temporary shelter is available for your animals. Emergency shelters for people impacted by natural disasters can't always accept displaced animals, so your plan should provide for their care.

You can also reach out to friends and family members who aren’t affected by the disaster to see if they could temporarily house your pets. Other options include making a list of pet-friendly hotels in your area in case you have to find shelter quickly for the entire family.

When natural disasters occur, all too often victims are unprepared, believing that such calamities only happen to other people in other areas. Be prepared for these events, no matter how unlikely. It may be the best plan you ever put to paper.

Bradley Davis

Monday, September 24, 2018

You Matter!

You Matter!  Caregiver Awareness & Self-Care
T KarcherYears ago.... self-care was an eye roll.  A weakness.  Last on the list.
Thankfully, this has changed; caregivers are no longer willing to be continually mentally exhausted, ill-nourished, overwhelmed, or physically unable to provide care, it causes too much additional family stress. While it is difficult to make time for yourself, you’ll hear it repeatedly: Make the Time for You.
Caregivers often have their head down, their task list in hand, and they execute logistics that would make a 4-star amazed. However, this focused effort is rarely sustainable. This will vary for everyone, but no one is a robotic machine forever. Please don’t wait until you fall ill or become so overcome that you don’t see which end is up. Sharing your experience and gaining perspectives with friends and other caregivers can be very beneficial.
You probably micro-schedule the rest of your life, so try to add good nutrition, exercise, relaxation, meditation, quiet, social time, or something that is yours into that schedule too. There are numerous options for small-group fellowship in local organizations, the faith-based communities, and sports facilities. Respite care is hard to find, so intentionally carving out time for you is necessary.  Every little bit helps. 
You need it.  You matter.  Take charge of your self-care.
Linda Kreter and the VeteranCaregiver Team

Thursday, September 6, 2018

SPAR - Sensitive Patient Access Report

See VHA Directive 1605.01, Sections 7-4 and 38-9

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3233 (copy & paste into browser

"SENSITIVE RECORDS" - Many caregivers have voiced concern over who is accessing a veteran's records, especially for evaluations.  While evaluations are to be conducted according to the caregiver law, alternative staff is sometimes accessing a veteran's medical records for evaluation or appeal records review.  

If you are concerned, have the veteran request their Medical Records be marked "Sensitive" by the Privacy Officer at your local VAMC. This means the LOG of all those accessing records will be supplied in a SPAR report (Sensitive Patient Access Report). Don't forget to request reporting time frame (all). 

VHA Directive 1605.01 (Sections 7-4 and 38-9) is also posted in our www.VeteranCaregiver.com website Resources section.

Linda Kreter and the VeteranCaregiver Team

Tuesday, August 28, 2018

Obtaining CATS and PATS Records

CATS and PATS Records:   For those in the Program of Comprehensive Assistance for Family Caregivers Program and those anticipating joining the program, obtaining these records on a periodic basis is vital to understanding the entire CG Program picture.

CATS (Caregiver Application Tracking System) and PATS (Patient Advocate Tracking System) are NON-medical records completed by Caregiver Support Coordinators and Patient Advocates respectively.  The information contained is often used for program re-evaluations, continuing eligibility, and sometimes reflect different information than the medical records.  Without this information, you lack the capability to review for accuracy, correct errors, and understand the full picture.

We have concerns.  CATS and PATS were not openly disclosed and found only from patterns discerned through thousands of seemingly illogical caregiver decisions.  VACO has confirmed these records, and acknowledged in writing that both CATS and PATS usage will continue.  Once these non-medical databases became known and caregivers submitted requests (only available through FOIA requests, or Freedom of Information Requests), there have seemingly been deletions from the records, and apparent removal of information that may have assisted in reversing Caregiver Program decisions for Tier Reduction or Program Termination.

Starting the process means a Freedom of Information Request (FOIA) to your local VAMC staff outlined below.  To obtain these records, there is no form, and we suggest language similar to:

TO:              Privacy Officer, VA Medical Center __________ (name)

CC:              VA Medical Center Director ___________ (name)

FROM:        VA Caregiver ___________________ (name)       
                    Veteran _____________ (name)   _____ (last 4 of SS#)

(Caregiver Application Tracking System and Patient Advocate Tracking System Records)

Dear Sir or Madam,

This request is for specific records needed to respond to an appeal/eligibility to the VA Program of Comprehensive Assistance for Family Caregivers (PCAFC).  Our deadline for appeal is ___________ (date).     

We are requesting unchanged, unmodified, non-redacted, and complete CATS (Caregiver Application Tracking System) and PATS (Patient Advocate Tracking System) records from date of application __________ (month and year) to the VA Caregiver Program through today _________ (date) for Caregiver _____________ (name) of Veteran ___________ (name), last four of SS# ____.”  This information is critical to our timely documentation submission.

Thank you for your prompt response.

Very respectfully,

CG name and signature
Veteran name and signature

Submit this request to the Privacy Officer (or FOIA Officer at some centers) at your local VAMC and keep copies for yourself, noting the date and time of submission, the person submitted to, and any notes of conversations.  If you receive a response saying it will be an lengthy time period, exceeding your need for the information to appeal, provide a copy to your Caregiver Support Coordinator, their Supervisor, and request an extension of the appeal period in writing. 

Once records are received, review them carefully with the Veteran’s medical records for accuracy.  If there are errors, you must submit a line-by-line correction document, along with documentation (if available) requesting record corrections.  Submit these to the same Privacy Officer for submission and ask timelines.  Check for confirmation of this information.

There are further steps you may need to make, but please not only obtain these documents, but also document every single step in the ADL’s and Supervision/Protection provisions for program eligibility.  For those pre-9/11 veterans anticipating application into the program, do this documentation now, in advance, and be prepared to follow the same eligibility requirements.

We hope this information is helpful, and if you’re working with an advocate, cc them on the memorandum also.  If this process changes, we will let you know, and meanwhile, knowledge is invaluable, and sharing it with others is as well.

We recommend you print this blog posting and wish you the best of success.

Best to you,

Linda Kreter and the VeteranCaregiver Team