VA New England Healthcare System SUMMER 2012 SUMMER

VETERANS’healthy living

A Safe Haven for All

New Project Helps ALS Patients A Place of Healing and Remembrance Dear Veterans A Message from the Network Director Veterans’ Healthy Living Michael F. Mayo-Smith, M.D., M.P.H. Editorial Board Network Director Maureen Heard VISN 1 Communications Officer

Kathleen Makela VISN 1 Public Affairs Officer

Have you considered that there are three Sally Riley holidays that recognize and honor Veterans? VISN 1 Communications Specialist They are Memorial Day, Fourth of July, and Veterans Day. Diane Keefe VA Boston HCS, Public Affairs Officer Our leaders understood the sacrifices made for our freedoms and set aside days to acknowledge and give honor to you, our John Paradis nation’s service men and women. VA CW Massachusetts HCS, Public Affairs Officer Pamela Redmond Page 3 has an inspiring story about the new and improved VA Connecticut HCS, Public Affairs Officer “ALS Redesign System of Care” at the Providence VAMC for patients diagnosed with ALS, or Lou Gehrig’s disease. Many Website: www.newengland.va.gov Veterans and VA staff members were involved in streamlining Veterans’ Healthy Living is published as a patient education service by VA New the care and equipment process at this facility. We are here for England Healthcare System. The publication you every step of the way! is intended to provide information to help you maintain good health and learn about The feature story for this issue of Veterans Healthy Living the many health services available through VA. This publication is not intended as a focuses on the Memorial Wall at the Manchester VAMC. The substitute for professional medical advice, story behind its design is a humbling one and gives proper which should be obtained from your VA healthcare provider. All articles may be attention to some of those who have gone before us in service reproduced for educational purposes. and sacrifice to our nation. I encourage you to read “A Place of Healing and Remembrance” on page 4.

At the Bedford VA, a new program called “Safe Haven” was recently established to ensure that Veterans who have fallen on hard times will not “fall through the cracks” of VA housing programs. You’ll find that story on page 6.

Finally, on page 7 you can read about the research being performed and the strides made on Palliative Care at White River Junction VAMC and how they are partnering with a well- known medical school in this effort.

At this mid-year mark, we celebrate our freedom, and we pause to remember our fallen. Thank you for your service. Now let us serve you! VA Mission: Michael F. Mayo-Smith, M.D., M.P.H. Honor America’s Veterans Network Director by providing exceptional health care that improves 2 Veterans’ Healthy Living their health and well-being. VA New England Healthcare System | Summer 2012

The ALS System of Care redesign team, from left to right: William Luderer, PT, Stephen Mernoff, MD, Marie Sullivan, LICSW, Erinn Raimondi, OTR/L, Approximately 420 words Laurie Wilson, NP, Ellen Tragar, PT, Diane Blier, NP, and Maureen Hebert, MSW

New Project Helps ALS Patients

In 2008, Veteran John Antonizio remaining cognitively intact. equipment needs, requirements, was referred to Erinn Raimondi Although patients with ALS and and equipment return policies inFar, the Providence VA Far Medical theirAway families will face many was created. Raimondi said, Center’s Occupational Therapy struggles, thanks to a recently “By developing the toolkit, we Department with a diagnosis of formed “ALS System of Care” provided pertinent information ALS, also known as Lou Gehrig’s redesign, ALS patients now have to not only give patients and disease. From that moment on, an improved and specialized their families help, but also give Erinn and John worked together, method of receiving care. them something they can hold forging a path into the unknown on to every step of the way.” for equipment, therapy proto- “Before starting this project, cols, and resources. Months there was no consistent, The project is currently in passed before John made his standardized process in place its final phase—completing a way to the Spinal Cord Injury at the Providence VAMC to comprehensive patient resource (SCI) Clinic, where he was help Veterans with ALS— guide that was the brainchild of provided with interdisciplin- both on the healthcare side William (Bill) Szeliga, another ary care. “There were so many as well as the benefits side,” Veteran with ALS. With his help questions left unanswered,” said Raimondi, leader of the gathering the information, the Raimondi recalls, “but at least redesign project. Each Veteran guide is nearly complete and now there were more hands painstakingly carved his or her includes the names and contact carving the path.” own path through the system information for all of the key to get pieces of equipment ALS team members, a list of ALS, or amyotrophic lateral necessary for their care.” all of the services the VA can sclerosis, is a progressive provide on an as-needed basis, neurodegenerative disease But the redesign project has and additional information affecting nerve cells in the changed all that. The first three regarding equipment, grants, brain and the spinal cord. phases of the project resulted in and additional support systems. There is no known cure. shorter wait times for a patient’s Patients diagnosed with ALS initial visit to the SCI/ALS The plan is for this project to must face the grim reality clinic. Clinical documentation serve as a VA best practice that that they will lose their ability was vastly improved when a is another “gold standard of to function physically while clinician “toolkit” addressing care” for the VA.

Thank you for your service. Now let us serve you. 3 Summer 2012 | VA New England Healthcare System

A Place of Healing and Remembrance

In honor of the fallen service and a half years to research the main lobby of the Medical members of Operation Enduring and reach out to the families of Center, provides a place for Freedom (OEF), Operation Iraqi these fallen heroes, and it was peaceful remembrance and Freedom (OIF), and Operation truly a labor of love,” Krinsky a place of healing for family New Dawn (OND), a Memorial said. “Although just a few members and friends of those Wall has been constructed at volunteers made this happen, who were lost.” the Manchester VAMC for the it was a collaborative effort of families and friends of these Gold Star Families, volunteer Krinsky said, “The VAMC brave heroes. support, and donations.” made every effort to be inclusive rather than exclusive Debra Krinsky, Chief of The Memorial Wall currently in honoring our heroes. Voluntary Services said, “When consists of two rows of framed For example, not all of the you first walk through the photographs, one of each of the Veterans pictured were killed memorial, it is overwhelming. As 54 fallen warriors. According to in action. The bottom line you walk the hall and pass the Tammy Follensbee, Associate for us was that it was a loss. portraits of the fallen, over time Director of the Medical Center, We are helping their families you feel as though you get to “There is a purpose and plan process that loss.” know them. It is very powerful.” for the way they are presented, Stella Lareau, Public Affairs The Memorial Wall began as matted, and framed.” She said, a way for Gold Star Parents “All portraits are colored in Office for VAMC said, “The to honor their fallen soldiers sepia tone in order for them to best thing about the Wall is from recent wars. In 2009, stand united as brothers on the that people aren’t forgetting. Krinsky met a Vietnam Memorial Wall. For this reason, The mother of one Veteran Veteran who was passionately we did not include their branch whose picture is on the Wall committed to honoring the of the military or their rank. works at the hospital. Every fallen from OEF, OIF, and The portraits are arranged in day she goes to her son’s OND, and posted a picture of chronological order by the date of picture and tells him, ‘Good each in the hallway that leads death. The Wall’s location, in the morning.’ She knows her son to primary care. “It took two quiet central core hallway, just off won’t be forgotten.”

4 Veterans’ Healthy Living VA New England Healthcare System | Summer 2012

Debra Krinsky, Chief of Voluntary Services, and New Hampshire Governor John Lynch. “The mother of one Veteran whose picture on is on the wall works The Wall is open 24/7 so was vacant, but someone had at the hospital. Every it is accessible to family at come across all the letters on any time. It is very honoring George after his death — letters day she goes to her and speaks to what these from dignitaries to his mother son’s picture and tells Veterans have sacrificed.” along with George’s military him, ‘Good morning.’ photo. “The Veteran brought all “We still have 13 portraits that She knows her son of George’s belongings to us,” won’t be forgotten.” we’re missing,” Lareau added. Krinsky said. “I believe George “They’ll come, but they’ll wanted to be on the Wall with depend upon where the family his brothers. We are proud to is in the grief process. If more have him there.” names come to light, we will add them. We pray we don’t The public dedication of the need to add any more, but Memorial Wall was held during there’s room if we have to.” the National Salute to Veterans on February 14, 2011. Local Last December, during a media, politicians, Gold Star private viewing, Krinsky Family members, Governor said she was showing the Lynch, dignitaries from other Memorial Wall to a Veteran. service organizations, Veterans, There was an empty place VA employees, and the general for a fallen soldier named public attended. George Rowell. She said they had researched him but were A quote by New Hampshire unable to get any information native Daniel Webster hangs or pictures. The Veteran said, above the portraits, as moving “I believe I have a picture of as their service and sacrifice. George Rowell in my truck.” It reads, “…yet will their He explained that the home remembrance be as lasting Secretary of Veterans Affairs, George’s mother lived in as the land they honored.” Eric Shinsecki.

Thank you for your service. Now let us serve you. 5 Summer 2012 | VA New England Healthcare System

Framingham Save Haven A “Safe Haven” for All A new pilot program through the go and end up sleeping in cars, for its residents so the Veterans Bedford VA called Safe Haven on the street, or at area shelters. staying at the house can start was recently established to making better decisions about The primary goal of Safe ensure that Veterans who have their care and their lives,” Haven is simply to shelter these fallen on hard times will not said Chaplin. Improving Veterans who are at great risk. “fall through the cracks” of VA the quality of life for these The program has two separate housing programs. Veterans by encouraging them houses – one in Boston and one to take advantage of available The Veterans who participate in Framingham – and each have VA programs, as well as the in the program are mainly 10 rooms with one bed per room. resources within the community, “chronically homeless and Although Veterans have minimal is yet another key component of actively experiencing issues requirements to remain in the Safe Haven. with substance abuse or mental program, there are still guide- health disorders,” says Jim lines that must be followed. For While the goal for VA is to Chaplin, LICSW, VA liaison example, drug or alcohol pos- eliminate homelessness for our session and use on the premises country’s Veterans by 2015, for the Safe Haven program. is prohibited. Residents are also Chaplin said, “It’s a success to Many have not had success in required to meet with a case plant the seed and get them to traditional treatment programs manager every week to discuss think about making changes.” where, if a Veteran returns future housing goals. to substance abuse, they are For more information contact immediately discharged from “Safety is paramount and Safe Jim Chaplin by email at James. the program. Once released, Haven is tasked with providing [email protected] or by phone at they often have no place else to a safe and healthy environment 781-983-9207.

6 Veterans’ Healthy Living VA New England Healthcare System | Summer 2012

Palliative Care Research at White River Junction VAMC We’re With You Every Step of the Way!

When a patient receives the more serious illnesses, the focus “Palliative care is diagnosis of a chronic and/or is more on the quality of life, not part of good care. serious condition, the impact necessarily curative only.” can be overwhelming and A whole team of even devastating. Palliative White River Junction VAMC doctors, nurses, is under the umbrella of the care serves as a means to help nutritionists, cope with these emotionally Dartmouth Medical School distressing challenges. (now called Geisel School of social workers, and Medicine), and has been a part chaplains are all While hospice care is palliative of multiple research efforts involved, and they care, palliative care is not on the effects and benefits of hospice care. Palliative care is palliative care in conjunction provide an extra specialized medical care that with Dartmouth-Hitchcock layer of support.” helps patients and their families Medical Center. live as fully as possible when facing a life-threatening illness. The current study is researching Hospice focuses on patient care the most beneficial time to intro- in a person’s remaining days; duce palliative care. Dr. Lambert usually six months or less. related that multiple research Palliative care focuses on the studies have demonstrated patient’s needs as well as the that palliative care improves needs of their caregiver. It aims health care quality in three to address the patient as a whole areas: it relieves physical and person, attending to his or her emotional suffering; improves physical comfort, confidence, and strengthens the patient- emotional well-being, spirituality, physician communication and and dignity while dealing with a decision-making process; and it medical condition. assures coordinated continuity of care across multiple health- According to Dr. Lisa Lambert, care settings – hospital, home, Primary Investigator on hospice, and long-term care. Palliative Care Research at White River Junction Veterans “What’s exciting,” Dr. Lambert Affairs Medical Center (VAMC), says, “is that our research proves “Palliative care is part of good we have the ability and the tools care. A whole team of doctors, through palliative care to care for nurses, nutritionists, social the whole person and to improve workers, and chaplains are all the quality of life for both the involved, and they provide an patient and their caregiver.” extra layer of support.” She added, “In recent years there For more information on has been a movement toward palliative care at VISN 1, contact palliative care; as people get your local VAMC.

Thank you for your service. Now let us serve you. 7 PRST STD U.S. Postage PAID VISN 1 Communications Lansdale, PA Department of Veterans Affairs Permit 491 200 Springs Road Bedford, MA 01730

VERMONT Houlton Outreach Clinic Lynn CBOC Somersworth CBOC VA MEDICAL CENTERS White River Houlton Regional Hospital 225 Boston Street, Ste. 107 200 Route 108 Junction VAMC 20 Hartford Street Lynn, MA 01904 Somersworth, NH 03878 215 North Main Street Houlton, ME 04730 (781) 595-9818 (603) 624-4366, ext. 3199 CONNECTICUT (877) 421-8263, ext. 2000 (800) 892-8384, ext. 3199 White River Junction, New Bedford CBOC VA Connecticut VT 05009 Lewiston/Auburn CBOC 175 Elm Street Tilton CBOC Healthcare System (802) 295-9363 15 Challenger Drive New Bedford, MA 02740 630 Main Street, Ste. 400 Newington Campus Lewiston, ME 04240 (508) 994-0217 Tilton, NH 03276 (207) 623-8411 Ext. 4601 (603) 624-4366, ext. 3199 555 Willard Avenue COMMUNITY-BASED Pittsfield CBOC Newington, CT 06111 (877) 421-8263 Ext. 4601 73 Eagle Street (800) 892-8384, ext. 3199 (860) 666-6951 OUTPATIENT CLINICS Mobile Medical Unit Pittsfield, MA 01201 RHODE ISLAND West Haven Campus CONNECTICUT Main Street (413) 499-2672 950 Campbell Avenue Bingham, ME 04920 Middletown CBOC Danbury CBOC Quincy CBOC One Corporate Place West Haven, CT 06516 (866) 961-9263 114 Whitwell Street (203) 932-5711 7 Germantown Road Middletown, RI 02842 Danbury, CT 06810 Portland CBOC Quincy, MA 02169 (401) 847-6239 (203) 798-8422 144 Fore Street (617) 376-2010 MAINE Portland, ME 04101 Springfield CBOC VERMONT VA Maine New London CBOC (207) 771-3500 25 Bond Street Healthcare System 4 Shaw’s Cove, Suite 101 Bennington CBOC Springfield, MA 01104 1 VA Center New London, CT 06320 Rumford CBOC 186 North Street 431 Franklin Street (413) 731-6000 Augusta, ME 04330 (860) 437-3611 Bennington, VT 05201 Rumford, ME 04276 (207) 623-8411 Worcester CBOC (802) 447-6913 Stamford CBOC (207) 369-3200 (877) 421-8263 Stamford Health System 605 Lincoln Street Brattleboro CBOC 1275 Summer Street Saco CBOC Worcester, MA 01605 71 GSP Drive MASSACHUSETTS Stamford, CT 06905 655 Main Street (508) 856-0104 Brattleboro, VT 05301 Edith Nourse Rogers (203) 325-0649 Saco, ME 04072 (802) 251-2200 Memorial Veterans Hosp. (207) 294-3100 NEW HAMPSHIRE Waterbury CBOC Colchester CBOC 200 Springs Road Conway CBOC 95 Scovill Street 162 Hegeman Ave., Unit 100 Bedford, MA 01730 MASSACHUSETTS 71 Hobbs Street Waterbury, CT 06706 Colchester, VT 05446 (781) 687-2000 Causeway Street CBOC Conway, NH 03818 (802) 655-1356 (203) 465-5292 251 Causeway Street (603) 624-4366, ext. 3199 VA Boston Windham CBOC Boston, MA 02114 (800) 892-8384, ext. 3199 Newport Outpatient Clinic Healthcare System 96 Mansfield Street (617) 248-1000 1734 Crawford Farm Rd. Keene Outpatient Clinic Brockton Campus Willimantic, CT 06226 Newport, VT 05855 Fitchburg CBOC 640 Marlboro Street (802) 334-9700 940 Belmont Street (860) 450-7583 275 Nichols Road Keene, NH 03543 Brockton, MA 02301 Winsted CBOC Fitchburg, MA 01420 (802) 295-4900 Rutland CBOC (508) 583-4500 115 Spencer Street (978) 342-9781 232 West St. Littleton CBOC Jamaica Plain Campus Winsted, CT 06098 Rutland, VT 05701-2850 Framingham CBOC 658 Meadow Street, Ste. 4 (802) 772-2300 150 S. Huntington Avenue (860) 738-6985 61 Lincoln Street, Suite 112 Littleton, NH 03561 Boston, MA 02130 Framingham, MA 01702 (603) 444-1323 (617) 232-9500 MAINE (508) 628-0205 Portsmouth CBOC West Roxbury Campus Bangor CBOC 35 State Hospital Street Gloucester CBOC 302 Newmarket Street 1400 VFW Parkway 298 Washington Street Portsmouth, NH 03803 West Roxbury, MA 02132 Bangor, ME 04401 (207) 561-3600 Gloucester, MA 01930 (603) 624-4366, ext. 3199 (617) 323-7700 (978) 282-0676 (800) 892-8384, ext. 3199 VA Central Western MA Lincoln Outreach Clinic (Bangor Satellite Clinic) Greenfield CBOC Healthcare System 143 Munson Street 421 North Main Street 99 River Road Lincoln, ME 04457 Greenfield, MA 01301 Leeds, MA 01053 (413) 773-8428 (413) 584-4040 (207) 403-2000 Calais CBOC Haverhill CBOC NEW HAMPSHIRE 50 Union Street 108 Merrimack Street Manchester VAMC Calais, ME 04619 Haverhill, MA 01830 718 Smyth Road (207) 904-3700 (978) 372-5207 Manchester, NH 03104 Caribou CBOC Hyannis CBOC (603) 624-4366 163 Van Buren Road, Ste. 6 233 Stevens Street (800) 892-8384 Caribou, ME 04736 Hyannis, MA 02601 (508) 771-3190 WHERE TO RHODE ISLAND (207) 493-3800 Fort Kent Outreach Clinic Lowell CBOC Providence VAMC 130 Marshall Road FIND US 830 Chalkstone Avenue 3 Mountain View Drive Fort Kent, ME 04743 Lowell, MA 01852 Providence, RI 02908 (978) 671-9000 (401) 273-7100 (207) 834-1572 (866) 590-2976