Developed in collaboration between We Honor Veterans and the Department of Veteran Affairs (VA), the Community Nursing Home Initiative (CNHI) pilot program’s goal is to improve hospice care for terminally-ill Veterans in VA-contracted community nursing homes (CNH) by engaging hospice partners to provide targeted training to facility staff on caring for Veterans at the end of life. As part of this initiative, five training modules were developed and presented to CNH staff. These modules provided education to facility staff on caring for Veteran residents, identifying and addressing suffering and trauma, providing support in a Veterans’ final hours, and hosting ceremonies to honor Veteran residents.
WesleyLife Hospice, a Level 4 WHV hospice partner, demonstrates their unwavering commitment to Veterans at end of life through their active participation in WHV and the Community Nursing Home Initiative (CNHI). WesleyLife began its involvement with WHV in 2014. As a Level 4 partner, this Iowa-based hospice has taken part in numerous Veteran-centric program requirements including staff education, implementation of Veteran-specific intake and screening procedures, Veteran hospice volunteer recruitment, and community partner engagement. Through their involvement as a WHV partner and their participation in the CNHI, WesleyLife has impacted the lives of countless Veterans and their families.
The training modules developed as part of the CNHI are available for use by all WHV partners. Through conversations between WHV and WesleyLife, a number of insightful lessons were learned from this pilot program that can inform future WHV hospice partners who wish to integrate the five training modules to provide education to CNH’s on caring for Veterans at end-of-life. Best practices identified by the CNHI include:
Who benefits most from this training?
Given nursing assistants spend the most time delivering hands-on care to Veterans in nursing home settings, the CNHI training modules are most valuable for nursing assistant employees of the CNH facility team. While CNH staff schedules and turnover can make training attendance challenging, supportive facility administration is key to overcoming staffing barriers. Additionally, hospice partners who choose to integrate these modules into CNH education in the future, might consider offering trainings in flexible and accessible formats to increase facility employee participation.
How should these trainings be delivered?
Optimally, the five training modules should be delivered by a community hospice facilitator who is trained and knowledgeable about the delivery of hospice care in nursing facilities. Trainings scheduled in short, frequent intervals are best for meeting the needs of CNH staff.
Realizing the challenges of bringing nursing facility staff together for in-person trainings, WHV hospice providers integrating these modules into CNH education in the future may choose to offer a virtual, asynchronous option. Including pre and post testing to ascertain the impact of these trainings on CNH staff is imperative. Additionally, providers wishing to integrate these trainings in the future may consider combining virtual training completion with in-person debriefing sessions with the community hospice facilitator. This has the potential to provide a more in-depth review of the material as well as support for nursing staff in delivering this often emotionally sensitive care.
What benefits did these trainings produce?
Following their participation in the CNHI trainings, CNH staff reported improved effectiveness with the following skills:
- Using non-drug therapies for common end-of-life symptoms
- Honoring Veteran residents with special ceremonies
- Caring for Veterans from different cultural groups
- Coping with resident-family conflicts about end-of-life care
- Meeting providers’ own self-care needs when working with residents at the end of life
As a WHV partner, utilizing these best practices to provide education to CNH’s on Veteran-centric end of life care can help your organization complete your community engagement requirement to earn your next WHV Level!
Interested in learning more about the VA’s research into the difference in hospice care quality for Veterans in VA-contracted nursing homes versus VA community living center? Check out the WHV Webinar: Comparing Quality of Hospice Care in VA Nursing Homes and VA-Paid Community Nursing Homes.
