I consider myself blessed to be able to do what I do every day. I am a social worker with the VA's Home-Based Primary Care based in Tampa, Florida. Our team, unlike many community home care programs, sees our veterans in the home to provide primary care. We do not have a limit on the length of time we can see our veterans. Some of our veterans have been with our program for more than 10 years. As the social worker, I complete an initial psychosocial assessment on my first home visit. This assessment requires asking many personal questions about areas of the veteran's life that most people are not comfortable talking about, especially questions posed by a stranger coming into their home. I've had to learn a unique style of my own to very quickly establish rapport, gain trust, and assess for needs. It does not hurt that I am a born and bred Southerner from Louisiana. Often I revert to my southern, down-home Cajun roots to do this. It also doesn't hurt that I am the granddaughter, daughter, daughter-in-law, and wife of veterans. Gaining rapport and establishing trust quickly comes from being focused on the other person, not on one's self. I listen to content and context of the information/stories told to me. I'm always listening for the story behind the story, what many healthcare professionals miss. This usually occurs because they are task oriented and just wanting to "check" the task off the list. Listening without judging a person gains trust and rapport. It has taken years of experience and maturity to accomplish this task effectively.
Recently, I was at the home of a veteran and his wife. This veteran suffers from the early stages of Alzheimer's-type dementia. While asking him and his spouse questions, it became apparent that this veteran had lost many of his social skills/graces. In order to gain my attention if I was speaking with the spouse, he would yell "hey, hey" until I acknowledged him. Part of my assessment is to complete a memory screen. I asked him if he would write a sentence, any sentence at all. His sentence was, "You sure do ask a lot of nosy questions." He clearly verbalized what I believe many people just quietly think!!
As most of us who practice in home care know, there isn't much that would surprise us anymore. I have made it my goal to attempt to learn the story behind the story with each veteran and family. This isn't always easy to do but can be very rewarding.
One of my 80+ year-old veterans lives alone and has lost his wife and daughter. He's on the verge of requiring another level of care as he grows frailer by the day. What he doesn't tell you, until you get to know him better, is that he was in the first wave of troops in Normandy on D-Day. All of his buddies were killed before his eyes. His grandmother had a prayer cloth blessed by the Pope before he went overseas. He took it with him and to this day still has it. He believes that is what saved him.
One of my veterans was at Ground Zero of Nagasaki 2 weeks after the bomb was dropped and later was on the floor of the Nevada desert during the atomic bomb testing. What he doesn't tell you until you know him better is how his wife died very suddenly and how much he still misses her 20 years later.
One of my African American veterans was a sergeant in the US Army in WWII and knew the ugly side of prejudice. What he doesn't tell you until later is how he drove with the legendary Red Ball Express during the war, bringing needed supplies to the front. He is married to a Women's Army Corps (WAC) member he met in the war. Later in their life, they both have been active in the local National Association for the Advancement of Colored People (NAACP).
Service to country was and still is meaningful to our veterans. Taking the time to listen is the greatest form of caring. It is an honor and privilege for our interdisciplinary team to serve these veterans today.