You get to choose how you will handle MS.

World MS Day, 25 May 2016 - Logo

I Have MS but MS Does Not Have Me

Every day I wake up, just like everyone else, and see the sun shining and the birds chirping and have the promise of the entire day set before me – 24 hours, 1,440 minutes – just like everyone else. The only thing that makes my waking up a little different than your waking up is that “I have multiple sclerosis (MS), but MS does not have ME.” I believe in the poem “It Couldn’t Be Done” by Edgar Albert Guest…

Somebody said that it couldn’t be done
But he with a chuckle replied
That “maybe it couldn’t,” but he would be one
Who wouldn’t say so till he’d tried.

Capt. Philip White

Capt. Philip White

MS is just on the journey with me to do what is part of my DNA – teach, mentor, and lead. These three things have been part of my life career as a Retired Captain in the US Air Force and a community volunteer. You can do anything you set your mind to do and like any challenge, you get to decide every day how you will overcome the obstacle.

I have a “use it or lose it” philosophy about the cognitive and physical aspects of my disease. We all have a bank of mental and physical energy with which to get it done – and every day we get a new deposit to spend anew. Life with MS is a choice to be healthy and to choose how to spend my energy account. I have learned to listen to my body and know how to space out my activities to maximize my output for the results I seek to achieve, whether it is celebrating the centennial of my fraternity, Omega Psi Phi Fraternity, Inc., serving as the Gateway MS Ambassador, or giving out over 15,000 school bags to students in the St. Louis Public Schools, I choose how to maximize my energy resources.

I continue on and so can you

When I wake up and my body or my mind act like they want to hold me back, I remind them that I am directing this destiny and I do not say, “I can’t” because “can’t” only means “constant act of not trying.” I refuse to let that be a part of my life story. It may mean that I choose to do one or two things instead of the three or four that I might normally do, but I continue on and so can you. MS means “MOST STUFF” to me, that on most days I can do most things.

I refuse to let “can’t” be a part of my life story.

You have a choice, remember that, you did not choose MS, but you do get to choose how you will handle MS. Living with a chronic illness is only limiting if you believe “I can’t” instead of “I can.” You must monitor your energy level, think of your longevity, and keep your mind sharp. Read a book, go to museums, challenge yourself with a new task, eat a healthy diet, and exercise daily. I choose every day to put one foot in front of the other and use my 24 hours for the greatest good instead of allowing MS to stop me.

MS also challenges our cognitive abilities and I choose every day how to keep my mind sharp. I keep busy through volunteering with the Oasis Intergenerational Tutoring Reading Program, along with my work with the VA, and serving as the Upsilon Omega Foundation Vice President and the Omega Center Manager (community service center). As an active member of my fraternity, I was challenged in 2011 to plan a huge centennial conference in St. Louis, some thought it couldn’t be done, but “I DID IT!”

What can life with MS look like? It looks like a man who was Area Captain for four states and who traveled to make history. It looks like a man, for the second time, who donned a tuxedo to attend the inaugural balls for the nation’s re-elected first black president. It looks like a man sitting proudly in the blue section of the inaugural ceremony. It looks like a man who mentors through the Boys and Girls Club, who reads at Lexington Elementary School, and who recruits through Team 100. It looks like 1,440 minutes of “I CAN.”

Every new day is a new opportunity to be greater than your limitations. Remember, “I have MS, MS does not have me.”

About Captain White

Captain (Ret). Philip White is a native of St. Louis, MO. For 26 years he served proudly with the United States Air Force, stationed in several U.S. posts and countries including Korea, Japan, Philippines, and Germany. Following his retirement from military service, he returned to his teaching roots at Whitman Air Force Base, accepting a position as Director of Air Force Junior Reserve Officer Training Corps (AFJROTC). After retiring from his position as Director, he accepted a volunteer position as a member of Team 100, with Oasis Intergenerational Tutoring.

May 25 is World Multiple Sclerosis Awareness Day.

A day to celebrate global solidarity and hope for the future.

It brings the global MS community together to share stories, raise awareness and campaign for everyone affected by multiple sclerosis.

In 2016, the theme for World MS Day is ‘Independence’. It’s all about how people with MS can be independent.

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A Smart Home for Veterans with Brain Injuries

Fictional image of neurons of light firing in the brain

A Smart Home for Veterans with Brain Injuries

VA researchers are doing amazing things to improve the lives of Veterans.

Here’s just one example: the Smart Home. This unique project uses advanced technology to help patients with traumatic brain injury (TBI) independently plan, organize and complete everyday activities.

Some Veterans with TBI have lost the ability to manage basic tasks like doing the laundry or taking out the trash.

Smart Home has been described as a “cognitive prosthetic.”

VA’s Smart Home helps them relearn those skills by tracking their movements around their house and then sending them text or video prompts when they get off track. The remarkable indoor tracking technology can pinpoint the Veterans’ location to within six inches.

 Ben “Ty” Edwards and wife Anna Edwards

Ben “Ty” Edwards and wife Anna Edwards

The Tampa VA Medical Center has installed the high tech equipment in five apartments housing 10 Veterans. It has a system that not only tracks their locations but has sensors that monitor the use of appliances. For example, the washing machine sensors determine when the Veteran puts soap in the machine and also shows when he or she empties the machine after the load is completed. If the user forgets to do either, a nearby screen prompts them to complete those steps. The Smart Home can also notify a caregiver if an activity is not completed.

Other sensors in the bathroom determine how long a patient has been shaving and if they are taking too long, they are prompted to finish that task and move on.

The technology promotes Veterans’ independence by providing reminders for the management of other daily activities such as medication, meal planning, and other necessary tasks.

Smart Home has been described as a “cognitive prosthetic” with the goal of rehabilitating Veterans with TBI so they can function normally in society.

A powerful feature of the Tampa Smart Home is the precision of the customized therapeutic information that can be provided to the recovering Veteran. Data for every interaction with clinical and medical staff are recorded continuously and analyzed, helping the staff visualize subtle but therapeutically significant behavioral changes. Reports are sent back to the clinical team on a weekly basis

This helps to better inform treatment plans and potentially prevent problematic medication effects on Veterans’ memory, as well as gait and balance.

 Joseph “Pepper” Coulter and wife Jill Coulter

Joseph “Pepper” Coulter and wife Jill Coulter

A little more technical information? The Veteran patients and VA staff wear wrist tags linked to a real-time location system that tracks the tags using wall sensors. It’s ultra-wideband technology. The wrist tags broadcast their ID on a 6-to-8 gigahertz channel and uses time-delay-of-arrival and angle-of-arrival methods to determine position in three dimensions.

The Smart Home innovation recently received third place in VA’s Brain Trust summit. The national summit brought together the public and private sector, Veterans, caregivers, clinicians and innovators to tackle the issues of brain health.
Dr. Steven Scott, co-director of VA's Center of Innovation on Disability and Rehabilitation Research

One of the leaders of the project is Dr. Steven Scott, co-director of VA’s Center of Innovation on Disability and Rehabilitation Research and chief of physical medicine and rehabilitation at the James A. Haley Veterans Hospital in Tampa. Scott is a nationally known expert in the fields of physical medicine and rehabilitation with research expertise in polytrauma and traumatic brain injury. Much of his work focuses on the rehabilitation and reintegration of Veterans who have experienced blast-related injuries.

Advances like this are being celebrated this week, Research Week, at VA medical centers around the country.

Join us as we celebrate 91 years of research excellence and attend one of the many activities being conducted nationwide.

For more than 90 years, the VA’s Research and Development program has been improving the lives of Veterans and all Americans through health care discovery and innovation.

VA research is unique because of its focus on health issues that affect Veterans. The groundbreaking achievements of VA investigators—more than 60 percent of whom also provide direct patient care—have resulted in three Nobel prizes, seven Lasker awards, and numerous other national and international honors.


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GeriPACTs – Specialized Care for Older Veterans

Two male Veterans sitting with female VA Employee looking at a paper flyer

GeriPACTs – Specialized Care for Older Veterans

America is Getting Older – How is VA Responding?

The VA “has your six” – a military term that means I’ve got your back*.  Indeed, the VA has got the back of every Veteran who receives care at VA. Each one has a primary care provider, and that provider has a whole team working with them.

This team model of care is called PACT (Patient Aligned Care Team) and it provides continuous and coordinated care throughout a patient’s lifetime. Veterans receive primary care in PACT clinics, so you may know them by color names, like silver, or military alphabet names, like Bravo.

The fastest growing age group of Veterans VA serves is those age 65 and older. By 2017 almost 10 million of our 21.7 million Veterans (46%) will be over 65. VA is responding with PACT teams customized for older Veterans.

GeriPACTS – Customized Care for Older Veterans
A GeriPACT (Geriatric Patient Aligned Care Team) is a PACT team designed for our older and chronically ill Veterans – those who have complicated health problems made even more challenging by social factors and mental health issues. Watch this GeriPACT video to learn more.

The Veteran is at the center of his or her GeriPACT, which includes an “army” of health care providers from many disciplines.

The Veteran’s GeriPACT includes an “army” of health care providers.

Shared Decision Making for Long Term Services and Supports

Experts in the care of older adults – like the GeriPACT team – work together with Veterans to identify challenges that may be barriers to health, independence and quality of life. They ensure that Veterans and their families/caregivers are aware of and connected to the services and supports they need to maintain the Veteran’s independence and quality of life. This shared decision making process helps Veterans decide about the kinds of services and supports, such as Home and Community Based Services, that would best meet their needs and preferences, now and in the future. 

Visit for more information on Shared Decision Making and Long Term Services and Supports. 

Veterans Benefit from Shared Decisions and a Team Approach

Mr. Hastings, an Army Vietnam Veteran in Kentucky, explains, “Lori Paris, a social worker, visited me in the community hospital and talked with me about the full range of programs the VA had to offer and told me about what was available in my community.  One of the options she told me about was the Medical Foster Homes, so I drove out here to check it out and decided to stay!  This is my home now where I am happy and feel safe.”

Another Kentucky Veteran (Navy, WW II) and GeriPACT patient, Mr. Weyrauch, used the website and the Shared Decision Making Worksheet for Veterans and says, “This information has been helpful in helping me to talk with my Home Based Primary Care Team about my needs and to be aware of other programs that can help me.”  
Both Veterans are receiving care through GeriPACT.

GeriPACT – Moving Forward

VA’s Office of Geriatrics and Extended Care convened a three-day summit on GeriPACT in Albany New York March 15-17.  Over 120 VA physicians, nurses, nurse practitioners, social workers, pharmacists, and psychologists from all networks of VA shared their experiences, insights, challenges, and best practices to grow and improve GeriPACT. 

Summit attendee, LeAnn Bruce, LCSW, MVF-CSW Summit attendee, LeAnn Bruce, LCSW, MVF-CSW said, “Several sessions emphasized the value of shared decision making in support of the patient-aligned care model and illustrated what a good fit it is for GeriPACT and the Veterans it serves.  We use shared decision making across VISN 9 where I work, and hopefully it will be provided by your GeriPACT soon!”

* Basically means “I’ve got your back.” Comes from the old pilot system in which directions correspond to hours on the clock, where 12 o’clock is forward and 6 o’clock is behind. Thus anyone behind you is “at your six.”

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Women Vets and Violence

Image of an older woman and a younger woman sitting together at a table.

Paula Boothe (r) and Megan Brown, social work student at West Virginia University, part of the Intimate Partner Violence Assistance Team at the Beckley VA.

Every nine seconds a woman is battered in the United States, according to the American Medical Association.

“That’s a staggering number,” said Paula Boothe, a social worker at the VA Medical Center in Beckley, W.Va. “Most people aren’t aware of how big a problem this really is.”

Particularly Bad

Boothe runs the Intimate Partner Violence Assistance Program at Beckley — a program that sprang into existence less than a year ago.

“We felt there was a real need for something like this,” Boothe said. “Intimate partner violence is a serious problem throughout the country, but here in West Virginia it’s particularly bad. We rank 13th in the Nation for domestic homicide and suicide events. That’s depressing. It’s also unnecessary, because there’s something we can do about it.”

Boothe said emergency room personnel at the Beckley VA are now attempting to screen all their female patients for signs of domestic violence.

“Here at the VA we want to treat the whole person,” she said. “So if you come into our emergency room with a broken nose or a black eye, we’re going to treat you. But we’re also going to bring up the subject of domestic violence with you. If you’re in a bad situation at home, we want you to know we’re here to help, that you don’t have to keep on enduring what you’re enduring.”

“You have to believe that you’re strong enough to leave.”

Troubled Waters

Boothe noted that an abusive relationship can be the root cause of numerous other health issues for a woman, not just broken bones or a swollen lip.

“A woman who’s being routinely abused, physically or verbally, is in a state of constant anxiety and stress,” she explained. “She might develop high blood pressure, or a stomach ulcer. She might develop mental health problems. She’s a candidate for all kinds of trouble.”

So, if you tell someone at the Beckley VA that you’re in a physically abusive relationship, what happens next?

“We’ll hook you up with a social worker here,” Boothe explained. “Someone you can talk to, someone you can trust, someone who can explain your options to you. And there are always options.”

She added: “If you tell us you feel like you’re in imminent danger, that you don’t want to go home again, we’ll find a place for you to stay. There are several local and state organizations we partner with in the area, including the Women’s Resource Center here in Beckley and the Family Refuge Center over in Lewisburg. These folks provide food, shelter, clothing, employment assistance and a bunch of other services for abused women who are trying to start their lives over.”

She continued: “Women need to know there’s all kinds of help just a phone call away. Just pick up the phone, or walk into a VA hospital, clinic or Vet Center and ask for help. Because you’re not alone. You may feel like you’re alone, but you’re not.”

Over 40 percent of victims of severe physical violence are men. – CDC

Sticking Around

Boothe, a victim of domestic violence herself, said a lot of people can’t comprehend how an abused woman can opt to stay trapped in a relationship with a violent partner.

“People will ask you, ‘How do you put up with that? Why don’t you just leave?’” she observed. “Sadly, there are lots of reasons a woman sticks around, even though she’s being beaten. One big reason is fear. You’re afraid that if you leave, he’ll get even angrier than he already is; that he’ll find you and kill you. I sort of felt like that when I was in this situation. I said to myself, ‘He’s going to kill me if I leave.’ Then one day I realized he was going to kill me if I stayed.”

Women will also remain in an abusive relationship because they feel they have no place else to go, according to Boothe.

“They’re isolated,” she explained. “Their self-esteem has been battered into the ground. They have no job, no money of their own. They’re afraid that if they leave they’ll be homeless. A lot of them don’t leave because they feel like they’ll lose their kids. There are a ton of reasons a woman will stay in a very bad situation and just try to ride things out, day by day. Fear, hopelessness and despair can immobilize you.”

Saving Yourself

Boothe said it’s her job to assure a woman that she is stronger than she realizes, that somewhere inside her she has the courage to start over.

“We can’t make you leave someone who’s abusing you,” she said. “You have to want to leave. You have to want to save yourself. We can give you support and encouragement, but you’re the one who has to make the decision to take back your life.”

Boothe said that, on average, a woman will leave an abusive relationship and then return to it about seven times before finally leaving for good.

“A big life change like this often doesn’t happen overnight,” she said. “Sometimes it does, but usually it’s more of a process. We just want you to know that when you’re ready to make that change, we’ll be here for you. We want you to know you deserve a better life.”

To learn more about Intimate Partner Violence and where to turn for help, visit or VA’s National Center for PTSD at


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Sharing Advantages of VA Home Based Care

A doctor visits a patient in his home and takes his hand.

Dr. Milton Havron treats a Veteran patient in his home.

“How inconvenient and needlessly expensive it is for a chronically ill patient who cannot walk to be brought to a clinic by an ambulance crew.

“How much more sense it makes for medical people to go to them. In the patient’s home I am in their milieu, and can better understand how they cope with their illness day to day.“

Dr. Milton Havron is describing VA’s Home Based Primary Care program. He is the director of the program at the Martinsburg, WV, VA Medical Center. And one of VA’s proudest proponents of the program.

“In the patient’s home I can better understand how they cope.”

In a recent letter to the Washington Post, Dr. Havron agreed with a doctor who says “In today’s corporatized, professionally fragmented medical landscape, it is almost impossible for a primary-care doctor to take the time to truly connect with patients and their families.” Dr. Havron’s friendly rejoinder was, “I am blessed, however, to work in a setting that allows just that: the Veterans Health Administration.”

Home based primary care (HBPC), pioneered in the VA system in the mid-1970s, started with a few major centers. Today it has expanded to about 150 programs at VA centers around the country.

It is designed to take care of patients with serious chronic illnesses for whom routine clinic-based care is difficult to get due to geographic barriers or severe physical disability.

HBPC Allows Time for Comprehensive Assessment

As Dr. Havron describes HBPC, “I can spend time getting to know their principal caretakers. I can spot things going on in their homes which may impede their progress. The design of VA’s HBPC program allows me and my staff time to do a comprehensive assessment which is very difficult in the private sector due to time pressure.

“HBPC also serves as an alternative to institutionalized assisted living, allowing the infirm Veteran to stay home. Without regular easily accessible medical care, many of these frail patients will get sick and get admitted to the hospital for prolonged stays.

“While HBPC cannot prevent all such hospitalizations, the statistics tell the story that patients admitted to VA HBPC programs have fewer and shorter hospitalizations, saving on inpatient expenses and sparing the patient much suffering and inconvenience.”

Dr. Havron says that there are many HBPC medical directors around the country doing the same thing he does. “HBPC is a team concept with multiple players, from our head of geriatrics Dr. Elisabeth Sethi, to the midlevels, the RNs, the allied professionals, and our staff.”

Dr. Sethi points out that, “Under Dr. Havron’s leadership, our HBPC program has been one of the fastest growing nationally, supported by VHA rural health grants, by our facility and the VISN (Veterans Integrated Service Network).”

Services Provided to Veterans in Their Homes

HBPC programs generally offer these core services to patients in their homes:

  • A medical provider (physician, nurse-practitioner, or physician assistant) to take a history, examine the patient and prescribe a course of treatment
  • a registered nurse to act as the provider’s eyes and ears in between provider visits
  • a psychologist if counseling is required
  • a social worker to untie many a bureaucratic knot
  • a pharmacist to help providers prescribe medications in the safest and most effective way
  • a physical or occupational therapist to check the home for safety and prescribe exercises for musculoskeletal ailments.

Dr. Thomas Edes, Executive Director of VA’s Geriatrics & Extended Care Clinical Operations, adds, “HBPC is an important part of the future of health care, demonstrating that for those who have the greatest need for frequent care yet face the greatest challenges in access to care, we can increase access, improve quality, and lower total costs of care. The success of VA HBPC contributed to the successful implementation of the Medicare demonstration of HBPC called “Independence at Home.”

“Proud that VA has been a leader”

HBPC also works alongside home hospice services for terminal patients and with specialized home care nurses providing wound care or short-term intravenous drug therapy in the home.

In recent years VA has also been developing telemedicine as a way to bring at-home patients and specialist doctors together.

Home-based primary-care programs can be a refuge where doctors, and their nurse-practitioner and physician-assistant colleagues, can practice traditional personalized medicine while enjoying the benefits of modern communications technology.

“I am proud that the VA has been a leader in this concept,” he said.

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Surgical Implant Prosthesis for Veteran Amputees

Black and white image of Veteran Patient standing with a implanted prosthetic, a close up of the legs and wheel chair.

The muscle grows stronger as the rod fuses with the bone

A giant step in the next generation of prostheses for Veteran amputees

Researchers and physicians hold their collective breath as Veteran Ed Salau clicks his new prosthetic leg into place and stands on it for the first time.
“Oh my gosh, I can’t believe this day is here, it’s so surreal, I have goosebumps,” says Dr. Sarina Sinclair, a key researcher on the team.

And then fist pumps all around as Ed jokes about the Hokey Pokey dance being a whole lot easier now.

In 2004, Salau’s platoon was ambushed by the enemy while out on patrol in Iraq. Two rocket propelled grenades penetrated his patrol vehicle and his left leg was so badly damaged it later had to be amputated just above the knee.

“It’s so weird. I can feel the ground again. I haven’t had that sensation in eleven years,” said Salau.

“It’s perfect. I’m stoked”

Male Veteran with prothesis implant

What started as scribbled ideas on posted notes all over the wall of a research lab is now a reality that could impact the lives of these two Veterans and countless others in the future.

Leg is attached without a socket

The device is called a percutaneous osseointegrated prosthesis or POP. It features a titanium rod surgically implanted into the bottom of the thigh bone. The rod allows a prosthetic leg to be securely attached without the need for a socket.

This team has worked years to get to this day. Peter Beck, an attending orthopedic surgeon for VA and an adjunct professor for the University of Utah, has been invested for over a decade. He says the big barrier for years was preventing infection and perfecting the surgical procedures for inserting the rod into the femur bone.

“Bryant, you’re up.” Says Bart Gillespie, VA Salt Lake City physical therapist.

Veteran Bryant Jacobs was also injured in Iraq in 2004.

He sees himself as a trailblazer willing to take this risk for other Veterans that may follow. He wife is right by his side as he stands on the POP for the first time.

“It’s perfect. That’s what we want. I’m stoked”

Bryant wants to be able to use the rowing machine without a prosthetic sleeve jabbing him in the groin. He also wants to snowboard again in the Utah mountains. After voluntarily having his leg amputated two years ago, Bryant begged to be a part of the clinical study.

“I’m really excited. This is going to be a game changer for him,” said Gillespie.

Ed hopes to be able to climb Kilimanjaro one day, but in the near future, a long walk on the beach with his wife is a good start.


A Male Veteran patient wearing a hat and standing with a prosthetic implant

The pair is the first ever in the United States to receive the POP implant. Their first surgery was on December 7, 2015, to insert the metal rod. In a follow-up procedure on Feb. 8, 2016, doctors attached a docking mechanism, extending from the implanted rod and through the skin, to which the leg is attached.

Veterans enjoying fit and comfort

Both Veterans are already raving about the comfort and fit of the new device. Initial first steps have now become longer stretches of walking and stair climbing. Each day the muscle grows stronger as the rod fuses with the bone, and each day the Veterans feel a little more confident and comfortable with their new legs.

But researchers and physicians warn this is just the beginning of a long process and there may be more barriers to overcome along the way. “As researchers we are anxious to gather our results and allow for future improvements. The thing about research is we don’t have all of the answers when we start,” says Dr. Larry Meyer, Director of Research, VA Salt Lake City Health Care System.

This is a VA-funded clinical trial, approved by the Food and Drug Administration. It will assess the feasibility and safety of the new implant in ten VA patients over the course of several years. It could be five years or more before the technology is widely available.

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Marking 70 Years of Volunteers Serving Veterans

Voluntary Services Logo Celebrating their 70th Anniversary

“Even if it’s a little thing, do something for those who have need of help, something for which you get no pay but the privilege of doing it.” —Albert Schweitzer

National Volunteer Week, April 10-16, is a great time to showcase the impact and power that VA volunteers have on those they serve.

VA Voluntary Service is celebrating 70 years of Volunteer support and philanthropic donations to VA facilities this year. It is through the sincere dedication of volunteers and trusted partnerships that allow us to live up to the VHA mission of “Honoring Service and Empowering Health” of Veteran patients nationwide.

Personal contributions of time and expressions of care are the hallmark and the foundation of VA Voluntary Service. VA volunteers epitomize the one-to-one sharing and caring that is a core value of our Nation. Last year, over 76,000 VA volunteers gladly gave more than 11 million hours of service to Veterans.

Three generations of Volunteers.

The human connection is essential to providing great clinical care. Without volunteers, the quality of VA services and programs would be lessened.

Our volunteers do the endless list of jobs that are necessary in caring for Veterans. Some of our volunteers even blaze their own paths, using their unique skills and creative vision to find new ways to thank Veterans.

Our volunteers do what it takes to make their heroes feel at home.

A Veteran Patient work with a member of Voluntary Services

Voluntary Services, helping Veterans.

Our volunteers do what it takes to make their heroes feel at home. They read to patients, provide recreation transportation, entertainment and training. They offer respite for caregivers, coaching and friendship. Sometimes the value of a volunteer is as simple as the offer of a sympathetic ear.

Award-winning actor Gary Sinise asks “What will you do?”

VA’s Voluntary Service Office Director, Sabrina Clark, adds that, “The volunteer’s personal dimension of kindness and concern goes to the heart of VA health care. We are blessed to have volunteers who make life better for those who gave selflessly of themselves. As we treat increasing numbers of Veterans at VA, our reliance on community support and involvement continues to grow.”

A new generation of proud, young American fighting men and women is serving and sacrificing for freedom around the world, and they are coming to VA medical facilities like ours for care. Their special needs and challenges require the hearts and hands of a new generation of VA volunteers.

Hear stories from VA Volunteers and patients.

VA’s Voluntary Service program is a key link between Veterans who seek care with VA and their communities. It is an avenue through which every citizen and organization can show our Veterans, young and old, that America cares and remembers.

Find out how you can volunteer.

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Occupational Therapists in Home Based Primary Care

A man in a wheelchair shows a wooden dollhouse to another man.

David Benthall, OT, visits with Veteran proudly demonstrating woodworking project. Benthall assisted with proper lighting and adaptive visual aids needed for the project.

Here’s another positive way teams of VA health care professionals are taking care of a special group of Veterans. And VA’s occupational therapists are key members of those teams.

It’s Home Based Primary Care (HBPC) which is a VA health care program provided to Veterans in their home, Veterans who have complex health care needs for whom routine clinic-based care is not effective.

The HBPC team at the Durham VA Medical Center in North Carolina is comprised of physician, physician assistant/nurse practitioner, social worker, occupational/physical therapy team, pharmacist, dietitian, psychologist and access to chaplain services.

April is Occupational Therapy Month

April is Occupational Therapy Month, an opportunity to learn more about this important profession that helps Veterans across the lifespan do the things they want to do and live life to its fullest.

Occupational therapists focus on “doing,” using occupations and meaningful life activities to help individuals maximize their potential.

Today, comprehensive primary care requires a coordinated team-based approach that promotes shared decision-making, sustained relationships with patients and families, and quality improvement activities.

In contrast to services reimbursed by other funding mechanisms such as Medicare, HBPC provides comprehensive care of the patient often for the remainder of their life.

HBPC targets frail, chronically ill Veterans who require interdisciplinary health care teams, continuity, coordination of care, and the integration of diverse services to cover their complex medical, social, rehabilitative, and behavioral care needs.

To manage the complex health problems of chronically or terminally ill patients, HBPC is provided directly by an interdisciplinary team.

This team promotes collaboration and coordination among all team members. The HBPC team members work interdependently in assessing, planning, problem solving, and decision-making to meet the complex needs of Veterans.

The Role of Occupational Therapy

The use of Occupational Therapy within the Home Based Primary Care at the Durham VA Medical Center is a non-traditional approach for the use of OT services with a proactive focus on prevention, education and wellness. This contrasts from traditional home therapy services which have a short-term, rehabilitative or restorative focus.

Occupational Therapists contribute to the team by performing the initial and ongoing assessments of the Veteran’s functional status in the home environment. This allows them to monitor and support clients as they go through the natural aging process and into the end-of-life.

A Veteran in a wheelchair poses next to an accessible ramp to his house

Jim Mathues, OT, coordinated a Home Depot Grant project to improve accessibility in the home of this Veteran who had been limited to living in his basement due to environmental barriers but now can enjoy his upstairs patio with door widening and ramp installation.

Occupational Therapists also evaluate the Veteran’s home for safety and structural modifications needed to make the home environment safe and accessible, including adaptive equipment needs.

Occupational Therapists maximize function and safety in the home environment supporting Veterans’ goal to remain in their home during the aging process.

Important Interventions

Other important interventions include helping with lifestyle modification to minimize the impacts of chronic conditions such as chronic obstructive pulmonary disease, diabetes and dementia. They also focus on safety and falls prevention within the home environment.

There are numerous other unseen tasks involving a lot of important details such as educating the Veteran and their families about access to VA or community resources including grants to assist with modifying their home and automobile for accessibility, home repair resources and community transportation options.

As the largest health care system in the nation, VA is the single largest employer of occupational therapists, whose primary goal is to help Veterans optimize their functional performance in areas that are meaningful to their lives.

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VA Honors Vietnam Vets for Service and Sacrifice

A man captures a pencil rubbing of a Servicemember's name engraved on the Vietnam Wall

A man captures a pencil rubbing of a Servicemember’s name engraved on the Vietnam Wall.

It’s time for Americans to show their appreciation to those who served, especially those who continued to sacrifice long after the war ended.

As part of the 50th Commemoration of the Vietnam War, VA and 29 states and territories are marking the anniversary of the final withdrawal of U.S. troops from Vietnam with a day of appreciation celebrated on March 29.

“Our nation’s Vietnam War Commemoration is a long-overdue opportunity for all Americans to recognize, honor, and thank our Vietnam Veterans and their families for their service during one of America’s longest wars.”

—Robert A. McDonald
Secretary, Department of Veterans Affairs

Across America today, March 29, Vietnam Veterans Day, VA medical centers and other facilities will be saying “Thank You” to millions of Vietnam Veterans for their sacrifice on behalf of the United States and will thank and honor the families of these Veterans.

Philadelphia VA Medical Center

The VA medical center in Philadelphia is named the Corporal Michael J. Crescenz VA Medical Center. Corporal Crescenz is the only Vietnam-era serviceman from the Philadelphia area to receive the Medal of Honor.

Dr. Himanshu Singh, Acting Director is sending a letter to all Vietnam Veterans enrolled at the Aleda E. Lutz Medical Center in Saginaw, Mich., which says in part, “Many of you never received a thank you when you were discharged from active duty. We want to take this opportunity to thank you for your commitment and sacrifice. Your dedication to serving when your country called on you will never be forgotten.”

Bronze sculpture of a soldier seated

Bronze sculpture of Pfc. Dennis Lee Lobbezoo.

The Ralph H. Johnson VA Medical Center in Charleston, S.C., is named after a Vietnam Veteran who posthumously was awarded the Congressional Medal of Honor. Read his story here. The medical center also honors Pfc. Dennis Lee Lobbezoo, a young Marine who lost his life in 1968 during the Vietnam War, with the statue pictured above. The sculpture was created by Vietnam Veteran Dr. Edward Byrd.

Military and VA officials present Veterans with recognition pins.

Lt. Col. Nathan Molica of the U.S. Army Corps of Engineers and Charleston, S.C. VA Medical Center Director Scott Isaacks recognize Vietnam Veterans.

The Ralph H. Johnson VA Medical Center also handed out special Vietnam 50th Commemorative lapel pins to Veterans who served in Vietnam. Medical Center Director Scott Isaacks and Lt. Col. Nathan Molica, Deputy Commander of the US Army Corps of Engineers Charleston District, presented the pins.

Michael J. Fitzmaurice

Michael J. Fitzmaurice, retired plumber at the Sioux Falls VA Medical Center, is South Dakota’s only surviving Congressional Medal of Honor recipient. Vietnam Army Veteran Fitzmaurice served other Veterans as a VA plumber from 1987-2011. A humble man, he never mentioned that he earned America’s highest award for valor for his heroic actions at Khe Sanh, Republic of Vietnam in 1971. Read his story here.

Columbus Tyson

Want to know what it was like to serve in Vietnam? Read a dramatic diary of a Veteran who was there. Take a few minutes and read this extended account by Columbus Tyson, an Environmental Management worker at VA’s Brooklyn Campus.

Servicemember Sam Powell receives a medal in military uniform

The Martinsburg, W.V., VA Medical Center shared this photo of VA employee Sam Powell receiving an Arcom Medal for finding a well-hidden major VC base camp on aerial photography. They will be displaying more photos of Vietnam Veterans during their welcome home event on March 29.

Dr. John David Berryman at the Vietnam Veterans Memorial

Dr. John David Berryman pauses at the Vietnam Veterans Memorial on the grounds of the Beckley, W.V., VA Medical Center. Berryman, Beckley Chief of Staff, is a Navy Veteran who served as a Surgical Medical Officer in Vietnam for two tours (1965 to 1971).

Check with your local VA facility for events near you.

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Veterans with Epilepsy: You are not alone

A Veteran being treated by his VA doctor

Dr. W. Curt LaFrance Jr., principal investigator for a pilot study of Veterans with epileptic seizures at the Providence VA Medical Center, conducts a finger-tapping exercise with Veteran Ernest J. Avery as part of an exam at the Providence VA Medical Center. Avery served in Operation Enduring Freedom.

Photo by Winfield Danielson

VA Releases Video Series on Veterans with Epilepsy

In an effort to address the stigma of epilepsy and educate Veterans, their caregivers and the general public about living with epilepsy, VA Epilepsy Centers of Excellence have developed a video series titled “Veterans and Epilepsy: Basic Training.”

The video, now available on YouTube, focuses on the diagnosis of epilepsy. Subsequent videos will include topics such as, epilepsy medications, social issues faced by individuals living with epilepsy, seizure first aid, and traumatic brain injury (TBI). The goal is to promote public awareness of the impact of epilepsy on the lives of Veterans and show that these patients are able to live full, productive and successful lives.

“There is a culture of stoicism in the military, which prevents Veterans with epilepsy from reaching out to get more information about their epilepsy. Hopefully these videos will show Veterans and all individuals living with epilepsy they are not alone,” said Stephanie Chen, epilepsy nurse practitioner with the San Francisco VA Medical Center.

“I’m not a quitter,” says Veteran Matthew in epilepsy video.

Many consider traumatic brain injury, or TBI, to be the signature injury of the wars in Iraq and Afghanistan. According to the Department of Defense, 333,169 U.S. military Service members have been diagnosed with TBI since 2000, and the number is growing. In addition to symptoms such as memory problems, depression and posttraumatic stress disorder (PTSD), Servicemembers and Veterans with TBI are at greater risk for seizures and epilepsy.

“Veterans present unique challenges because their seizure-related psychosocial difficulties are often amplified by posttraumatic stress disorder and traumatic brain injury,” said Dr. W. Curt LaFrance Jr., principle investigator for a pilot study of Veterans with epileptic seizures at the Providence VA Medical Center. “Among our goals of caring for Veterans with epilepsy is developing effective treatments for these psychosocial comorbidities.”

Therapy Results in Improvement in Quality of Life

The Providence VAMC has been using a 12-session seizure therapy intervention in Veteran patients with non-epileptic seizures and with epilepsy, which resulted in a reduction in seizures, improvement in anxiety and depression, and improvement in quality of life. The treatment has been used successfully for epilepsy in non-Veterans in prior pilot trials at other facilities.

A grant from the Matty Fund, a Rhode Island-based nonprofit, in April 2015 is helping bridge treatments, research, training and education by supporting a Brown University student who worked with the study. This support is facilitating the Providence VAMC in providing seizure therapy for 20 Veterans with epilepsy in the pilot study. The Veterans will continue with existing treatment with their current care providers. Some will receive the additional seizure therapy provided as part of the study in order to compare a cognitive behavioral-informed psychotherapy with standard medical care by assessing seizures, co-morbid symptoms, quality of life and functioning.

To meet the needs of Veteran patients nationwide, VA created Epilepsy Centers of Excellence, or ECOEs, at 16 sites across the VA health care system, which are linked to four regional centers. The ECOEs strive to ensure high-quality care for Veterans with seizures, and conduct outreach, research and education efforts.

Veterans with seizures interested in seeking services at one of the ECOEs should speak with their primary care provider or neurologist who can help determine if the individual might benefit from the services provided by an ECOE, and assist with scheduling an appointment. For more information, please email or visit

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