Tips for Supporting a Veteran at the End of Life

 In General

On a recent interview for End-of-Life University Podcast, Qwynn Galloway-Salazar, an end-of-life doula who specializes in veteran care, spoke about the unique needs of those who have served in the military as they enter hospice care. A veteran herself with a PhD in Industrial and Organizational Psychology and Masters Degree in Professional Counseling, Galloway-Salazar points out that the end-of-life care offered to veterans often falls short of their needs, primarily because those who have not served in the military are unaware of the challenges that are common during that experience.

Galloway-Salazar shares these suggestions for working with veterans in all aspects of healthcare, but particularly as they approach the end of life:

Ask questions about military service

Some veterans want and need to talk about their experiences and others prefer to remain silent. Ask questions about branch of service, which conflict they encountered, and if their service was in combat or non-combat to gain an understanding of their history, but be respectful if they choose not to share stories of their military experiences.

Screen for mental health issues

Veterans are at greater risk for depression, anxiety, substance abuse, suicidal ideation and moral injury so be sure to ask about past mental health history, including post-traumatic stress. Some of the suicide deaths that occur every day for veterans and military personnel in this country could undoubtedly be prevented if better screening were done and these difficult conversations were initiated.

Be aware of stoicism when assessing symptoms

In the military culture pain and fear are viewed as signs of weakness so some veterans may be reluctant to talk about their symptoms. They may receive inadequate pain management if providers don’t recognize this possibility and provide simple tools for symptom evaluation. Using a pain scale and mentioning that pain is a common and expected experience for certain illnesses can help veterans be more open about reporting their symptoms.

Be sensitive to shame and survivor’s guilt as potential negative emotions

Some veterans may withdraw and refuse help when it is offered because they suffer from shame and guilt following their combat experiences. Addressing these emotions openly by providing a safe, non-judgmental space for expression can lead to healing and self-forgiveness. Also family members need help understanding that they may be pushed away because of these negative emotions when they offer assistance to a veteran.

Build trust by utilizing veterans as volunteers

Military service is a unique experience that only another veteran can truly understand. Recruit and train veterans as volunteers who can sit with veteran patients, peer-to-peer, in order to foster greater trust and a feeling of safety when working with your hospice team.

Offer trauma-informed care

Recognize that military service can be traumatic for all who take part but women and LGBTQ+ veterans may have experienced additional trauma and assault during their time of service. Be sensitive to the fact that “non-traditional” veterans may feel invisible and excluded from the care that others receive. Maintain a safe environment for them, be mindful of physical touch that might be triggering, and be fully present and authentic as you offer care.

Practice self-care to avoid secondary trauma

Working with and hearing the stories of veterans can be traumatic for providers so remember to look after yourself. Find support when needed and have compassion for yourself when you feel overwhelmed and don’t know how to help the person you are caring for.

As a hospice volunteer and end-of-life doula, Qwynn Galloway-Salazar has seen firsthand that veterans have a better end-of-life experience when care providers are well-informed and sensitive to their needs. On this Veterans Day may we commit to better serve those who have made sacrifices for our freedom as they live out their final days in our care.

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