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Durham VA Health Care System

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Pilot program expands to community facilities

The COACH programs sends nurses and social workers to homes of dementia patients for assessments and to provide support to caregivers.

Durham VA Medical Center will soon expand its COACH program for caregivers and dementia patients to Greenville and Morehead City. The program helps keep Veterans with dementia in their homes longer by offering education and support.

By Shannon Mann, Durham VAMC Public Affairs Office
Thursday, March 6, 2014

Dementia can be a tough disease. It is tough not only for those inflicted, but for the families and caregivers at home.

The Durham VA Medical Center entered into a pilot program in 2010 that has now become a fully funded program in Durham and is expanding to Greenville and Morehead City.

Judith Davagnino, Durham VAMC social worker coordinator who started the program here in 2010, is passionate about sharing the news of the Caring for Older Adults and Caregivers at Home Program, or COACH as most know it in the center.

Davagnino explained that most caregivers at home struggle to understand and accept dementia, and most importantly they do not know how to manage the behaviors associated with the disease. Her program aims to not only help the Veteran, but to help the caregiver as well.

The program, which is open to Veterans aged 65 or older living within a 50-mile radius of either the Durham VA Medical Center, Greenville VA Health Care Center or Morehead City VA Community-Based Outreach Clinic with a caregiver at home, has produced some impressive numbers since its inception at Durham a few years ago.

Through education and support, the COACH program offers a patient-centered approach with individualized interventions by an interdisciplinary team of doctors, nurses, psychiatrists, pharmacists and licensed clinical social workers. The VA team provides a comprehensive medical and psychosocial assessment, a home safety evaluation, medication review and a plan to improve the Veterans care at home.

But the program is as much about the caregiver as it is the Veteran. The caregiver is offered support through counseling and education on dementia and behavioral management.  A caregiver support group is offered on a monthly basis to them at the Durham facility.

In addition, the statistics reflect a decrease of 38% of caregiver strain, above the 20% goal. In addition to improving quality of life and decreasing caregiver burden, the program has also proven quite cost effective for the VA.

“One of our goals is to delay nursing home placements,” said Davagnino, “as most people chose to live in their own home for as long as possible. A Veteran will stay in our program until they die or are placed in a facility.”

Ms. Betty Zimmerman, the wife of a 79-year-old Veteran with dementia, is a strong supporter of this concept. Zimmerman has been in the program since its inception.

“Having someone who understands that I can call and talk with, and the home visits, means a lot to me,” said Zimmerman, who is unable to travel to the Durham facility, but participates in conference calls and home visits with nurses and social workers.

Zimmerman explained that this program has given her peace of mind in that fact that she doesn’t have to worry about her husband being put in a nursing home facility, away from his home, where she would have difficulty getting to him. She said one of the biggest benefits of the program is “to see him at home in his own environment.”

“This program has given me the inspiration to learn more about the problems of aging veterans,” Zimmerman said.

So far, the program has served 236 veterans and 329 caregivers. Enrollments for Greenville HCC and Morehead City CBOC will begin the first week of March

For more information about the program and a full list of eligibility criteria contact Ada Massenburg at (919) 416-5807.

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