![]() ![]() ![]() Peers understand the social and historical experiences shaping the veterans and connect with veterans in a different manner than the rest of their health care team. Peers promote recovery by using their common bond of being veterans and sharing their own recovery stories, providing encouragement, instilling a sense of hope, and teaching coping, empowerment, and social skills to veterans. Continued education is required of all peers, including a minimum of 15 hours of competency-related training every year. Expected competencies include recovery principles, peer support practices, cultural competence, whole health approach to services, and advocacy. Peer certification training is conducted by a single contractor hired by the VA mental health services office. Peers are required to be veterans and must complete peer certification training. Peers are veterans hired by the VA to help other veterans, usually those with serious mental illnesses, to engage them in their treatment successfully. Ī promising approach to address these gaps at the VA concerns the use of peer support specialists (peers). Innovative interventions are needed to identify unmet needs and bridge the gap between needs and services in partnership with patients and family caregivers. Attending to the unmet health needs of older veterans with HNHR and planning services and solutions centered around what older people need based on what matters most to them is becoming an urgent public health priority. Other adverse events include falls, inadequate nutrition, depression, incontinence, discomfort, and decreased quality of life. When these needs go unmet, patients are at higher risk of adverse outcomes such as hospitalization, LTIC, and death. Their ability to maintain health is further complicated by complex unmet medical and social needs. Veterans with HNHR who are sicker and frailer often miss appointments and fail to visit the clinic for their care. ![]() Older veterans with HNHR face disproportionate disparities and barriers to engaging in their care, which includes accessing care and services. Veterans with HNHR have complex needs that include not only physical but also mental, functional, and social needs, specifically frailty, social isolation, mobility challenges, and self-care deficits. The VA Geriatric and Extended Care (GEC) office recommends that veterans with HNHR be enrolled in long-term services and supports programs, including home- and community-based services, for best outcomes. The VA Geriatric and Extended Care Data Analysis Center (GECDAC) uses predictive modeling to identify veterans with HNHR at the highest risk of LTIC, hospitalization, or death. Keeping older veterans with high needs and high risk (HNHR) who are at risk of long-term institutional care (LTIC) safely in their homes for as long as possible is a Department of Veterans Affairs (VA) priority. Participants receive a peer-led home visit to identify unmet needs and home safety risks aligned with the age-friendly health system model care coordination, health care system navigation, and linking to needed services and resources in collaboration with their PACT and patient empowerment and coaching using Department of Veterans Affairs whole health principles. The Peer-to–Patient-Aligned Care Team (Peer-to-PACT P2P) intervention is a multicomponential home visit intervention designed to support older veterans with HNHR to age in place. The use of peer support specialists (peers) is a promising approach to improving patient engagement and addressing unmet needs. Veterans with HNHR often have poor ability to maintain health owing to complicated unmet health and social needs. Older veterans with HNHR face disproportionate barriers and disparities to engaging in their care, including accessing care and services. ![]() Keeping older veterans with high needs and high risk (HNHR) who are at risk of long-term institutional care safely in their homes for as long as possible is a Department of Veterans Affairs priority. ![]()
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