Interest in and acceptance of a peer-driven end-of-life care model within a state run veterans home

Purpose: To describe veterans' thoughts and feelings on death and dying, and to determine general interest and acceptance of a peer-driven end-of-life care model within a state run Veterans Home. Methods: This is a mixed methods design grounded in a Donabedian structure-process-outcome framework. Sixty-eight veterans were convenience sampled. Data collected include demographics, service history, feelings about death and dying (FDD), and social support (NSSQ). Three focus groups were conducted, using interpretive methodology, on willingness to provide and receive care from fellow veterans. Results: Mean age was 56 years (28-80). Majority of participants were enlisted while serving, and 20% saw active combat. 20% considered the VA home. 67% were somewhat or very religious. 61% knew someone who was in hospice, 38% having cared for someone. If needed 35% did not know who could care for them, while 49% believed the VA would. 85% said they would use end-of-life care services if provided by the VA Home. Subjects were most fearful of dying alone, losing those they care about, and having to depend on others (>9cm VAS), and least fearful of existential fears (<5cm VAS). Focus group results suggest end-of-life care would be accepted and welcomed. Several expressed interest in volunteering. Conclusion: Many veterans surveyed felt end-of-life care would be accepted and desired at the VA facility. Many showed concerns of who would take care of them outside the facility. Veterans have a bond which is amenable to an effective and innovative peer-driven end-of-life care model.