"VA Steps Up Programs As More Veterans Enter Hospice Care"

RENEE MONTAGNE, HOST:

In a century that has embroiled America into two long wars, it's been much talked about that few Americans actually serve, less than 1 percent in fact, and that is more remarkable when set against past wars - World War II and Korea - when millions of men were drafted and both men and women volunteered. We're going to meet one of those veterans in this report by NPR's Quil Lawrence on what it takes to care for them near the end of their lives.

QUIL LAWRENCE, BYLINE: You've seen places like Woodland Assisted Living in Hallowell, Maine - little white cupola with a weathervane, circular driveway, no steps, an automatic sliding door.

UNIDENTIFIED MAN: B-15. B-15.

LAWRENCE: And, yes, there is bingo.

UNIDENTIFIED MAN: N-42.

LAWRENCE: But it's not for everyone.

FLORENCE KELIHER: I'm not a bingo player. I love cribbage.

LAWRENCE: Cribbage was sort of the official game of anyone who was on a ship in World War II, like Florence Keliher.

KELIHER: I served during World War II in the Army Nurse Corps, and I was on Tinian, the little island in the South Pacific.

LAWRENCE: Keliher sailed across the Pacific to Tinian in 1945, a year after the U.S. took the island and set up an airstrip and a hospital.

KELIHER: We had a ward full of patients - airplane crashes and things like that. They flew from Tinian to Japan to bomb. Some of them had trouble taking off sometimes. I didn't call my work hard because I did a lot of chatting and things like that.

LAWRENCE: Keliher came home to Maine and worked as a VA nurse for 30 years. Now she's 92, and she needs some nursing help herself these days. So do a lot of veterans.

SCOTT SHREVE: This past year, out of all American deaths, 1 in 4 have been a veteran.

LAWRENCE: Dr. Scott Shreve directs hospice care for the VA nationwide. The VA took notice about 10 years ago when millions of World War II and Korea vets reached old age. One result has been a program called We Honor Veterans. Shreve says it's set up to help hospice workers ask patients the right questions.

SHREVE: Are you a veteran? How did that military experience impact your life? And how can we help work with you in perhaps dealing with some very difficult and intrusive memories as you come to the end of your life?

LAWRENCE: At the end of life, for example, PTSD can sometimes show up for the first time. VA hospitals have palliative care and hospice wards, but the vast majority of vets aren't in those hospitals; they stay near their families. The program aims to reach them where they live - people like Florence Keliher, who lives up the road from her son, Pat.

PAT: I've got the girls this weekend, so I'll bring them by.

LAWRENCE: Pat stops in all the time, sometimes brings the grandchildren. They talk, but only in recent years has Florence said much about the war.

KELIHER: I don't remember talking about it. Do you remember hearing me tell a story?

PAT: Not until you wrote it down that one time. That's the first time I'd ever read it.

LAWRENCE: Her grandson typed up her stories about crawling under bullets in basic training and 16 days on a ship to the South Pacific, and about caring for young men as they lay dying of war wounds or malaria, calling out for their mothers. And now she's got more people she can talk with about all that.

KATHERYN ZWICKER: Hey, there. How are you?

KELIHER: Good.

ZWICKER: I haven't forgot about our cribbage game.

LAWRENCE: That's Katheryn Zwicker, she's a hospice volunteer who comes by as part of the We Honor Veterans campaign.

ZWICKER: We share an interest in reading, and we've swapped books and stories.

KELIHER: She has some interesting stories, too.

ZWICKER: Not as good as yours.

LAWRENCE: But only half the community hospices nationwide are taking advantage of the free program. VA officials say they'd like to get more on board. That's because half a million vets will be needing end-of-life care every year for the next five years. Quil Lawrence, NPR News.