Congress worries VA isn't ready to care for growing number of senior, disabled vets

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As veterans age and the population of senior veterans grows dramatically in the next eight years, Congress worries the Department of Veterans Affairs isn’t prepared for what lawmakers called a “silver tsunami.”

The number of veterans older than 75 enrolled in VA health care is expected to nearly double by 2028, VA leaders told Congress during a House Veterans Affairs Committee hearing Tuesday. About half of the 9 million total veterans who receive care at VA are older than 65.

As the veteran population gets older, their need for care also significantly increases, particularly for those with service-connected disabilities. The number of veterans with service-connected disabilities is expected to increase by more than a third by 2028, such as Vietnam veterans ill from Agent Orange exposure or Gulf War and post-9/11 veterans exposed to other toxins. The demand for long-term care -- anything from help around the house to round-the-clock care, including help eating or bathing -- is expected to rise in particular. 

But VA may struggle to meet that demand, according to a recent Government Accountability Office (GAO) report. 

VA faces workforce shortages for nursing assistants and other jobs, which result in waitlists for long-term care and challenges reaching veterans in rural or remote areas, where about a third of all veterans live, according to Nikki Clowers, managing director of health care at GAO. 

VA will need to spend $14 billion annually to keep up with this increasing demand for long-term care, according to GAO. In 2018, VA provided or paid for long-term care for more than half a million veterans. 

VA officials promised Congress Tuesday that the department was working on a strategic plan to care for senior veterans.

The number of veterans 85 and older has increased nearly 300 percent between 2003 and 2018 and is expected “to surge close to 500 percent by 2038,” said Teresa Boyd, an assistant deputy undersecretary at the Veteran Health Administration. 

Many of the veterans who use long-term care services are significantly disabled, some in the "catastrophically disabled" category. Others are more likely to be low-income or live in remote or rural areas, according to Adrian Atizado, deputy national legislative director for Disabled American Veterans. 

About 80 percent of aging veterans will need long-term services and support, Boyd told lawmakers, and in the past, most of that care has been provided by family members, with women taking on the greatest burden of care. 

The number of possible caregivers for each veteran in America is about seven. But that number is expected to decrease to about four by 2030. The availability of caregivers can be jeopardized by work responsibilities outside the home and other factors, Boyd said.