Advancing Quality Care a Constant Priority
When World War II veterans came home with spinal cord injury (SCI), doctors, nurses and other medical service providers were largely unprepared to care for them. At the time, until the discovery of penicillin, people generally didn’t survive long after SCI because of the high rate of infection.
“I think a lot of that is Paralyzed Veterans’ method of operation,” he said. “We work side by side with the Department of Veterans Affairs (VA).”
As Paralyzed Veterans’ President Bill Lawson put it, “It’s the consumer who’s advocating for the quality of care.”
VA treats about 42,000 SCI veterans and another 16,000 veterans with multiple sclerosis (MS). Additionally, VA treats veterans with amyotrophic lateral sclerosis (ALS), which was just several years ago named a presumptively compensable illness for veterans with 90 days or more of continuously active service in the military. VA also treats many with other spinal cord diseases, such as transverse myelitis.
“VA is above the rest of anyone who treats people with spinal cord injuries and diseases,” Lawson said. “It excels past anyone in the private sector. I think a lot of it is because the work Paralyzed Veterans does, and our 34 chapters. Our chapters have hospital liaisons who regularly monitor the quality of care in the VA medical facilities.”
While care for those with spinal cord injuries was slightly improved in the early 20th century by the advent of X-rays, and advances in bacteriology and disinfection, few lived very long. By World War I, the two-week survival rate of those with cervical spine injuries was still less than 20 percent.
And life was an unpleasant lot for the 5 percent of people who survived past a couple years with SCI, who generally remained bedridden and stagnate with no hope for simple activities, such as visiting friends or getting jobs.
Realizing that neither the medical profession nor government had ever confronted the needs of a SCI population, returning World War II veterans became their own advocates and formed Paralyzed Veterans. Told that their life expectancy was weeks or months, these individuals set out as their primary goal actions that would maximize the quality of life and opportunity for all veterans and individuals with SCI.
Frank Rigo, long-time Paralyzed Veterans member, served in World War II and in the Korean War. He joined Paralyzed Veterans in 1958, months after a spinal cord injury. Now in his late 80s, the very active Rigo is an example of how much progress has been made in the treatment of spinal cord injuries.
However, an aging population of veterans in general, and those with spinal cord injuries in particular, is a concern for Lana McKenzie, associate executive director of Medical Services and Health Policy.
“We focus on research and extending life expectancy,” she said. “As people with spinal cord injuries live longer, they’re going to need (geriatric) care.”
She noted that VA has about 30,000 long-term care beds, but only 150 are equipped for those with spinal cord injuries.
There are 22.7 million veterans in the U.S., according to VA. That’s expected to drop to fewer than 15 million by 2035. Much of the expected reduction is because the large population of World War II, Korean and Vietnam War veterans. These veterans are making greater demands of the VA health-care system.
“It’s going to get worse,” McKenzie said. “VA is not prepared for the baby boomers.”
As seniors put larger strains on the VA’s health-care system, fewer resources are available for specialty services, such as the VA’s 24 SCI centers. McKenzie said the past 10 years has seen major advances in the technology of caring for people with spinal cord injuries, but the VA staffing for those services is getting stretched.
Doug Volmer, Paralyzed Veterans’ associate executive director of Government Relations, said “Overall, VA is doing a good job. With advanced appropriations and some growth in the SCI system, they’re meeting the needs for our members.”
However, Volmer said that a cumbersome hiring process is failing to keep pace with staffing needs at the VA medical centers.
“That’s not to say there are not challenges in those systems,” he said. “There’re still some problems with appropriately staffing these systems.”
Additionally, Volmer noted that VA is behind on needed infrastructure maintenance and improvements, and that Congress has failed to adequately fund those items. And talk among members of Congress about looking into privatizing some of the VA’s health-care functions has Paralyzed Veterans concerned.
“We don’t think that there are facilities in the private sector to do what the VA’s SCI centers do,” Volmer explained.
Patrick McCallister is a reporter in Florida and frequent contributor to PN Magazine.