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VA Maryland Health Care System


VA Supports Caregivers

A family spending time with a Veteran at a VA facility

VA provides support for those caring for Veteran patients.

Thursday, February 24, 2011

When Marie Immaculata Iacono married Harry Dutton Grunwell 42 years ago, she knew to expect the unexpected. Grunwell, a childhood friend and her high school sweetheart, graduated from Penn State and had enlisted in the Army because he’d been drafted. Stationed in California for almost a year as a Korean language student at the Defense Language School at The Presidio of Monterey, Grunwell was homesick for his native Pennsylvania, his family, and for her. He’d called Iacono, asking two questions: Did she still know how to cook, and would she marry him?  The couple, who had been dating since age 16, asked their parents’ permission and Marie—together with Grunwell’s parents—boarded an airplane bound for California, carrying a wedding dress, a cake, and a gift from her family. "At this point, I didn’t know where we were going to be married, who the priest was, where we were going to live or anything else," she said. "I knew I had two suitcases and one was full of pots and pans. I was expecting an adventure and I got one."

They began their married life in California as a career military couple, moving from duty station to duty station, and raising their daughter Jeanne Marie, who is now a senior writer for the daily soap opera "Days of Our Lives" and a published children’s book author. During his 23-year-long Army career, Harry achieved the rank of Chief Warrant Officer 4.

"Harry was deployed to Korea on five unaccompanied tours. He missed out on a lot as our little girl grew. But, I was so proud of his service to our country. During a number of the years he was in Korea, our daughter and I always went back home to Pennsylvania to be with my parents, and I was able to get my old job back," said Marie.

Then Marie unexpectedly became the sole caregiver for Harry, who in his late 40s was diagnosed initially with relapsing-remitting multiple sclerosis before it was upgraded to secondary progressive multiple sclerosis, a chronic central nervous system disease that affects roughly 400,000 people in the U.S. When Harry first became diagnosed, the couple learned that they were not alone, that help was available. "I could not accomplish all that I do for my husband without all the help from the VA," Marie said. "Aid from the VA has helped keep him safe and well, and we also would not have been able to afford the expensive things they have provided. VA has been with us from the beginning of this ordeal," she said.

Currently, Marie serves as Harry’s helping hand, providing support in all forms, including physical needs related to transferring him to and from a wheelchair, bathing, medical and safety requirements, transporting him to and from medical appointments, medicine and meal preparation, and the important inner needs such as friendship, compassion and respect.

At the early stages of his diagnosis, Harry was still working and mobile, and Marie continued to work at the Baltimore Gas and Electric (BG&E) Company. But the forward thinking Harry considered how things would change in the future, and because the couple were already caring for Harry’s mother, they constructed a house with wider hallways, lower counters and other design elements suitable for the handicapped and elderly. "By the time Harry got around to being less mobile and wheelchair bound, the house required only minimal changes," said Marie.

"The VA is committed to caring for those who care for our Veterans," said Margaret Kazmierski, MSW, LCSW-C, MSCS, the spinal cord injury coordinator at the VA’s Multiple Sclerosis Center (MS) of Excellence East, coordinated at the Baltimore VA Medical Center. "The MS Center of Excellence-East health care team includes health care professionals such as the MS  Nurse Case Manager, Lisa Mitchell, who all work together to provide support and resources to both the Veteran and the caregiver."

Typically, the VA provides a variety of services for caregivers assisting Veterans with multiple sclerosis. One such service is a respite care program that can consist of four weeks of inpatient care at the Loch Raven VA Community Living & Rehabilitation Center and six hours of in-home respite care for up to 40 hours per week. "This allows the caregiver to have shorter durations of respite care and the Veteran can stay home," said Kazmierski.

VA also offers a homemaker/home health aide program that provides a licensed professional from a licensed home health agency to assist the Veteran with bathing and personal care for up to 10 hours weekly. A new service offered by the MS Center of Excellence in Baltimore is free monthly conference calls to provide education and support for Veterans and caregivers. The second Monday of every month at 8 p.m., MS specialists and other experts talk for about a half hour on topics of interest, followed by a question and answer period.  Caregivers also can participate on another monthly support and education call, facilitated by a clinical social worker. The support call takes place every 4th Monday night from 8 p.m. to 9 p.m. and can be accessed using an advance pass code.  Topics such as benefits, resources and others are also presented and discussed.

"Mrs. Grunwell acts as her husband’s advocate, often suggesting therapies and devices that may be helpful for her husband, " said Lisa Mitchell, RN, BSN, CDE, the nurse case manager overseeing the Grunwell’s care. "The MS Center of Excellence East is committed to improving the quality and consistency of health services provided to our Veterans with MS through our four functional cores: clinical care, education and training, research and development and informatics."  

Although the couple’s home already contained design elements suitable for the handicapped from when the couple cared for their elderly relatives, it still required further modifications. A Home Improvements and Structural Alterations (HISA) grant through the VA Maryland Health Care System’s Prosthetics and Sensory Aid Service helped the couple to complete further renovations, paying for modifications that helped facilitate a VA-approved ramp, accessible open shower, an additional bathroom and shower rails, which increased the bathroom’s safety and accessibility levels to accommodate the progressive nature of Harry’s illness. "The VA did so much for us as Harry’s illness progressed. Without all the VA provided, we’d be in a very sad situation," Marie said.

Being a caregiver, Marie noted, can be a challenge, because health issues arise for the caregiver, no matter the preventive care they take. "I never golfed in my life, but now I have golfer’s elbow from the heavy lifting due to transferring. However, with a few cortisone shots, the elbows are doing well."

Although Marie did not expect to become her husband’s caregiver, she can’t imagine doing things differently. "Harry knows that he has to keep his mind sharp, and so he does. I don’t feel resentful because I know if things were reversed, Harry would be there for me. We take care of each other, and family is everything, no matter the sacrifice."
The VA offers a variety of caregiver support programs.  If you are caring for a Veteran and need assistance, call the VA’s Caregiver Support Line for help toll-free at 1-855-260-3274 Monday – Friday, 8 a.m. – 11 p.m. ET and Saturday, 10:30 a.m. – 6 p.m. ET.


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