The Silent Salute: Why Elder Veterans Require and Deserve a Different Standard of Care

As America’s Veteran population continues to age, a critical truth demands recognition: military Elder Veterans do not age like their civilian counterparts. Their healthcare needs, emotional journeys, and end-of-life experiences are shaped by a life of service often characterized by physical hardship, mental strain, and a deeply rooted culture of sacrifice.

This is not just a matter of differing personal stories. It is a population-level distinction with clinical, social, and policy implications. To provide proper care and honor to those who served, we must first acknowledge the key differences that set them apart in their later years.

Higher Prevalence of Chronic and Service-Connected Conditions

Elder Veterans are more likely to live with service-related chronic conditions. Studies from the U.S. Department of Veterans Affairs (VA) show higher rates of:

• PTSD and Depression: These conditions may remain undiagnosed for decades, only to resurface with greater intensity in old age, often triggered by cognitive decline or loss of independence.

• Musculoskeletal Injuries: Years of physical training, combat, or military labor often result in arthritis, chronic pain, and mobility challenges.

• Traumatic Brain Injury (TBI): Even minor TBIs sustained in service can exacerbate cognitive decline and increase the risk of dementia in later years.

• Agent Orange and Other Exposures: Vietnam-era Veterans face higher rates of cancers, diabetes, and heart disease due to toxic exposures.

In contrast, while civilians also experience chronic conditions, the origins and trajectories of their illnesses tend to follow more conventional patterns of aging.

Different Psychological and Emotional Realities

Aging brings reflection, but for Veterans, the memories often include combat, loss, and moral injury. Many Elder Veterans face late-onset stress symptomatology, symptoms that emerge or worsen decades after service, intensified by aging, isolation, or nearing death.

In care delivery settings, these unresolved emotional wounds may surface as:

• Regret or guilt over actions taken in war

• Emotional detachment or difficulty trusting providers

• Reluctance to discuss service or trauma.

Civilian elders may struggle emotionally as well, but typically without the layered psychological complexities connected to military service.

Unique End-of-Life Needs and Preferences

Veterans often embody duty, stoicism, and independence. Qualities that may lead them to delay accepting non-medical home care, home health, hospice, or palliative care.

Many Veterans have strong preferences for:

• Military honors or chaplain involvement

• Peer-based support (Veteran-to-Veteran programs)

• Care providers who understand military structure, rank, and culture

• Recognition of military identity at end of life

These needs differ from civilians, who generally have fewer identity-based preferences tied to service, sacrifice, or camaraderie.

A Different System of Support

The VA healthcare system while robust is complex. Elder Veterans often need assistance accessing:

• VA pensions & Aid and Attendance

• Service-connected disability compensation

• Home-based primary care

• VA contracted hospice

• The Homemaker & Home Health Aide Program

• Veteran-Directed Home and Community-Based Services

Without skilled guidance, many miss out on benefits designed specifically for them.

Civilian seniors, by contrast, generally rely on Medicare, Medicaid, or private insurance, systems with fewer specialized pathways.

The Cultural Gap Between Veterans and Civilians

Veterans age with a perspective shaped by discipline, camaraderie, loss, and silence.

A caregiver unfamiliar with this culture may unintentionally fail to connect. But when care is delivered with military-informed sensitivity, it can transform the Veteran’s final chapter with dignity, recognition, and peace.

A Call to Serve the Served

America’s Elder Veterans have already borne the weight of war and the burden of service. As they enter the final chapter of life, they deserve not just gratitude, but precision and specific informed compassion in care.

Home care agencies, home health agencies, hospices, healthcare systems, and policymakers must embrace this distinction, not as a challenge, but as a sacred opportunity: to give one final salute by honoring the complexity, sacrifice, and humanity of our aging heroes.

The Referral Edge: What This Means for Home Care Agencies

How to Gain More Veteran Clients and Deliver Excellence in Care

Below are strategic, actionable steps designed specifically for non-medical home care agencies that want to serve more Veterans, build stronger community partnerships, and honor this population with excellence.

1. Become VA-Literate. Deeply and Thoroughly

Most home care agencies know a little about VA benefits. Few know enough to guide families confidently.

To become a go-to Veteran resource:

Train your entire team on:

• Aid & Attendance eligibility

• The Homemaker & Home Health Aide (H/HHA) Program

• Veteran-Directed Home & Community Based Services

• Service-connected disability basics

• How VA referrals, authorizations, and renewals work

Action Step: Hold a monthly “VA Power Hour” training with your staff using real case studies.

2. Build Relationships with Your Local VA Network. This doesn't include JUST the big VA hospital in your market. 

Veteran referrals increase dramatically when an agency becomes known as “the one that gets it.”

Build relationships with:

• VA social workers

• Care coordinators

• VA Home-Based Primary Care Teams

• VA palliative and hospice coordinators

• Veterans Service Officers (VSOs)

• County Veteran Affairs Departments

• Local Veterans' Non-Profits

Action Step: Schedule one VA outreach meeting per week for 60 days. Your knowledge + consistency = trust.

3. Hire Veterans Whenever Possible. Reach out if you'd like to discuss the Statement of Support through ESGR. 

Veterans overwhelmingly prefer care from someone who understands:

• Rank and chain of command

• Military structure

• The meaning of unit, mission, brotherhood

• The culture of silence and stoicism

Action Step: Launch a “Veterans Caring for Veterans” hiring initiative. Even one Veteran caregiver can shift your entire brand presence.

4. Incorporate Military Culture Training Into Orientation

Teach caregivers:

• How to address Veterans respectfully (rank, titles)

• Why certain behaviors (startle response, hypervigilance, emotional guardedness) are normal

• What to do if combat memories surface

• How to provide trauma-informed support at end of life

Action Step: Add a 20-minute military culture module to your caregiver onboarding process.

5. Create a Veteran-Centered Community Education Strategy

Families often don’t know what Veterans are entitled to.

Your agency can become the trusted educator in your market by offering classes like:

• “How to Get VA Benefits to Pay for Home Care”

• “Understanding Aid & Attendance”

• “Care Options for Aging Veterans”

Action Step: Host one Veteran-focused seminar per quarter at:

• American Legion

• VFW-Senior centers

• Churches

• Libraries

6. Partner with Local Veteran Organizations

Collaborate with:

• VFW Posts

• American Legion

• Disabled American Veterans (DAV)

• Marine Corps League

• AMVETS

• Vietnam Veterans of America

• Iraq & Afghanistan Veterans Organizations

Action Step: Offer to sponsor coffee and donuts for their monthly meeting in exchange for 5 minutes to introduce your Veteran support services.

7. Position Your Agency as the “Veteran Concierge”

Families need a guide. Someone who helps them navigate the VA and care options.

Your agency can provide:

• Benefit education

• Document checklists

• Help connecting with VSOs

• Scheduling and guidance on medical appointments

• Care coordination between VA programs and non-medical services

Action Step: Create a Veteran Navigation Packet branded to your agency and distribute it everywhere Veterans gather.

8. Honor Their Service Visibly and Authentically

Small gestures create immense trust and emotional comfort.

Consider:

• A Veteran Welcome Ceremony for new clients

• Military branch flags in your office

• Veteran-specific care plans

• End-of-life pinning ceremonies

• Veteran badges or lanyards for caregivers

Action Step: Implement a “Final Salute Protocol” for every Veteran receiving end-of-life support.

9. Document, Track, and Report Your Veteran Impact

Data matters.

Track:

• Number of Veteran clients served

• Hours delivered under VA benefits

• Referrals from VA and Veteran-focused organizations

• Average time to authorization

Action Step: Add a Veterans KPI section to your CRM dashboard.

10. Build a Veteran-Focused Brand Identity

Your marketing should make Veterans feel seen.

Include in your messaging:

• “We proudly serve those who served.”

• Dedicated Veteran landing page

• Photos of Veteran clients (with permission)

• Videos of your Veteran initiatives

• Case studies showing the impact of home care

Action Step: Add a “Veteran Services” page to your website optimized for SEO with local keywords such as: “San Diego Veteran home care,” “VA Aid & Attendance help,” “Veteran caregiver support.”

Final Word: A Sacred Opportunity

Serving Elder Veterans is not only a business opportunity. It is a moral obligation for those of us in senior care. When we understand their distinct needs, honor their identity, and guide their families with competence and care, we do far more than provide services.

We give a FINAL SALUTE through the dignity of exceptional care.

And for a population that has sacrificed so much, nothing less is acceptable.

Reach out to me if you'd like the following materials: 

1. VA Power Hour Training – Full Monthly Curriculum

2. Military Culture Module – Caregiver Training Script

3. Community Education Strategy – Veteran-Focused Seminar Assets