美国国家公共电台 NPR Some VAs Are Dropping Veteran Caregivers From Their Rolls

 

RACHEL MARTIN, HOST:

Even with all the VA clinics and hospitals, that $180 billion budget for the U.S. Department of Veterans Affairs, even with all those resources, the day-in-and-day-out care of disabled veterans often falls to their own family members. Congress recognized that. And finally, in 2010, created the VA Family Caregiver Program. The program offers support and, in some cases, a little financial help for those family members. Veterans have signed up in huge numbers. NPR's Quil Lawrence reports that family caregivers in some cities say they are now being dropped from that program without any explanation.

QUIL LAWRENCE, BYLINE²: Jim Graham wears thick, "Terminator" sunglasses indoors, even with the blinds drawn³. Light is a big deal.

JIM GRAHAM: Light's a very big deal, actually.

LAWRENCE: Graham got knocked out by a mortar⁴ blast on his third deployment⁵ as a combat medic to Iraq in 2006.

J. GRAHAM: Part of my brain injury, one of the things is that I'm light-sensitive. So I have to wear the darkest sunglasses I can find all day, every day.

LAWRENCE: Otherwise, he gets migraines - not just headaches. Those he has all the time.

J. GRAHAM: I've had a headache ever since I got hurt.

LAWRENCE: You've had a headache for 11 years, almost.

J. GRAHAM: Yes. And then I get migraines on top of it. When I get one, it lasts for days, months. If I'm some way able to get rid of a migraine, I'm lucky if I get a week off before another one hits me.

LAWRENCE: The brain injury means he can't remember to turn off the kitchen stove or turn off the shower once he gets in it, or drive or pay bills. Graham also has post-traumatic stress disorder⁶, which gives him panic attacks and makes it hard to leave his house in Jacksonville, N.C. The two-hour drive to the VA in Fayetteville is almost unbearable⁷. Alishia, Jim's wife, takes care of him around the clock.

ALISHIA GRAHAM: I have not been able to work outside of our home since he was injured.

LAWRENCE: The VA's Family Caregiver Program was designed for people like Alishia, mostly wives, sometimes parents, who've had to leave their careers to help their veteran with daily living. Jim got rated at the highest tier in the program, which meant VA paid Alishia a stipend⁸ of nearly $2,000 per month. But I got in touch with Alishia Graham because of something I'd been hearing for over a year, caregivers claiming they'd been dropped from the program without cause.

A. GRAHAM: I was watching as all of these caregivers were going up to their reassessments. And one by one, they were sharing that they'd gone to their re-assessment, and they were dropped.

LAWRENCE: Alishia said around Fayetteville, everyone was scared. And she'd heard similar things around the country. Before I could make it down to see her, something came in the mail.

A. GRAHAM: The letter was sitting on the top. And my stomach dropped because I knew what it was.

LAWRENCE: Nothing about her case had changed. If anything, Jim's condition was a little worse. But the Fayetteville VA said he no longer qualified⁹ for a caregiver.

A. GRAHAM: And it's not even like, oh, we dropped you a tier because we think he doesn't need as much help. No, we think he's totally fine, and he doesn't need any help. I'm insulted for him because I know what he struggles with.

LAWRENCE: They're not the only ones stymied¹⁰ about why they were dropped. From the Graham's house, I drove down the road to visit another veteran couple, Brianna and Josh Schaudi.

JOSH SCHAUDI: Fourteen years in the Marine¹¹ Corps¹², them just to say, OK, well here you go.

BRIANNA SCHAUDI: Met with the doctor for about 10 minutes and a few weeks later, got the letter saying bye-bye.

LAWRENCE: Then, on the phone, Drew and Kari Evans in Idaho Falls said the same thing.

KARI EVANS: Nothing changed from the time we were put on to when we were kicked off. And that's what I got frustrated¹³ about.

LAWRENCE: So did Chrissy Hogan, who takes care of her Army vet¹ husband Sean in Cincinnati.

CHRISSY HOGAN: Yeah, I mean, it was a nice program. It helped, you know. I just got cut. I got the letter December 19.

LAWRENCE: And Jenn Wilmot and her husband George, who use the VA in Charleston, S.C.

JENN WILMOT: Home nurse came out. She didn't know anything changing or anything like that. So I'm thinking, OK, we're good. And then, seven days later, after her report went in...

LAWRENCE: NPR spoke¹⁴ with 10 couples who'd been cut from the program. But the VA says overall, the numbers have grown, not shrunk.

MEG KABAT: The program is not cutting back in any way.

LAWRENCE: Meg Kabat is director of the VA Caregiver Support Program. The program had a rocky start in 2011. VA expected to serve four or 5,000 caregivers. It's now serving over 22,000. Kabat says initially¹⁵ there were too few coordinators at some VA's.

KABAT: We've been able to expand the number of caregiver support coordinators and really continue to monitor that. We also train our staff on a regular basis because this is such a unique program and focuses in on family members of the veteran, which is very different than what anybody else is doing in the medical center.

LAWRENCE: Kabat says there's been no pressure nationally to push people off the program, though the eligibility¹⁶ requirements have gotten clearer. VA data does show it added 6,300 caregivers in the past three years. But the same data show it hasn't been consistent. The VA is infamous¹⁷ for inconsistency from station to station. Of 140 medical centers, most added caregivers. But 32 of them cut their numbers, some drastically. At Charleston, S.C., where Jenn and George Wilmot get care, there were 197 caregivers in 2014. Now there are only 11. So 95 percent of their caregivers have been dropped.

The Charleston VA says some of those vets¹⁸ improved and don't need the program; others probably never should have qualified. The Portland, Ore. VA cut 60 percent of its caregivers in three years. Seattle cut 50 percent. The South Texas VA cut half. To repeat, most VA's are adding caregivers. But if you're Alishia Graham taking care of your disabled Iraq-vet husband Jim out of Fayetteville and it seems like half the caregivers you know have been cut, that's because Fayetteville cut half its caregivers in the past three years.

A. GRAHAM: That means my family is - oh, nicer word, hold on - is janked (ph) out of $2,000 a month.

LAWRENCE: Alishia says she made sure never to live paycheck to paycheck. And she knows there were some people in the program who shouldn't have qualified. And Jim has a pretty high disability check from VA, so they're not starving. And she says Jim hates leaving the house, so it's not like they were going to save up for a big vacation anyway. But Jim says it's more about Alishia's hard work no longer being recognized.

J. GRAHAM: It's insulting because I know how much she does do, how much help I do need with everything. I gave everything I had to what I was doing, always did. To not get back the same or equivalent that I gave up is a slap to the face, basically.

LAWRENCE: The Fayetteville VA says Jim is no longer clinically eligible¹⁹ for the program and that the Grahams are welcome to appeal and that the VA, quote, "can't thank caregivers enough for the vital role they play in helping²⁰ veterans recover from injury and illness." Quil Lawrence, NPR News.

1 vet   

n.兽医，退役军人；vt.检查

参考例句：

• I took my dog to the vet.我把狗带到兽医诊所看病。
• Someone should vet this report before it goes out.这篇报道发表之前应该有人对它进行详查。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 drawn   

v.拖，拉，拔出；adj.憔悴的，紧张的

参考例句：

• All the characters in the story are drawn from life.故事中的所有人物都取材于生活。
• Her gaze was drawn irresistibly to the scene outside.她的目光禁不住被外面的风景所吸引。

4 mortar   

n.灰浆，灰泥；迫击炮；v.把…用灰浆涂接合

参考例句：

• The mason flushed the joint with mortar.泥工用灰浆把接缝处嵌平。
• The sound of mortar fire seemed to be closing in.迫击炮的吼声似乎正在逼近。

5 deployment   

n. 部署,展开

参考例句：

• He has inquired out the deployment of the enemy troops. 他已查出敌军的兵力部署情况。
• Quality function deployment (QFD) is a widely used customer-driven quality, design and manufacturing management tool. 质量功能展开(quality function deployment,QFD)是一个广泛应用的顾客需求驱动的设计、制造和质量管理工具。

6 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

7 unbearable   

adj.不能容忍的；忍受不住的

参考例句：

• It is unbearable to be always on thorns.老是处于焦虑不安的情况中是受不了的。
• The more he thought of it the more unbearable it became.他越想越觉得无法忍受。

8 stipend   

n.薪贴；奖学金；养老金

参考例句：

• The company is going to ajust my stipend from this month onwards.从这一个月开始公司将对我的薪金作调整。
• This sum was nearly a third of his total stipend.这笔钱几乎是他全部津贴的三分之一。

9 qualified   

adj.合格的，有资格的，胜任的，有限制的

参考例句：

• He is qualified as a complete man of letters.他有资格当真正的文学家。
• We must note that we still lack qualified specialists.我们必须看到我们还缺乏有资质的专家。

10 stymied   

n.被侵袭的v.妨碍，阻挠( stymie的过去式和过去分词 )

参考例句：

• Relief efforts have been stymied in recent weeks by armed gunmen. 最近几周的救援工作一直受到武装分子的阻挠。 来自辞典例句
• I was completely stymied by her refusal to help. 由于她拒不相助， 我完全陷入了困境。 来自互联网

11 marine   

adj.海的；海生的；航海的；海事的；n.水兵

参考例句：

• Marine creatures are those which live in the sea. 海洋生物是生存在海里的生物。
• When the war broke out,he volunteered for the Marine Corps.战争爆发时，他自愿参加了海军陆战队。

12 corps   

n.(通信等兵种的)部队；(同类作的)一组

参考例句：

• The medical corps were cited for bravery in combat.医疗队由于在战场上的英勇表现而受嘉奖。
• When the war broke out,he volunteered for the Marine Corps.战争爆发时，他自愿参加了海军陆战队。

13 frustrated   

adj.挫败的，失意的，泄气的v.使不成功( frustrate的过去式和过去分词 )；挫败；使受挫折；令人沮丧

参考例句：

• It's very easy to get frustrated in this job. 这个工作很容易令人懊恼。
• The bad weather frustrated all our hopes of going out. 恶劣的天气破坏了我们出行的愿望。 来自《简明英汉词典》

14 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

15 initially   

adv.最初，开始

参考例句：

• The ban was initially opposed by the US.这一禁令首先遭到美国的反对。
• Feathers initially developed from insect scales.羽毛最初由昆虫的翅瓣演化而来。

16 eligibility   

n.合格，资格

参考例句：

• What are the eligibility requirements? 病人被选参加试验的要求是什么？ 来自英汉非文学 - 生命科学 - 回顾与展望
• Eligibility for HINARI access is based on gross national income (GNI). 进入HINARI获取计划是依据国民总收入来评定的。

17 infamous   

adj.声名狼藉的，臭名昭著的，邪恶的

参考例句：

• He was infamous for his anti-feminist attitudes.他因反对女性主义而声名狼藉。
• I was shocked by her infamous behaviour.她的无耻行径令我震惊。

18 vets   

abbr.veterans （复数）老手，退伍军人；veterinaries （复数）兽医n.兽医( vet的名词复数 )；老兵；退伍军人；兽医诊所v.审查（某人过去的记录、资格等）( vet的第三人称单数 )；调查；检查；诊疗

参考例句：

• I helped train many young vets and veterinary nurses too. 我还帮助培训了许多年青的兽医和护士。 来自互联网
• In fact, we've expanded mental health counseling and services for our vets. 实际上，我们已经扩大了退伍军人的心理健康咨询和服务。 来自互联网

19 eligible   

adj.有条件被选中的；(尤指婚姻等)合适(意)的

参考例句：

• He is an eligible young man.他是一个合格的年轻人。
• Helen married an eligible bachelor.海伦嫁给了一个中意的单身汉。

20 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。