1. WOMEN VETERANS UNIQUE and SPECIAL NEEDS Safe Patient Handling Program Tampa, Florida Sept 15-18, 2008 Peggy Mikelonis ANP-BC, MS, NE-BC Lead Women Veterans Program Manager VISN 8

2. OVERVIEW Increasing number of women veteransIncreasing number of women veterans –Access –Needs Primary Care/Gender Specific CarePrimary Care/Gender Specific Care –Provider needs –Equipment needs Women Veterans with Special NeedsWomen Veterans with Special Needs –Who, What, Why and How

3. Women Veterans Using VA

4. More women veterans on the way “Freshman class” of women military Army 20 %Army 20 % Navy 20%Navy 20% Air Force 28%Air Force 28% Marines 6%Marines 6%

5. Age groups Women Veterans Using VA

6. The OIF/OEF Woman Veteran Impacts VA She is utilizing VA Services: 42.2% enrollShe is utilizing VA Services: 42.2% enroll She is coming to VA frequentlyShe is coming to VA frequently –45.6% were seen 2-10 visits –38.5 % seen 11 or more times since 2002

8. Demographics–Age N = 94,010 Women Veterans Age Group Frequency Percent / Cum % <20 years 2,880 7.3 / 7.3 20-2923,384 58.9 / 66.20 30-397,651 19.3 / 85.50 40 and over 5,384 13.6 / 99.10 Unknown409 1.0 / 100.0 VA Healthcare Utilization Among 94,010 Female OIF/OEF Veterans Through 1 st Qtr. FY 2008 Environmental Epidemiology Service

9. VHA Health Policy Gender specific care is primary careGender specific care is primary care –Challenge: How to provide sufficient numbers of interested and proficient primary care providers for women veterans –One stop shop and what it means: Her primary care provider provides gender specific care Mental Health integration into Primary care is essential for women’s healthcareMental Health integration into Primary care is essential for women’s healthcare

10. VA Challenge Responding to influx of womenResponding to influx of women –Proficient Providers Training ProgramsTraining Programs –Nurses, Support staff Appropriate and adequate equipmentAppropriate and adequate equipment –Tables (hi-lo) for breast and pelvic exams –Gynecological equipment for handicapped women

11. WHO are these Women Veterans? WHAT are their special Needs? WHAT is different? WHY do we need to focus on this issue now? HOW do we care for them?

12. Who are WV with special needs?? –Young. Old – Single, Married, Divorced, Same sex partners sex partners – Have young children – Employed, unemployed – Homeless – Various racial, ethnic, cultural and religious backgrounds

13. What are some of the Special Needs?? AmputeesAmputees PolytraumaPolytrauma TBITBI Burn victimsBurn victims Survivors of MST (military sexual trauma)Survivors of MST (military sexual trauma)

16. Diagnosis same as men but not treated the same SCISCI Mental Health IssuesMental Health Issues Mobility limitationsMobility limitations BlindBlind ObesityObesity Stroke victimsStroke victims Multiple sclerosisMultiple sclerosis

17. UNIQUE Women's NEEDS Gynecological DisordersGynecological Disorders –Bleeding disorders –Cancers (cervical, ovarian, uterine, vulvar) –Infertility PregnanciesPregnancies Breast cancerBreast cancer –Reconstruction –Implants –Self image issues

18. Why do we need to be concerned? Equal but not the SameEqual but not the Same New generation of veteransNew generation of veterans NEW FACE of VANEW FACE of VA Training needsTraining needs PRIVACY and SAFETYPRIVACY and SAFETY

19. HOW DO WE DO IT It takes a VILLAGEIt takes a VILLAGE Address/focus on women in every new program developed, equipment purchased, policies developed, and staff hired at your facilitiesAddress/focus on women in every new program developed, equipment purchased, policies developed, and staff hired at your facilities Work with Local WVPMWork with Local WVPM Be INVOLVEDBe INVOLVED THANK a WOMAN VETERAN FOR HER SERVICETHANK a WOMAN VETERAN FOR HER SERVICE

21. YOU SERVE, YOU DESERVE YOU SERVE, YOU DESERVE THE BEST CARE ANYWHERE THE BEST CARE ANYWHERE QUESTIONS??? QUESTIONS???COMMENTS Thank you