QUERI – Quality Enhancement Research Initiative

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Caregiver Support (VA-CARES)

Durham, NC

Caregiver Support (VA-CARES)


The Caregivers and Veterans Omnibus Health Services Act of 2010 (Public Law: 111-163) enacted legislation to ensure services and supports for family caregivers of Veterans through two landmark programs: The Program of Comprehensive Assistance for Family Caregivers (Comprehensive Program or PCAFC), and the Program of General Caregiver Support Services. These two programs – referred to as the Caregiver Support Program – serve to enhance support and services for family caregivers for qualifying Veterans, including education and training and respite care. Since the Comprehensive Program’s inception, uptake in participation has far surpassed initial projections with more than 100,000 applications received and over 37,000 caregivers served by the end of FY2018.  In FY2018, VA obligated over $500 million in support of the overall budget for the Caregiver Support Program. VA-CARES QUERI will evaluate the impacts of these programs on Veterans and caregivers.

VA CARES QUERI evaluated the short-term impacts of the Comprehensive Program and the Program of General Caregiver Support Services by addressing the following aims:

  • Assess the impact of the Comprehensive Program on the health and wellbeing of Veterans by examining healthcare encounters expected to be sensitive to caregiver support (i.e., acute, primary, and specialty utilization);
  • Assess the impacts of the Comprehensive Program on the health and wellbeing of primary family caregivers;
  • Understand how caregivers use and value components of both the Comprehensive Program and the Program of General Caregiver Support Services; and
  • Generate a detailed profile of the costs and services provided in both programs to assess the value of the program to Veterans, caregivers, and the VA healthcare system.

VA CARES QUERI also is working to:

  • Examine the effect of Comprehensive Program participation on Veterans’ total healthcare costs at three years;
  • Conduct formative evaluation of the Comprehensive Program application process to identify areas and approaches for supporting consistency across VA; and
  • Characterize and examine the caregiver and Veteran characteristics associated with discharge of Veterans from the Comprehensive Program, and whether these drivers vary across facilities.

Findings and Impacts:

VA CARES found Veterans in PCAFC had higher total VA healthcare costs up to three years following PCAFC enrollment and despite intensive supports, caregivers still experience high levels of depressive symptoms. VA CARES Center findings have informed multiple briefings of the Deputy Secretary and other decision makers. VA CARES also has created and validated a survey instrument of Caregiver Perceptions About Communication with Clinical Team Members (CAPACITY). In addition, the VA CARES Center has produced 10 novel data sets to date and 6 publications.

Principal Investigator
Courtney Van Houtven, PhD; contact at Courtney.VanHoutven@va.gov .

Operations Partner
The VA Caregiver Support Program (CSP), part of VA Care Management and Social Work Services, strives to help those who partner with VA to care for people who have 'borne the battle' through specific programs and a support line that offers emotional support and resources to family members and friends, who care for Veterans on a daily basis.