© 2024 NPR Illinois
The Capital's Community & News Service
Play Live Radio
Next Up:
0:00
0:00
0:00 0:00
Available On Air Stations
Illinois Issues
Archive2001-Present: Scroll Down or Use Search1975-2001: Click Here

A Home for Their Own: State Veterans' Homes Struggle to Recruit During Nursing Shortage

Patrick O'Keefe served in the U.S. Army during the Korean War era and lives at the Manteno Veterans' Home.
Patrick O'Brien
/
WUIS/Illinois Issues

For 87-year-old Frances Staszewski, the Manteno Veterans' Home near Kankakee is nothing less than a lifeline and a salute to the service he gave as a member of the U.S. Merchant Marine in World War II. 

“Thank the State of Illinois for giving us a home. We have no place else to go. We have all we need to take care of ourselves,” he says. 

Staszewski says he has more freedom at the Manteno facility than he would at home, where he had limited mobility without a wheelchair. 

Meanwhile, 173 more veterans have registered for a chance to stay at Manteno. 

The state's veterans' homes face multiple challenges to meet the needs of a changing and growing population. 

A nationwide nursing shortage is even more severe for the state's veterans' homes because all four homes are outside the Chicago area, making recruiting more difficult. Private hospitals offer incentives the state cannot, and Illinois scrambles to hire nurses as quickly as possible. That shortage, combined with an increasing number of Vietnam veterans who are nursing-home age, threatens to further strain resources. 

“We admit [veterans] at our homes only when we have sufficient numbers [of nurses] to care for them,” says Manteno administrator Martin Downs. The home is not in the position of having to turn away veterans, however. 

Jessica Woodward, spokeswoman for the Illinois Department of Veterans' Affairs, says the average overtime for a nurse at Manteno is nine hours a month, compared with 20 hours at the LaSalle Veterans' Home in north-central Illinois. 

The nurses' union, the American Federation of State, County and Municipal Employees Council 31, has a contract with the state that requires them to work overtime as needed, she adds. 

Certified nursing assistants at LaSalle say they work an average of 15 mandatory overtime hours a week, and the burden affects their personal lives and makes it more difficult to care for residents. 

Jessica Becket, a nursing assistant at LaSalle, said at a Statehouse press conference that she ran her car into a ditch after an exhausting 16-hour shift. Becket and Kathy Reno, who leads the local union at the home, say as many as seven employees have been terminated for refusing to work overtime shifts. 

Both women stress that the overtime issue has had a far greater effect on their private lives than on the quality of care given to residents. They note that the nurses who remain at the home tend to be the most dedicated. 

The LaSalle home is finishing an 80-bed expansion, which will create more demand for staffing when it's completed this summer. 

Tammy Duckworth, director of the Illinois Department of Veterans' Affairs, says the pool of available nurses is small in rural areas, so downstate veterans' homes have to draw from the Chicago area. But nurses don't always want to leave Chicago. 

“It's significantly more difficult to get them to work in LaSalle than in Chicago. We can't compete with the private hospitals that are offering $10,000 to sign up,” she says. 

The department has begun offering $5,000 in tuition reimbursement and other enticements to make it easier to recruit nurses. Duckworth says most homes hired 20 nurses or more in the past year. 

Sen. John Sullivan, a Rushville Democrat, says a proposed measure to eliminate mandatory overtime for state employees could help retain nurses by allowing them to refuse double shifts and long work weeks without penalty. 

Duckworth says the department will work within the confines of the proposal if approved. The House approved the measure in April. It was in the Senate in mid-May with 34 co-sponsors. 

The shortage in nurses will soon be compounded by the increasing number of Vietnam veterans who need nursing care in Illinois. 

“We're really facing a double boom with the Vietnam vets,” Duckworth says. “We serve 114 of them in our homes, and that population is only going to grow. And when they enter, they could be with us for another 20 years.” 

According to Duckworth, the Veterans Administration in Washington, D.C., told a group of state veterans' administrators last fall that 80 percent of eligible Vietnam veterans have not yet applied for benefits at the state or federal levels. 

About 3 million Americans served in Vietnam, but it's unclear how many live in Illinois and would be eligible for such benefits. 

The federal agency reports 6,955 Vietnam veterans in Illinois, a count that Duckworth says is just a fraction of the actual number. If the federal government's statistics on the number of veterans eligible for care are correct, Illinois' real population of Vietnam veterans is closer to five times that. 

As those veterans reach retirement age, they often lose employer-related health care coverage, which is especially important considering the types of illnesses many of them may have. 

Some of those under-the-radar veterans were exposed to Agent Orange, a defoliant used extensively by the U.S. military in its herbicidal warfare program. They are entering the age where symptoms of diseases associated with the toxin, such as cancer, leukemia, hypertension and diabetes, become more urgent. 

According to Duckworth, medical technology in Vietnam saved many lives that would have been lost in earlier wars, meaning more residents have lost limbs   and suffered brain injuries and other wounds that complicate efforts to care for them. 

“With the entrance of the Vietnam generation, the injuries have become worse and the disabilities worse,” she says. 

Veterans with dementia or Alzheimer's disease require extra levels of care that other patients don't, so staffing shortages can hit particularly hard in those units. Sullivan says the cost and effort to care for that group of patients makes staffing shortages harder to get under control. 

At the Manteno home, the Alzheimer's unit must be locked down at all times. Currently at full capacity with all 40 beds occupied, 60 people wait to be admitted to the unit. Some will wait up to two years, which is not unique to that facility. 

“We need Alzheimer's beds everywhere,” Duckworth says. 

Woodward of the Illinois Department of Veterans' Affairs says the state has a total of 111 beds for Alzheimer's patients, and all are filled. 

Duckworth says she would like to build new Alzheimer's units because the cost of updating older homes like Quincy would be less efficient. 

The Alzheimer's unit in the southern Illinois Anna Veterans' Home is the model for future units. 

“I want to build a state-of-the art facility rather than cobbling something together that has to be fixed later,” Duckworth says. A proposal to build a new home in the Chicago area would include new beds for veterans with Alzheimer's. 

Yet partially because of staffing issues and ongoing construction, the existing homes are not currently operating at full capacity. 

The department reports that 850 veterans live in the state's five homes, with 1,232 being the maximum authorized capacity. There are 140 additional beds across the state unavailable because of remodeling. 

The state's current budget for the homes allows them to be staffed at 89 percent capacity. Next year's budget request for the Quincy home, however, would decrease funding and allow it to operate at 80 percent capacity because ­­of decreased demand. 

Rep. Lisa Dugan, a Bradley Democrat and member of the House committee that oversees veterans' affairs, says that even if the state made all the money available for full occupation of all beds, it would take time to find the staff. 

The waiting list at Manteno includes many veterans who were offered beds in the Quincy home but declined because they wanted to stay near Chicago. This trend is increasing, and the department says some veterans are opting for more expensive private care in the Chicago area. 

Care at the state home is $929 a month for almost every veteran, while private nursing homes can charge four to six times that amount, Downs says. 

State homes contain twice the number of beds as the federal veterans' homes in Illinois, and budget pressures on the federal system make Illinois' veterans' homes an important safety net. 

Illinois has three federal veterans' homes, in Danville, Marion and North Chicago. The federal system for veterans also is strained to care for the older generation of veterans as they focus on assisting the estimated 1.7 million recent veterans of the Iraq and Afghanistan wars. 

The veterans who rely on the homes   and who care for their fellow veterans say the nursing issues, however, have not impacted the quality of care. 

  Woodward says the state homes meet the federal standard of 2.5 hours' staffing per day for each resident. The Manteno home employs 60 registered nurses, 90 certified nursing assistants and three full-time physicians to care for its 250 residents. The facility also transports residents daily to the federal Edward Hines Jr. VA Hospital west of Chicago for medical care. 

“You would be hard-pressed to find anyone to argue with the quality of care,” Sullivan says. His district contains the largest veterans' home, with more than 500 residents in Quincy. 

Staszewski says he receives exemplary care. “I'd rather be here than in any other place. We're treated like veterans here.” 

Barry Baron says the quality of care is high because the home is run by veterans. 

Baron, the adjutant of the Manteno home, watches over fellow veterans who served in the same war he did and considers himself lucky to be able to do so. He served in the 9th Infantry Division in Vietnam from 1968 to 1970. 

He assists Downs in helping residents make the transition to being away from their own homes. He says he's continuing a tradition. “When we were overseas, we took care of ourselves and each other, and that continues.” 

Baron, himself in a wheelchair because of wounds he suffered in the war, says helping fellow veterans transition to the home has done wonders for him. 

“I'm fortunate to have the opportunity to work there. It's probably extended my life, to be able to help people.” 

Downs says the home has about 20 volunteers a day, including some veterans, who assist the staff and provide companionship and support for residents. 

Downs, also an Army veteran, says the common bonds between residents make the home less gloomy. “You don't get a sense of finality here, but a sense of camaraderie.” 

And the woman who oversees the operation of all the homes, Duckworth,   is an Iraq War veteran who lost both legs after her helicopter was shot down in 2004. 

Although Duckworth says the system is operating within its current constraints, building a new home in the Chicago area is crucial to meeting current and future needs.             

Woodward says roughly 50 percent of the state's veterans live in Cook and the surrounding counties, but the closest homes, in Manteno and LaSalle, are more than an hour's drive from Chicago. 

The department says a Chicago-area home will provide easier access for veterans' families using the extensive public transportation system in Cook County. The department also says the high cost of private nursing home care in Cook County means veterans need another option for care in the area. 

“It's not just capacity, it's where the capacity is at. It's very difficult to visit a loved one,” Duckworth says. 

The plan to build a home in the Chicago area, however, depends on funding from a statewide construction plan being negotiated in Springfield. 

Duckworth says the potential capital plan would earmark $15 million for the project, and if approved, Illinois would move up in line for a federal matching grant. The federal match would provide 65 percent of the project's funding, with the state providing the remainder. 

Even with the challenges in staffing the homes and a looming influx of more residents, the homes continue to serve veterans in a unique way. 

Baron says the Manteno home is a place where veterans can be comfortable knowing they're with others who know their struggles. “We're all in the same fraternity. Some of the things they've shared in their lives they can only share with other veterans.” 

Illinois Issues, June 2008

Related Stories