VA Geriatrics, Palliative and Extended Care
The Geriatrics, Palliative and Extended Care service line provides a coordinated array of services to veterans in need of comprehensive interdisciplinary assessment and care for functional impairment, cognitive decline, chronic disease management and end of life care. We do so in the home, clinic, hospital, VA Community Living Center, hospice and community nursing homes.
The goals of the Service Line are to prevent unnecessary institutionalization, promote independence, restore and maintain function, and maximize quality of life.
This is accomplished through a continuum of programs consisting of a Geriatrics clinic, a Geriatrics inpatient consultation service, a Palliative Care consultation service, VA -based nursing home care (including palliative care, rehabilitation, post-acute restorative care, respite care, and chronic disease management), home based primary care, and contracted services (including community nursing home care, adult day health care, respite care, skilled home care, hospice, and homemaker/home health aid services).
The San Francisco VA Health Care System (SFVAHCS) The Hospice and Palliative Care Service
What Is Palliative Care
- Help with pain and other symptoms, such as shortness of breath, nausea, fatigue
- Discussing preferences for future care
- Psychological and spiritual support
- Access to and coordination of community and VA services
The San Francisco VA Health Care System (SFVAHCS) Outpatient Palliative Care
The San Francisco VA Health Care System (SFVAHCS) Inpatient Palliative Care Consult Team
The San Francisco VA Health Care System (SFVAHCS) Inpatient Hospice
The San Francisco VA Health Care System (SFVAHCS) Geriatrics Clinic
The San Francisco VA Health Care System (SFVAHCS) Home Based Primary Care
The SFVAHCS Home Based Primary Care (HBPC) is a national VA program designed to provide interprofessional, longitudinal, comprehensive team-based primary care in the home. HBPC specializes in caring for veterans with complex chronic disease and psycho-social co-morbidities with difficulty accessing the health care system. Teams of physicians, nurse practitioners, physical and/or occupational therapists, social workers, registered dieticians, pharmacists, mental health providers, and program support assistants based in San Francisco, Santa Rosa, Ukiah, and Eureka serve underserved veterans in rural, urban, and suburban settings. Teams collaborate with veterans, their caregivers, and associated VA and non-VA services to overcome the challenges of functional decline and chronic disease and maximize independence in the community through the final months and years of veterans' lives.
The San Francisco VA Health Care System (SFVAHCS) Community Living Center
The Community Living Center (CLC) of the SFVAHCS is the skilled nursing home for the veterans. We provide short term rehabilitation, skilled nursing care as well as long term dementia and long term continual care. Our team of interprofessional providers (physicians, nurses, social workers, restorative care nurse, dietitians, recreational therapists, geropsychologist, mental heal clinical nurse, physical therapists, occupational therapists and pharmacist) manage veterans with complex medical, social and mental health illness. Our goal is to meet each veteran’s needs and provide patient centered care. Within the CLC, we have three specialty programs: Hospice care (please see more details under Inpatient Hospice); Social Focus Cohort which focuses team management of veterans with complicated psychosocial illnesses; and Respite program which offers a much-needed rest for 24/7 caregivers of veterans in the community. Veterans in the respite program stay at the CLC for 1-2 weeks which allows their caregiver’s some time to rest or visit families or friends.
The San Francisco VA Health Care System (SFVAHCS) Veterans' Integrated Perioperative Clinic
The Veterans' Integrated Perioperative Clinic began in October of 2017. It was created to provide a more coordinated, interdisciplinary preoperative evaluation (Hospital Medicine, Geriatrics, PT, OT, SW, and Pain Psychology) for frail or medically complex veterans undergoing surgery. In addition to guidance on medical optimization, special emphasis is given to patient education & expectations, medication review and management, cognitive & functional status, and overall health preparation. The clinic is particularly well-suited for patients with multiple co-morbidities, who are elderly or frail, who have chronic pain, mental health or substance use issues, and/or those with limited social supports. At present, the clinic sees patients scheduled to undergo orthopedic surgeries only, but will soon expand to other surgical services.
San Francisco Veterans Affairs Medical Center
4150 Clement Street, 181G
San Francisco, CA 94121