In coming months, physicians at Veterans Affairs hospitals will start their patient visits with a seemingly mundane but potentially radical question: “Should someone else be in the room too?”

The move is part of a new initiative by VA leaders and the caregiver-focused Elizabeth Dole Foundation to make sure that spouses, parents and loved ones providing direct care for injured veterans are included in every step of their medical planning and treatment, something that happens inconsistently today.

Advocates said the goal is not only to improve health care for veterans but also for their families and the entire department health system.

“(Caregivers) manage veterans medication … They do their best to keep veterans spirits up,” said Dole, a former North Carolina senator and caregiver to her veteran husband, former Senate Majority Leader Bob Dole. “They are the first line of defense against the worst of all possible outcomes: suicides.

“These hidden heroes provide care that is extensive, intimate and around the clock. Just imagine the insight our medical professionals have to gain from them.”

According to past research with VA, roughly two-thirds of veterans’ caregivers reported difficulty accessing their loved ones’ medical records or being fully involved in their medical visits.

The new initiative, starting at three regional department networks today, includes training for hundreds of doctors, nurses and social workers on how to better include caregivers in veterans’ medical plans. That includes making sure they are invited to appointments, asking for their observations and input, and including their information in medical charts.

VA officials said for many younger medical professionals, those practices are already part of their normal routine. But the approach has not traditionally been part of past medical school training, and is not always required by outside medical systems.

“This is a no-brainer for us,” said Lisa Pape, deputy chief officer for patient care services at VA. “We should be engaging these caregivers in treatment of veterans … and acknowledging what they contribute.”

The efforts are separate from a congressionally-mandated expansion of VA’s stipend program for caregivers, which awards monthly payouts to individuals who provide full-time monitoring for injured or infirm veterans. That program is currently open only to post-9/11 veterans. Expansion to other groups has been delayed until later this year.

Pape said the new training program will be expanded from the first three sites to the rest of the VA system later this year, after a short trial period to troubleshoot any issues. Veterans and caregivers may not see results immediately, but hopefully will notice a gradual integration into VA care plans over the next two years.

Steve Schwab, CEO of the Dole Foundation, said numerous outside medical systems are also closely monitoring the effort.

“We want to create a new standard for care here,” he said.

More information on the initiative is available on the campaign’s web site.

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

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