Document Type

Final Project

Graduation Date

Spring 5-4-2024

Degree Name

Doctor of Nursing Practice

First Advisor

Dr. Trina Aguirre

Abstract

Objectives: This program evaluation of Veteran Administration’s (VA) Home-Based Primary Care Program (HBPC) measured the differences in loneliness, diagnoses of Major Depressive Disorder (MDD), Post Traumatic Stress Disorder (PTSD), Anxiety, and Traumatic Brain Injury (TBI) and multimorbid conditions in rural and urban older adult veterans compared with older adult community-dwelling veterans. The correlations of loneliness using the 11- Item Revised University of California Los Angeles (R-UCLA) Loneliness Scale will describe the relationship of loneliness to mental health diagnoses, multimorbid conditions, demographic data, caregiver presences and the number in-person and phone contacts with the HBPC providers of a Midwestern Veterans Administration (VA) Home-Based Primary Care veterans enrolled in one HBPC Program. Methods: Sixteen male veterans (84.21%), mean age 83.125 (SD: 7.779), three female veterans ages (mean age: 76.7; SD: 6.0277; range 71 – 83) completed the 11-Item R-UCLA Loneliness Scale. Results: The oldest veterans (World War II Era and Korean Era) had lower R-UCLA Scale scores than Vietnam Era veterans. There was no significant difference in rural and urban, or having caregivers and no caregivers in loneliness scores. HBPC veterans endorsed feeling lonely at least some of the time at 52.98% and often feeling lonely 17.54%. Significantly, the three female veterans with mental health diagnosis had the largest number of comorbidities, highest number of prescriptions, highest number of contacts with HBPC providers. Conclusion: Loneliness scores in the oldest veterans was lower than the Vietnam Era veterans, conversely, the female veterans who have a mental health diagnosis have higher loneliness scores, more comorbidities, increased prescription use and receive more contact with HBPC providers. Research into determining if findings are applicable to other HBPC Programs in the Midwest U. S. so that interventions can be formulated to reduce the negative impact of loneliness on physiological, psychological well-being, for all of the aging veterans. The focus of future interventions should target reducing loneliness with the growing number of aging female veterans.

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