Families often describe the need as “someone has to be here,” which is a different need from “someone has to help Dad get dressed.” Aid and Attendance is an increase in the VA pension, and VA describes the aid and attendance need in more than one way. One way is a need for the regular aid of another person to protect the veteran from the hazards or dangers of his daily environment because of mental incapacity.1 If that is the gap in your house, a claim that lists only bathing and dressing describes the wrong need.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Write down the hazards before you hire

List the specific daily dangers in the veteran's own home: a stove left on, a door left open at night, walking out of the house alone, or running a bath without checking the water. Put each one beside the time of day it happens. A hazard list is concrete, and it is what a doctor can speak to. Ask the doctor whether the medical record describes the supervision need in plain terms or only names a diagnosis. A diagnosis alone does not show what he cannot safely do by himself.

Split the hours into two columns

Build the care plan with two columns. The first is hands-on hours: dressing, bathing, transfers, and meal preparation. The second is watch hours: awake presence that prevents the hazards on your list. Ask any agency or hired helper to show both columns in the written scope. The hours described on the claim should match the hours in the contract. Companionship, such as reading together or running errands, does not describe the protective need by itself.

Questions to ask before you sign

  • Does the scope list overnight watch separately from daytime watch?
  • If Dad wanders at night, is that hour staffed awake, or is the helper asleep in another room?
  • Who decides when a watch hour becomes a hands-on hour, and is that change written down?
  • What happens to the scheduled hours during a hospital stay or a move to another facility?

What this outline does not settle

This outline does not tell you whether Dad qualifies. VA decides from the evidence in the file, which includes the medical record, any exam, and the household facts. Read the criteria on the VA page before you describe the need in any claim.2

1 VA.gov, Aid and Attendance and Housebound benefits, https://www.va.gov/pension/aid-attendance-housebound/

2 VA.gov, Aid and Attendance and Housebound benefits, https://www.va.gov/pension/aid-attendance-housebound/