The problem this desk is built around is not always the one families expect. Money can be tight, but the core question for aid and attendance is whether the veteran needs regular help from another person with daily life. A household can pay every bill and still have no one who can help with bathing, dressing, or meals. Telling those two gaps apart is the first step.1

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.

Signs of a help gap

These are things a family can see and write down. None of them is a diagnosis, and none of them proves eligibility by itself.

  • Bills are paid on time, but mail from VA or from the bank sits unopened for days.
  • Meals are skipped, or the refrigerator holds food that has gone bad.
  • Laundry, dishes, or the bathroom are left undone for longer than they used to be.
  • Dressing or bathing takes so long, or is so unsafe, that the veteran avoids it.
  • There have been falls, near-falls, or a stove or appliance left on.
  • Known routes, appointments, or phone calls are missed.

Separate a money gap from a help gap

Ask a simple question: if the bills were covered tomorrow, would Dad still need someone with him for daily tasks? If yes, the gap is about help, and extra money alone will not close it. If no, the gap may be financial, and a different part of this desk applies. Both can be true at once, which is why the question is worth asking separately.

Keep a two-week written log

For two weeks, the family writes down each time the veteran could not complete a daily task without someone standing by, what the task was, and what happened. Use plain facts: the time, the task, the help needed, and any injury or near-miss. Keep the log in the family's own notes. Bring it to the veteran's doctor, who can judge which items are beyond what he can do safely and which reflect choices he is still able to make.2

When the veteran says he is fine

Many veterans resist the idea that they need help, and an argument rarely changes that. Keep the log, share the specific observations with the doctor, and ask the doctor to examine him directly. If there is an immediate danger to his safety, call emergency services first and sort out the paperwork afterward.

What the log does not do

A pattern is evidence for the family's own decisions and for the doctor. It does not decide a VA claim. VA evaluates the medical record and its own criteria for regular aid and attendance, so the log is most useful as one input among others.3 The St. Louis local help page lists the offices to call once the family is ready to talk through the next steps.

This desk is not affiliated with the U.S. Department of Veterans Affairs.

1 VA.gov, aid and attendance criteria under the pension benefit (38 CFR 3.352).
2 VA.gov, medical evidence guidance for pension claims.
3 VA.gov, how VA evaluates evidence in a pension claim.