No Veteran Leaves Alone: Ensuring Veterans Receive a Hero’s Final Salute

Community Cermeonies

Texas Health Arlington Memorial Hospital (THAM) has honored 531 veterans with Final Salutes since 2015. Before the official procession begins, designated employees drape the patient’s body with the flag. Physicians, nurses, and volunteers escort the body in a silent procession along with the family. On leaving, the veteran’s family receives the flag in honor of their loved one. A specially designed medallion has been placed in the lobby floor at the location where the Final Salute is rendered. Christi Evans, RN, BSN, ACM, manager for care
coordination at AnMed Health, Anderson, South Carolina, witnessed a Final Salute at THAM for a relative and took the idea to Mike Johnston, Director of Spiritual Care to establish the program at AnMed Health, which has provided 118 Final Salutes since 2018.

Central Maine Healthcare (CMH), which operates 3 hospitals, provides 2 ceremonies. The Final Salute occurs prior to the veteran’s passing and the Honor Walk gathers hospital personnel outside the patient’s room as they are moved. During the Final Salute, with the approval of a veteran’s family, a veteran employed by CMF presents the veteran with a folded flag and certificate and thanks them for their service and hospital employee salute. After the veteran dies, staff members gather in the hallway for the Honor Walk. Ascension Sacred Heart (ASH), Florida, where on average 260 veterans look for treatment every month, has taken the Final Salute to all 4 of their hospitals. Sabrina Granese, BSN, RN, Military Service Line Director at ASH explains, “Patients that are active duty or veterans are identified at the time of admission. When a veteran passes away, with the approval of a veteran’s family, ‘Code veteran’ will be heard over the hospital intercom. Staff members will have 5 minutes to make their way to the main hospital entrance for the Honor Walk.” Similarly, the skilled nursing facilities operated by Bethesda Health Group, St. Louis, Missouri, have implemented the Veteran Escort Ceremony. Employees, volunteers, family members, and residents line the hallways during the procession to salute and honor the passing of the veteran’s body.

Closure For Families

Simple yet magnificent, a Final Salute shows that a veteran is “gone but not forgotten” and also shows families they are not alone as they too made sacrifices to allow their loved ones to serve in the Armed Forces; it signals the hope of healing and closure.⁸ “The staff came to pay their respects,” recalled Cindy Roberts, a social worker at the VA Bay Pines, when her relative died at the Ozarks VAMC. She explained, I wasn’t expecting as much because it was 2 AM. I have never in my life had an experience like that. I wish there were words to describe it; I wish every VAMC in the country did that.”

Hope Danishanko, social worker at the VA Wilkes-Barre CLC, said veterans are appreciative of the program. “I have had many CLC residents tell me that the Honors Escort allows them to have closure. They also feel it provides respect to the veteran who has passed.”

Bettyanne Corkery noted that the Philadelphia CLC Honor Guard program is unique because it is veteran driven. “They have sessions in which they talk about what works and what doesn’t, and they recruit new volunteers themselves,” she said. “It has evolved into the most beautiful ceremony, and they are constantly tweaking it.” According to Gerry Donlon, “When you see all 8 members of the Honor Guard get a call at 2 AM, and everyone shows up, you know there’s personal satisfaction. I’d like to see every CLC [throughout VA] do this. I really would.”⁷

“Family members tell us they feel blessed and honored to be a part of the program. They are so grateful for the way we pay tribute to their veteran loved one,” says Leslie Schaeffer, support services manager and bereavement coordinator and coordinator of the Veteran Escort Ceremony at Bethesda Health Group communities.

Privileged and humbled—that is how staff and family members describe feeling after participating in a Final Salute. Its impact on the families has been amazing. Between the tears, there are thanks for the recognition of the sacrifices their loved ones made. When one family was informed of the ceremony by Reverend Tricia Lytle, Manager of Spiritual Care at AnMed Health, the “whole family responded by explaining how much that meant at such a difficult time. They began sharing stories about his service and how proud he was to be a veteran,” she reported. “As I [Rev. Lytle] leaned over to present the flag at the bedside, the wife reached up and took hold as she tearfully accepted it and embraced it close to her heart. The staff in the hallway looked on respectfully also in tears.”

Conclusions

The Final Salute is a brief ceremonial procession demonstrating that the mission to care for America’s veterans does not end at the bedside. It ensures that no veteran’s body is alone when led out of the health facility room to the exit. With these Final Salute practices, I hope that the rest of VA and community health facilities caring for veterans will implement a Final Salute program to better honor veterans who depart in their care.

Acknowledgments
The author would like to express gratitude to everyone who so openly shared their stories—your insight, advice, and encouragement are inspiring and invaluable. Thank you to all the facilities that consented to be featured in this article.