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Office of Public and Intergovernmental Affairs

Remarks by Secretary Denis R. McDonough

Elizabeth Dole Foundation Annual Convening Keynote
Washington, Dc
October 29, 2021

Good morning, everyone!

Senator Dole, thanks so much for that kind introduction, for your steadfast leadership of this amazing foundation, and for your decades of public service.  

I said it earlier this year, and I’ll say it again now: our nation is a better, more caring place because of you and your leadership—and the leadership of Senator Bob, as well.

We are all in your debt.

Thanks, as well, to Steve Schwab and Meg Kabat, our excellent hosts and two of the very best advocates for caregivers in this country. And, of course, thanks to all of you who have joined us today for the annual convening of the Elizabeth Dole Foundation. 

It’s a true honor to be here.   

You know, whenever I think of the work that you do, I remember a story I heard from a Veteran whose wife is his primary caregiver.

This Veteran is a quadruple amputee, and he needs his wife’s help for most everything—from brushing his teeth, to shaving, to getting dressed, to putting on his prosthetics in the morning. And when he tells his story, he notes that “people come up to [him] all the time and say, Thank you for your service.” And he appreciates that. Truly.

But he also says that “nobody ever comes up to [his wife] and thanks her for the service that she’s given to this country by taking care of [him].”

That’s wrong—and it gets to the very heart of what Senator Dole said earlier, which is that “[caregivers] should not be left to struggle alone. They should not be left behind.”

I know that at times throughout VA’s history, caregivers have been overlooked. Or not included. Or not appreciated for the back-breaking work they do, and the incredible service that they provide.  

But I’m here today to say, to any caregiver watching, that those days are over.

Let me repeat: those days are over.

At VA and in this administration, we see you. We hear you. We will do everything in our power to support you. And we thank you, from the bottom of our hearts, for all that you do—for our country and the Veterans you love.

Our job at VA and EDF is to help those caregivers—to find ways to make their lives easier—both because that’s the right thing to do, and because supporting caregivers improves outcomes for Veterans.

We know that many caregivers have to balance managing a household, childcare, legal and financial challenges, and complex medical conditions all at once. And now, on top of everything, they’re dealing with the tragedies and the dangers of this pandemic.

This is the type of stress that leads caregivers to suffer from anxiety, depression, and health issues more often than most Americans.

And it means that our shared mission to care for those caregivers has never been more important than it is right now.

During the pandemic, I know that EDF has risen to that challenge—partnering with VA to provide more than 500,000 dollars-worth of free, professional respite services to caregivers who needed it.

And our great VA employees have done the same—by vaccinating more than 85,000 caregivers and Veteran spouses through the SAVE LIVES Act, as Senator Dole mentioned earlier; by giving PPE to caregivers at the height of the pandemic; by delivering more care and more benefits to more Veterans than ever before—thus ensuring that caregivers didn’t have to shoulder the burden alone; and by adapting to telehealth and doubling the size of the program of comprehensive assistance, thus providing more direct support to more caregivers than ever before.  

In short, during this time when caregivers and Veterans have needed us most, we’ve been there for them—and we’ve done it together.

But we can’t stop here. Instead, with EDF’s help, we need to continue to do better for Vets and caregivers. We need to continue to be better for Vets and caregivers. And we’re going to do that by driving toward the four fundamental principles that shape VA’s vision for the future: Advocacy, Access, Outcomes, and Excellence.


First, advocacy. We’re working to make sure VA is the nation’s premier advocate for Veterans and caregivers. And when it comes to advocacy, it starts at the top.

Our shared mission could not be a higher priority for this administration, nor could it be closer to President Biden and the First Lady’s hearts.

You can see evidence of that dedication in Joining Forces, the First Lady’s initiative which—just this month—published a report that will help VA create new a program for Veteran families. You can see evidence of that dedication in our close collaboration with the Veterans’ Family, Caregiver, and Survivor Advisory committee—which is chaired by Senator Dole herself. And you can see evidence of that dedication in the very existence of Meg Kabat’s position as the first ever senior advisor for caregivers.

But as we all know, advocacy at the leadership level doesn’t mean anything if caregivers don’t use the benefits they deserve—which is where you come in. For many caregivers, you are their connection to VA. In many cases, you’re the ones who help them realize they are caregivers in the first place.

All of which is to say: EDF is one of VA’s most important partners. And I’m committed to working with you every day to improve access for the caregivers we serve.


Second, access. We’ll move heaven and earth to get caregivers timely access to their VA resources.

For caregivers who help Veterans with assisted daily living, that’s access to the Program of Comprehensive Assistance—which we’re soon expanding to cover all generations of caregivers. For other caregivers, that’s access to the Program of General Caregiver Support Services—for which we have dedicated staff at every VA medical center ready to meet with caregivers, help identify their Veterans’ needs, and come up with a plan to address them.

But access for caregivers doesn’t only mean access to programs—it also means access to the health care their Veterans receive, and to the great VA clinicians who provide it. Because caregivers are our partners, and they need to be in the room and in the know to help their Veterans achieve the best possible results.


Next, I want to talk about outcomes. Because as you know, the health and happiness of caregivers is inextricably tied to the health and happiness of the Veterans they serve.

This is perhaps best exemplified by the story of Cathy Thomas, a full-time caregiver to her husband—an army Vet who served in Afghanistan. She’s a part of VA’s Peer Support Program for caregivers.

Before that program, she said that she was “completely alone.” She had nobody to talk to, and it was wearing on her. But now, thanks to the program, she has a tight-knit group of caregivers to rely on. And that support system has had potentially lifesaving results.

Let me explain. A while ago, her husband—who suffers from post-traumatic stress and diabetes—seemed very depressed, and Cathy was worried that he might be suicidal. But she was reluctant to discuss it with him.

Then she spoke with her peer support group, and that conversation gave her the courage and comfort she needed to talk to her husband. And now, he’s doing better. They both are.

The point is that better outcomes for caregivers like Cathy lead directly to better outcomes for the Veterans they love.

That’s borne out by stories like Cathy’s and by recent VA research—which tell us that Veterans are better able to deal with chronic illnesses like diabetes if they have a caregiver looking after them.

In other words, by improving caregiver outcomes, we improve Veteran outcomes—and we at VA are going to stop at nothing to do both.

And one more thing on outcomes: we know that a lot of older Vets and non-Vets—especially those with mental health and cognitive challenges—are struggling right now to find home and community-based services that meet their needs. This is because of pandemic-related staffing issues, bed shortages at hospitals, and a lack of home-based services. It’s a reminder that you—and caregivers nationwide—are so often the pillars in Veterans’ lives that keep them from falling through the cracks.

You’re the ones managing Vets’ medications—and making sure their regimens are followed. You’re the ones helping them to and from countless appointments. You’re the ones who are up in the middle of the night, responding to everything from emergencies to nightmares. And in doing so, whether you know it or not, you are the onepreventing bad outcomes like homelessness and suicide.

So we’re laser-focused on finding innovative home- and community-based services that work for you and the Veteran you love. And all of you will be critical partners in that effort.


Finally, excellence. We’re seeking excellence in all we do for Veterans and caregivers by leveraging the strength and diversity that defines the Veteran population, the caregiving population, and this country. Every person entering a VA facility must feel safe, free of harassment and discrimination. And we will welcome all Veterans and caregivers.

Now, there’s so much I could say here, but it all boils down to this: for too long, too many Veterans who fought to protect our rights and freedoms have had to fight brutal battles here at home for their own rights and freedoms.

Tragically, many of those fights continue to this day.

But at VA, no caregiver or Veteran is going to have to fight to get the quality care, benefits, and services they earned—no matter who they are or who they love.

So that’s where VA is headed: providing more support to more caregivers than ever before—with Advocacy, Access, Outcomes, and Excellence as our guiding principles.

But make no mistake: we can’t do it without you.

Just ask Ilihia Gionson, a caregiver who says that EDF “played a big part in connecting me with the resources that help me care for my father.” Or Jen Ostan, a caregiver who says that EDF helps her deal with the “emotional burden” of this work.  Or Georgette Winton, a caregiver who says that EDF has helped her realize that she is “not alone in this journey.”

Those Veteran caregivers, and the 5.5 million like them across the country, are—as you so rightly call them—hidden heroes.

You know, President Biden often says that our nation’s most sacred obligation is to prepare and equip the troops we send into harm’s way, and then to care for them when they return home. Well, nobody keeps that promise quite like our nation’s caregivers—and nobody helps our nation’s caregivers quite like EDF.

You make us at VA better, and in doing so, you serve the caregivers who serve our nation’s Veterans. Our caregivers are happier, and our Veterans are healthier, as a result.

So thank you for your magnificent work, for your partnership, for putting up with me, and for all the work we will do together.

God bless you, our nation’s Veterans and the caregivers who serve them so well.

And may we always give them our very best.

Thank you.