No place like home: an innovative foster care program for disabled vets points the way to solving two of the nation's greatest challenges at the same time.

• Author: Gravois, John

As a boy, Rick Heady got used to the company of crusty old veterans. His parents ran a "family care" facility for some two dozen disabled ex-soldiers out of his childhood home, a cavernous three-story Victorian. Heady's grandparents did the same; in the 1930s, they even housed one of the last surviving members of the Union Army.

Heady always wanted to continue the family tradition, but in the hyperspecialized world of twenty-first-century America, he had neither the training nor the kind of facility it required. So he wound up working as an AutoZone manager and a sometime motorcycle mechanic, living in a modest single-family home outside Tampa, Florida.

Then one day a few years ago, Heady's dad told him about a new program run by the Department of Veterans Affairs. Known as the medical foster home program, it not only offers a solution for one of the deepest challenges facing American society--the explosive growth in the numbers of frail elderly--it also offers homeowners like Heady a way to earn a modest and meaningful living.

Under the program, the VA pairs veterans who would otherwise live in nursing homes with ordinary citizens who are willing to take them into their homes and help them with tasks like bathing, administering medication, cooking meals, changing diapers, and the like. Veterans pay their caregivers an average of just under $2,500 a month, using their Social Security checks, VA pensions, and whatever other benefits and savings they have. And most crucially, the VA supplies primary medical care for the veterans right in their foster homes via what is essentially a suped-up system of old-fashioned house calls from nurses, doctors, and therapists--who thereby also provide regular oversight of the homes. This allows for dramatically lower cost, and better-coordinated care. (Treating a vet in a medical foster home costs the VA about $52 a day, compared with an average of $580 a day for those in nursing homes.) It also helps prevent the neglect and elder abuse that can be common in other small residential settings.

Today, Heady cares for two disabled vets in his home. (The VA allows a maximum of three.) The guys live right down the hall from Heady's teenage stepdaughter, whose room is decked out in Twilight paraphernalia and painted deep purple. The family had to renovate one of its bathrooms to accommodate a...