A former nurse and the widow of a World War II vet­eran, Dorothy Jablonski, 84, had been living off her husband’s pension, her own Social Security and the proceeds from the sale of her house. But as her nest egg shrank, Jablonski’s sons had no idea how she would continue paying her monthly bill of about $6,000 at one of the Sunrise senior living communities in Maryland.

After talking with staff at Sunrise, a McLean-based company with about 300 assisted living facilities nationwide, Dan Jablonski learned that his mom might be eligible for a little-known benefit called Aid and Attendance (A&A).

A need-based, tax-free pension, A&A supports wartime veterans and their spouses who cannot pay for non-service-related medical needs. (Veterans with service-connected disabilities get compensation through a separate program operated by the Department of Veterans Affairs).

About 182,000 veterans and their spouses take advantage of the A&A benefit, which has been around since World War I, but VA officials say that many more are eligible.

“We know that we’re only hitting about one in four eligible veterans,” said Tom Pamperin, the VA’s deputy undersecretary for disability assistance. “There are a lot of veterans where it’s been 40 years or more since they’ve been on active duty. It just doesn’t occur to them there may be a benefit from the VA.”

Beneficiaries must be at least 65 years old. They are veterans or married to veterans who served during a wartime period — eligibility includes the Vietnam War era and the Gulf War of 1990 — and were honorably discharged; they do not have to have seen combat.

Applicants must also need help with at least one activity of daily living: dressing, eating, walking, bathing, adjusting prosthetic devices or using the toilet. Those who are blind, living in nursing homes or require in-home care may also be eligible.

Married veterans can receive as much as $1,949 per month. Single veterans could get a monthly A&A check for $1,644. A veteran’s surviving spouse could receive a maximum of $1,056. Though a beneficiary’s other income and benefits might reduce the amount of the pension, Pamperin said most people get the maximum.

Single veterans must make less than $19,736 annually. A married veteran’s income must be less than $23,396. Dorothy Jablon-ski’s annual income fell beneath the A&A $12,861 limit for a surviving spouse.

Within a year of submitting the forms (21-534, DD-214) required by the VA, she began receiving the maximum A&A benefit.

“It makes a difference,” said Dan Jablonski, a Johns Hopkins University physicist from Bethesda, “so there is no financial component for my mother’s end-of-life decisions.”

While grateful, Dan Jablonski added that without the guidance of a lawyer — half of whose fee was paid by Sunrise — “[the application] would have probably crashed and burned and not gotten anywhere.”

It’s not a simple process. A&A applicants must mail the forms, copies of service records, marriage certificates, proof of insurance and medical records to the regional VA office. If a third party is making the application, an additional form, 21-22-a or 21-0845, must be completed.

“It’s a difficult, challenging, bureaucratic system,” said Debbie Burak, 59, of Midlothian, Va. After applying on behalf of her mother, Burak established VeteranAid.org to help others navigate the process.

Once a pension is granted, the VA provides a lump-sum payment to cover the benefit retroactively from when the application was filed. The average wait is 90 days, according to Pamperin.

“We’re increasing output,” Pamperin said, “but for the last couple of years, it still hasn’t been able to match the incoming claims.” In 2009, the program paid out almost $2 billion.

Prospective applicants can get information from veterans organization such as the American Legion, and they can call the VA at 800-827-1000.

Dorothy Jablonski now uses A&A as supplemental income to help pay for her long-term care.

“By joining the Navy during World War II,” Dan Jablonski said, “one can make the case that my father traded his risk of being in the military during a war against the needs that my mother would have over half a century later.”