Impact of TBI on caregivers of veterans with TBI: Burden and interventions

Figures & data

Figure 1. Activities of daily living performed by caregivers of persons with TBI.

Figure 2. Instrumental activities of daily living performed by caregivers of persons with TBI.

Figure 3. Adverse effects reported by caregivers of persons with TBI.

Table 1. Recent milestones in VA caregiver support.

2007: VA Advisory Committee on Operation Iraqi Freedom/Operation Enduring Freedom Veterans and Families established. Responsible for reviewing VA services and benefits; providing advice to the Secretary on health care, benefits and family support issues; and making recommendations for tailoring VA services and benefits to meet the needs of OEF/OIF veterans and their families. 2007: Resources for Enhancing Alzheimer’s Caregiver Health (REACH-VA) program introduced [40]. The first national clinical translation of a proven dementia behavioural intervention covering multiple states and facilities. 2007: Eight caregiver assistance pilot programs at selected VA medical centres nationwide, to examine ways to improve education and provide training and resources for caregivers assisting veterans. One of these eight pilot programs focuses on providing education, skills training and resources to caregivers of veterans with TBI, including both OEF/OIF and non-OEF/OIF veterans. 2008: Caregiver Advisory Board established. Charged with developing a caregiver assistance program that addresses caregiver issues across VA’s health care disciplines and programs. The board is to identify core caregiver needs system-wide, the development of initial recommendations for VA caregiver support services, and the oversight of eight caregiver assistance pilot programs to assess the feasibility and advisability of various mechanisms to expand and improve VA caregiver assistance services. 2009: VA FACES study began, to help researchers understand more about the needs of caregivers for Veterans with TBI and polytrauma. 79 per cent of those who provide care to polytrauma patients are women; 62 per cent of those women are parents and 32 per cent are spouses. Nearly 25 per cent of all caregivers reported that they provide more than 40 hours per week of care [14]. 2009: VA Family Care Map piloted at VA’s four Polytrauma Rehabilitation Centers (PRC) to ensure family members are fully involved in the care of veterans with polytrauma. A uniform approach to involve and integrate the family, through education and collaboration, into the centre of the Veterans care for polytraumatic injuries [41]. 2010: Caregivers and Veterans Omnibus Health Services Act becomes law On 5 May 2010, President Obama signed Public Law 111-163, in an effort to aid family caregivers of eligible post-9/11 veterans by requiring VA to establish a comprehensive assistance program and general support services for caregivers. 2011: VA’s National Caregiver Support Line established Caregivers for Veterans can access a toll-free caregiver support line (1-855-260-3274), expanded education and training on caring for Veterans at home, and other support services such as counselling and support groups. 2014: Research in caregiving advances [42] Shows caregivers continue to provide care and support even after their loved ones have been placed in long-term care facilities, and this experience also takes a toll on family members involved in this process.

Figure 4. Comparison of Pre-9/11 and Post-9/11 Veterans and caregivers across medical diagnoses.

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