Factors related to perceived burden among caregivers of service members/veterans following TBI.

Abstract

To examine factors related to perceived caregiving burden in a sample of caregivers assisting service members and veterans (SMVs) across four areas: SMV injury and health status; caregiver life circumstances; caregiver duty and responsibilities; and caregiver needs. Research Method/Design: Participants were 214 caregivers (95.8% female; 86.0% spouse/partner; Age: M ϭ 38.6 years [SD ϭ 10.4]) of SMVs who sustained a mild, moderate, severe, or penetrating traumatic brain injury (TBI). Caregivers were recruited from Walter Reed National Military Medical Center and via community outreach. Participants completed the Caregiver Appraisal Scale, Mayo-Portland Adaptability Inventory-4, and Caregiver Questionnaire. The sample was divided into 2 Caregiver Burden groups: High (n ϭ 138) and Low Burden (n ϭ 76). Results: Factors significantly related to higher levels of perceived burden were (a) experiencing a greater caregiving time commitment now and over time, (b) caring for activities of daily living/instrumental activities of daily living, (c) experiencing an impact of caregiving on employment, income, and out of pocket expenses, (d) parenting more than 1 child, (e) having less time to devote to one's self now and over time, (f) having caregiver needs, and/or (g) assisting a SMV who had incurred a mild TBI; was experiencing greater functional disability; had a posttraumatic stress disorder (PTSD) diagnosis; received mental health and rehabilitation treatment; and/or used an assistive device (all p Ͻ .05; odds ratios [ORs] ϭ 1.13 to 14.57; ds ϭ .02 to 1.30). Conclusions/Implications: Providing care for a SMV after a TBI can impose a heavy burden, particularly for caregivers who provide support to SMVs with comorbid mental health problems, such as PTSD.

Posttraumatic Stress Disorder is a Stronger Predictor of Long‐Term Neurobehavioral Outcomes Than Traumatic Brain Injury Severity

“…The benefits of such an approach may have consequences beyond the individual. Reducing that additive burden may lessen the distress among family members caring for an SMV following TBI (Brickell et al., ). Treatment programs for TBIs, whether in the DoD, Veteran Affairs, or community programs, will have the most success with a holistic approach that attempts to address behavioral health concerns such as PTSD and helps individuals realize the important contribution of these factors in their overall health and functioning.…”

Effectiveness of remote interventions in improving caregiver stress outcomes for caregivers of people with traumatic brain injury.

“…Caregivers of people with brain injury have been found to have worse mental health compared with caregivers of people with dementia and caregivers of people with cancer (Harding et al, 2015). The uniqueness of caregiver stress for the caregivers of people with TBI is associated with the variance in the condition, the level of impairment, and the associated symptoms (Brickell et al, 2019). Severe TBIs, for example, are more likely to have a high impact on caregiver stress because the more severe the brain injury, the higher the chances that the person with TBI would experience long-term deficits in memory, attention, language, processing, and overall executive functioning (Manskow et al, 2015).…”

Role captivity: A concept of constraining dimensions in dementia care

“…They also pointed out how they had lost control of their lives. Brickell et al found that caregivers of veterans who had suffered traumatic brain injury reported having less time to devote to themselves and their personal needs as well as to the needs of their other family members. A decrease in relationships and social interactions with family, friends, and neighbors was also noted as an outcome of caregiver demands adding to the stress of caretaking .…”

“…When that pattern is disrupted, whether through choice (such as getting married) or through circumstance (such as a debilitating illness), usual social interactions are often altered or curtailed. Brickell et al reported caregivers of patients with TBI who perceived their caregiving as being “high burden” devoted less time to themselves and their other children. In a study of caregiver burden, it was noted that caregivers of persons with schizophrenia reported having to give up their previous social life and stay in or near their house.…”