Service needs and health outcomes among caregivers of service members and veterans following TBI.

Abstract

The purpose of this study was to examine the (a) prevalence of unmet caregiver needs across eight health care and social service needs and the (b) impact of unmet needs on caregiver health and appraisal outcomes. Research Method/Design: Participants were 264 caregivers (95.8% female; 85.2% spouse/partner) providing help to service members and veterans who sustained a mild to severe or penetrating traumatic brain injury. Caregivers were recruited from Walter Reed National Military Medical Center (Maryland) and via community outreach to participate in the congressionally mandated 15-year Longitudinal Traumatic Brain Injury Study (Sec721 NDAA FY2007) supported by the Defense and Veterans Brain Injury Center. Caregivers completed the Caregiver Appraisal Scale, SF-36v2 Health Survey, and caregiver questionnaire. Participants were divided into 3 health care and social service needs groups: no unmet needs, 1-3 unmet needs, and 4 -8 unmet needs. Results: Six of the 8 needs were each endorsed by a majority of caregivers (59.1%-70.1%). Each need was reported as unmet by 29.5% to 52.7% of caregivers. A significant linear relation was found between number of needs and poorer outcomes (i.e., 4 -8 needs Ͻ 1-3 needs Ͻ 0 needs). The cumulative number of unmet needs was significantly related to worse outcomes in most areas, while most individual needs were not significantly related to outcomes. One exception was the caregiver's unmet need for medical health, which was significantly related to increased bodily pain. Conclusions/Implications: Continued support from programs and expansion in the breadth and scope of health care and social services for caregivers is required, including identifying the issues that hinder caregivers accessing the services they need.

How eLearning Can Decrease Challenges of Informal Family Caregivers of Service Members & Veterans with Invisible Injuries

“…However, Ramchand et al (2014) recommended that formally developed programs, to include online training, webinars, and other formal courseware that could be programmatic, should be explored for the MVC population to learn how to become better caregivers. Many other studies have also revealed gaps in training and determined that training for caregivers of veterans or service members with mental health issues would be beneficial, also supporting the development of formal web-based support to the underserved community of military caregivers, (Brickell et al, 2018;Lorig et al, 2012;Miller et al, 2015;Patel, 2015;Ramchand et al, 2014;Stevens et al, 2015).…”

“…The purpose of this article is to show the challenges faced by caregivers of injured, ill, or wounded service members and veterans, as well as to suggest how eLearning if delivered appropriately, can be a viable way to provide essential support to this population. While there is a growing body of literature that addresses the needs of this population, it can be determined that very few education and training opportunities are available for the military veteran caregiver population (Brickell et al, 2018;Ramchand et al, 2014).…”

“…Further studies reported that hundreds of thousands of soldiers suffered from a traumatic brain injury (TBI) either due to a military training accident during a deployment, or from combat exposures, such as IED blast waves (Brickell et al, 2018;Carlozzi et al, 2016;Conard et al, 2017;Delgado et al, 2018;Easom, Wang, K., Moore, Wang H., & Bauer, 2017;Saban et al, 2016;Stevens et al, 2015;Tanielian et al, 2008;Tanielian et al, 2013).…”

“…Other researchers have also reported that training needs for Post 9/11 caregivers, those who care for a wounded, ill or injured service member who served after September 11, 2001, have very different training needs from caregivers of Pre-9/11 veterans, that is, those who care for individuals who served before September 11, 2001 (Miller et al, 2015); Ramchand et al 2014). What is significant to note is that scholars have increasingly suggested the importance of caregivers receiving the education and training necessary to care for and cope with these cognitive and mental diagnoses (Brickell et al, 2018;Carlozzi et al, 2016;Stevens et al, 2015). To understand a MVCs need for education, training, and support, it is critical to recognize the characteristics and needs of this population.…”

“…Additional studies tested web-based, skill-building training for caregivers of those with TBI and polytraumatic injuries (Lorig et al, 2012;Stevens et al, 2015) with more investigators recommending future formal education and training programs to a) lessen the stress, isolation, and caregiver burnout that MVCs had reported experiencing as a result of having duties that they did not understand how to perform; b) reduce negative effects that caregivers experienced as a result of not knowing how to help their loved ones; and, c) provide the alternative for veterans to remain in their homes as compared to being institutionalized in a nursing home (Bass et al, 2012;Brickell et al, 2018;Easom et al, 2017;Griffiths et al, 2010;Lorig et al, 2012;Nichols, et al, 2016;Stevens et al, 2015;Van Houtven et al, 2010). Figure 2 represents a map of the number of military caregivers that have self-identified in each geographical region.…”