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

Objectives: Describe State-of-the-Art in practice and research in caregiving with individuals, specifically, Veterans with traumatic brain injury (TBI) and the implications for current practice and future research. Sources: Professional literature and personal experience of review panel.Main Outcomes: Unpaid caregiving for individuals with TBI is most often provided by a spouse, parent or other blood relative; the majority of caregivers are women. Although caregiving can be rewarding, it also may create financial burden and psychological stress. Depression among family caregivers occurs four times more frequently than in the general population. Positive coping can help reduce the impact of stress, and Department of Veterans Affairs (VA) programmes are available to ease financial burden. Group interventions show promise in reinforcing and improving positive coping for both family caregivers and Veterans with TBI.Conclusions: Identifying the specific needs of caregivers and families of Veterans with TBI and other traumatic injuries, including post-traumatic stress syndrome (PTSD), will require further longitudinal research. Currently available group interventions and programmes appear to benefit injured Veterans and their family caregivers financially and psychologically. Increased understanding of characteristics of quality family caregiving and its long term costs and benefits is likely to lead to additional improvements in these interventions and programmes

A Needs Assessment of New York State Veterans: Final Report to the New York State Health Foundation, Summary

Mental health disorders and other types of impairments resulting from deployment experiences are beginning to emerge, but fundamental gaps remain in our knowledge about the needs of veterans returning from Iraq and Afghanistan, the services available to meet those needs, and the experiences of veterans who have tried to use these services. The current study focuses directly on the veterans living in New York state; it includes veterans who currently use U.S. Department of Veterans Affairs (VA) services as well as those who do not; and it looks at needs across a broad range of domains. The authors collected information and advice from a series of qualitative interviews with veterans of Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) residing in New York, as well as their family members. In addition, they conducted a quantitative assessment of the needs of veterans and their spouses from a sample that is broadly representative of OEF/OIF veterans in New York state. Finally, they conducted a review the services currently available in New York state for veterans. The study found substantially elevated rates of post-traumatic stress disorder (PTSD) and major depression among veterans. It also found that both VA and non-VA services are critically important for addressing veterans' needs, and that the health care systems that serve veterans are extremely complicated. Addressing veterans' mental health needs will require a multipronged approach: reducing barriers to seeking treatment; improving the sustainment of, or adherence to, treatment; and improving the quality of the services being delivered. Finally, veterans have other serious needs besides mental health care and would benefit from a broad range of services

Physical and psychological health following military sexual assault: recommendations for care, research, and policy /

This paper reviews data on the prevalence of sexual assault among servicemembers, predictors of disclosure, efforts to improve disclosure, victim needs and DoD efforts to provide necessary resources in the immediate aftermath of a sexual assault. The authors compared civilian and DoD guidelines for care and found them to be generally consistent. However, little is known about the fidelity with which DoD recommendations are implemented.Print version record.Cover; Copyright; Physical and Psychological Health Following Military Sexual Assault; Bibliography; About This Paper.This paper reviews data on the prevalence of sexual assault among servicemembers, predictors of disclosure, efforts to improve disclosure, victim needs and DoD efforts to provide necessary resources in the immediate aftermath of a sexual assault. The authors compared civilian and DoD guidelines for care and found them to be generally consistent. However, little is known about the fidelity with which DoD recommendations are implemented.Includes bibliographical references (pages 19-23).JSTO

The Unified Behavioral Health Center for Military Veterans and Their Families

The public-private partnership model embodied in the UBHC is an innovative approach to expanding services for veterans and their families. To foster understanding of the UBHC model and shed light on how it is serving veterans and their families, RAND evaluated the center's activities. The evaluation was intended to document the implementation of a unique public-private collaborative approach for providing care to veterans and their families, in order to assess the approach's viability, identify implementation challenges and successes that the program can learn from, and facilitate its replication in other communities should it prove successful. This report presents the results of RAND's evaluation. The evaluation addressed four questions: * What resources and capacities were available for providing care in the UBHC? * What barriers and facilitators to implementing this model of care did the center encounter? * What services were delivered, and what were the characteristics of the patients who received these services? * How did receiving care affect patients' health outcomes

Views from the Homefront: The Experiences of Youth and Spouses from Military Families

As the United States continues deployments of service members to support operations in Iraq and Afghanistan, it is increasingly important to understand the effects of this military involvement, not only on service members but also on the health and well-being of their children and spouses. The purpose of this report is to examine the functioning of a sample of youth in military families who applied to a free camp for children of military personnel and to specifically assess how these youth are coping with parental deployment. The report addresses the general well-being of military youth during and after parental deployment, with attention to their emotional, social, and academic functioning. It also examines the challenges that their nondeployed caregivers face. The study includes quantitative and qualitative components: three waves of phone surveys with youth and nondeployed caregivers, and in-depth interviews with a subsample of caregivers. The researchers found that children and caregivers who had applied to attend the camp confronted challenges to their emotional well-being and functioning. Four factors in particular (1) poorer caregiver emotional well-being, (2) more cumulative months of deployment, (3) National Guard or Reserve status, and (4) poor quality of family communication were strongly associated with greater youth or caregiver difficulties