Commonalities & Differences Shed Light on Individuality · 58 + 40 + 18 + Cond : Frostbite/ Cold...
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Commonalities & Differences Shed Light on Individuality Military Caregivers: Presented By Mary Brintnall-Peterson, Ph.D. Owner, MBP Consulting, LLC. Professor Emeritus, University of Wisconsin-Extension Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
Transcript of Commonalities & Differences Shed Light on Individuality · 58 + 40 + 18 + Cond : Frostbite/ Cold...
Commonalities & Differences Shed Light on Individuality
Military Caregivers:
Presented By Mary Brintnall-Peterson, Ph.D. Owner, MBP Consulting, LLC.
Professor Emeritus, University of Wisconsin-Extension
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
Presenter: Mary Brintnall-Peterson, Ph.D.
o Owner of MBP Consulting, LLC
o Professor Emeritus University of Wisconsin-Extension
o Over 25 years as an educator of family caregivers
o Personal and professional caregiving experiences
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
Statement of Purpose
Help professionals recognize and consider the commonalities and differences of military family
caregivers as they explore options to address the caregiver’s individual needs.
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
Webinar Objectives
o Professionals will be able to: • Recognize there isn’t a “typical military caregiver.” • Identify commonalities and differences a military caregiver
may have with other caregivers. • Determine the assets and challenges of each military
caregiver. • Identify resources for each military caregiver.
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
Polling Question
Do you work mostly with… A. Service members in active duty, guard or reserve B. Veterans C. Military family caregivers D. One of the above Service member types and their
caregiver
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Polling Question
How long have you worked with military family caregivers? A. Never B. Less than two years C. Two to five years D. More than five years
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QUESTION #1
What is the relationship or connection the caregiver and Service member or veteran have (i.e. parent, spouse,
girlfriend, sibling, grandparent, etc.)?
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Military caregivers are…
o Spouses or significant other o Parents o Children o Siblings o Grandparents o Someone close to the wounded warrior
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Relationship of Military Caregivers
o 70% Spouses o 16% Parents o 82% Primary Caregiver
o 32% Spouses o 62% Parents o 59% Primary Caregiver
Caregivers of Veterans Caregivers of OEF & OIF with TBI
Griffin, J. M., 2012; NAC 2009, NAC 2010
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
QUESTION #2
What is the sex and age of military caregivers?
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Sex & Age of Military Caregivers
o 96% Women o 16% Over the age of 50
o 79% Women o 84% Under the age of 60
Caregivers of Veterans Caregivers of OEF & OIF with TBI
Griffin, J. M., 2012; NAC 2009, NAC 2010
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
QUESTION #3
What medical condition(s) and/or disabilities do
caregivers assist Service members or veterans with?
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War Related Conditions
WWII Korean War
Vietnam Gulf War OIF , OND &
OEF
Age 86 + 78 + 58 + 40 + 18 +
Cond Frostbite/ Cold injuries, Infectious diseases (rheumatic fever, hepatitis, tropical diseases Wounds
Cold injuries such as frost and immersion (trench) foot
Malaria/ tropical diseases, Agent Orange
Chemical & biological agents, exposure to smoke, ALS, PTSD
PTSD, TBI
We Honor Veterans Hospice Professionals on a Mission to Serve WWII, Korean War, Vietnam, Gulf War and OIF, OND and OEF
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Veteran Differences
45 and younger 65 and older
Mental illness 78 56
PTSD 79 36
TBI 61 10
Diabetes 6 36
Cancer 4 27
Parkinson’s Disease 1 13
Manguno-Mire, G., 2007 ;Nac 2010
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All Severities (273,859)
2% 1%
8%
82%
7% Penetrating
Severe
Moderate
Mild
Defense and Veterans Brain Injury Center
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TBI by Armed Forces
58% 14%
14%
14%
ArmyAir ForceNavyMarines
Defense and Veterans Brain Injury Center
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QUESTION #4
Where do Service members/veterans receive
medical care?
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Distance Presents Complications
o Navigation of multiple health care systems o Care provided in more than one location o Rural communities often have fewer supports o Two households creates logistic issues o Loss of support network(s)
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QUESTION #5
What assistance do military caregivers provide to Service
members or veterans?
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Caregivers assist with…
o Health care systems o Benefits o Daily Activities o Medical Tasks o Advocate o Translate & Interpret
o Support o Decisions o Legal & Financial Issues o Injuries & Illness o Healthy Behaviors
Hoiser, A. 2013
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QUESTION #6
Is the military caregiver caring for
anyone else?
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Characteristics of Military Caregivers
o 24% Provide care to another individual
o 31% Caring for children or another dependent adult
Caregivers of Veterans Caregivers of OEF & OIF with TBI
Griffin, J. M., 2012; NAC 2009, NAC 2010
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
Caregivers Care for Others
o Children • Ages • Reactions/interactions with
Service member/veteran • Concerns about relationship
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Caregivers Care for Others
o Dependent Adult(s) • Condition(s) • Amount of time • Others helping • Where individual lives • Relationship
o Others
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QUESTION #7
Is the military caregiver employed?
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Characteristics of Military Caregivers
o 41% Employed o 55% Employed
Caregivers of Veterans Caregivers of OEF & OIF with TBI
Griffin, J. M., 2012; NAC 2009, NAC 2010
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Employment
o May return or continue working
o Almost half of military caregivers quit or retire
o May provide respite
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QUESTION #8
What challenges do military caregivers experience?
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Challenge–Caregiver Journey is Bumpy
o Notification o Confusion o Getting to the Service member o Recovery process o Coming home o Creating a new normal
Vulcan Productions, 2013.
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Challenge–Not Part of Care Team
o Lack of recognition o Not member of “official” care team o Translator at home o Ask lots of questions o Don’t understand medical condition(s) o Lack of support
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Caregiver Challenge
“I lost my job due to taking too much time off work to be with him.”
Warrior’s Spouse/Caregiver – Loxahatchee, FL
“Financially, it has just about killed us.”
Warrior’s Parent/Caregiver – Zanesville, OH
Wounded Warrior Family Care Report, 2009
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Challenge–Loss of Income
o Most pervasive and most damaging to the family • Caregiver may quit or reduce working • Decline in Service member’s pay and/or benefits • Medical bills not covered by health insurance • Higher rate of financial hardship for caregivers of
Service members with mental illnesses and TBI
Tanielian, T., 2013 ; Wounded Warrior Family Care Report
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Challenge–Loss of Income
o Loss of wages and benefits • $60,300 in 19 months
o Caregivers financial obligations
• More care means higher financial obligations • 41% had new financial obligations • 37% had unmet financial obligations which was
mostly increased credit card debt
Christensen, E. 2009; Tanielian, T., 2013
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Challenge–Warrior NOT willing to Seek Help
o Doesn’t want others to know about condition
o Stigma within military circles to seek help • 43% of service members who took
their lives in 2010 did not seek help from a military treatment facility in the month before their death
Caregivers’ Guide to Battling Suicide on the Home Front
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Challenge–Care Task(s) Complex
o Surviving serious trauma o Provide care at home o More complex o Multiple medical conditions
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Challenge–Length of Caregiver Journey
43% Expected to provide care longer. Twice the length of other caregivers.
NAC 2009, NAC 2010, Wounded Warrior Family Care Report
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Caregiver Challenge
“I needed someone who had been through this to be a mentor for me–to help me understand that I will get through this.”
Warrior’s Parent/Caregiver – Florida
Wounded Warrior Family Care Report, 2009
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Challenge–Lack of Support
o Families geographically dispersed
o Living in rural America o Unfamiliar with local resources
Tanielian, T., 2013 ; Wounded Warrior Family Care Report
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Challenge–Health Deterioration
o Decline in health (16-18% ) o In fair/poor health o Seek medical attention in crisis o Do not take care of themselves o Chronic health conditions 2 times rate of non-caregivers o Higher mortality rates than non-caregivers.
Tanielian, T., 2013
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Caregiver Challenges
“Families are falling apart and crumbling. My husband and I separated; we dealt with our son’s injury in different ways”
Warrior’s Parent/Caregiver – Indiana
“Our children have some support but still do not receive adequate mental-health care. The system is overloaded and cannot handle the number of kids that need help where we are. The qualified physicians are outnumbered by the children.”
Warrior’s Spouse/Caregiver – San Antonio, TX
Wounded Warrior Family Care Report, 2009
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Mental & Emotional Distress Reasons
o Multiple caregiving tasks o Grief about losses o Guilt when take time for self o Some leave caregiver role
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Challenge–Depression
o Most commonly reported distress
o Caring for veteran with depression, PTSD, anxiety, TBI, or amputee
o Health condition that needs medical attention
o Seek professional help o Condition can improve
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Ways to Help with Depression
o Follow your organization’s procedures o If no organizational procedures:
• Determine if caregiver needs immediate help • Discuss how depression is a medical condition • Encourage them to seek professional help • Provide information about helping professionals
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QUESTION #9
What are some ways military caregivers can take care of
themselves?
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Self-Care Techniques
o Take time for themselves o Live in the moment o Take care of themselves
• Exercise • Sleep • Eat healthy meals • Keep medical appointments • Take medications
o Ask for help o Make lists o Lots of others…
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QUESTION #10
What types of resources do military caregivers use?
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Types of Helpful Resources
o Medical information on Service member’s condition(s) o Being an effective caregiver o Organizational helps o Self-care assistance o Financial and legal support o Connecting with others
Tanielian, T., 2013
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QUESTION #11
What resource delivery methods do military caregivers
find most helpful?
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
Information Sources for Military Caregivers
o Word of Mouth-most common source • 6 out of 10 (63%) indicated it was very or somewhat helpful
o Care manager • 65% somewhat helpful for Service member • 43% helpful for her/himself
o Willingness to use internet news & information • 90% of active duty spouses • 75% of Veteran spouses
National Survey of Veterans, Active Duty Service Members, Demobilized National Guard and Reserve Members, Family Members, and Surviving Spouses, 2010
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Helpful Resources
o Military o Veterans Administration o National Resources o Educational Resources o Caregiver Organizations
• National • State • Local
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Summary—Commonalties & Differences
o Sex o Age o Relationship o Length o War or conflict o Service member/veteran medical condition
Caregiver Journey Influenced by…
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Summary—Caregivers of Active Duty Warriors
o Younger o Live with Service member o Have children o Employed o Parent (TBI); otherwise probably spouse/significant other
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Summary—Caregivers of Veterans
o Older o Spouses/significant other o Caring for parents/disabled adult o Live with veteran o More community resources for older adults
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Summary—Challenges
o Caregiver Journey o Not part of care team o Loss of income o Service member not willing to seek help o Care task(s) complex o Length of caregiver journey o Isolation o Health deterioration o Mental & emotional distress o Depression
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Summary—Salute Military Caregivers
o Unsung heroes o Critical to recovery o Have needs of their own o Need support
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
References
Bearon, L.B. (2013). The burdens and blessings of family caregiving. North Carolina Cooperative Extension, North Carolina State University. Retrieved September 6, 2013 from: http://www.ces.ncsu.edu/depts/fcs/pdfs/fcs464.pdf Caregivers’ Guide to Battling Suicide on the Homefront. eXtension. Retrieved August 8, 2013 from: http://www.extension.org/pages/65439/caregivers-guide-to-battling-suicide-on-the-home-front#.UhZgpfUo7IU. Christensen, E.; Hill, H. C.; Netzer, P.; Farr, D.; Schaefer, E.; & McCahon, J. (2009). Economic Impact on Caregivers of the Seriously Wounded, Ill and Injured. Courage to Care: Suicide Facts from Primary Care Providers. Helping Services Members and Families Overcome Barriers to Care. Retrieved on April 15, 2013 from: http://www.cstsonline.org/courage-to-care-suicide-facts-for-primary-care-providers/ Department of Defense (DOD). Defense and Veterans Brain Injury Center. Worldwide Numbers for Brain Injury. Retrieved on August 19, 2013 from: http://www.dvbic.org/dod-worldwide-numbers-tbi Griffin, J. M.; Friedemann-Sanchez, G. ; Jensen, A. C.; Taylor, B. C.; Gravely,A .; Clothier, B.; Simon, A.B.; Bangerter, A.; Pickett, T.; Thors C.; Ceperich S.; Poole J.; & van Ryn, M. (2012). The invisible side of war: Families caring for US Service members with traumatic brain injuries and polytrauma. Journal of Head Trauma Rehabilitation 27(1):3-13. Hoiser, A. (2012). Family Caregiver Health Bulletin: Joys of Caregiving. Cooperative Extension Service: University of Kentucky. Retrieved on September 6, 2013 from: http://clay.ca.uky.edu/sites/clay.ca.uky.edu/files/November_2012_Family_Caregiver_Health_Bulletin.pdf
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References
Hoiser, A. (2013). Family Caregiver Health Bulletin: Military Family Caregiving. Cooperative Extension Service: University of Kentucky. Retrieved on September 6, 2013 from: http://clay.ca.uky.edu/sites/clay.ca.uky.edu/files/June%202013%20Caregiver%20Health%20Bulletin.pdf IOM (Institute of Medicine). (2013). Returning home from Iraq and Afghanistan: Assessment of readjustment needs of veterans, Service members, and their families. Washington. DC: The National Academies Press. Manguno-Mire, G.; Sautter, F.; Lyons, J.; Myers, L.; Perry,D.; Glynn, S.; & Sullivan, G. (2007). “Psychological Distress and Burden among Female Partners of Combat Veterans with PTSD, (2007). Journal of Nervous Mental Disorders, Vol. 195, No.2, pp.144-151. Montgomery, R.J. V. & Kosloski. K. (2009). Caregiving as a Process of Changing Identity: Implications for Caregiver Support. Generations, 33, 47-52. Montgomery, R. J. V. & Kwak. J. (2008). Tailored Caregiver Assessment and Referral (TCARE) process: An evidence-based model for effectively supporting caregivers. American Journal of Nursing, 108. 54-57. National Alliance for Caregiving (NAC). (2010). Caregivers of Veterans—Serving on the Homefront. Bethesda, MD: National Alliance for Caregiving. Retrieved on January 1, 2011 from: https://www.unitedhealthfoundation.org/uhfassets/docs/2010/caregivers-of-veterans-study.pdf
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References
National Alliance for Caregiving & AARP (2009). Caregiving in the United States. Bethesda, MD: National Alliance for Caregiving. Retrieved January 10, 2010 from: http://www.caregiving.org/data/Caregiving_in_the_US_2009_full_report.pdf National Survey of Veterans, Active Duty Service Members, Demobilized National Guard and Reserve Members, Family Members, and Surviving Spouses (2010). Retrieved on September 19, 2013 from: http://www.va.gov/SURVIVORS/docs/NVSSurveyFinalWeightedReport.pdf PBS. (2008). Caregiving for your parents: The joys of caregiving. Retrieved September 6, 2013 from: http://www-tc.pbs.org/wgbh/caringforyourparents/handbook/pdf/cfyp_joys_caregiving.pdf Pinkus, E. (2011) Survey of Nebraska Members on Long-Term Care and Caregiving Issues. Washington, DC: AARP. Using the Internet. (2013). Retrieved on September 19, 2013 from: http://www.extension.org/pages/32551/using-the-internet#.Ujr-iNwo7IU Rewards of Caregiving. eXtension. Retrieved on August 14, 2013 from: http://www.extension.org/pages/9324/rewards-of-caregiving#.Ui4ZC_Uo7IU Savundranayagam, M.Y., & Montgomery, R.J.V. (2010). Impact of role discrepancies on caregiver burden among spouses. Research on Aging, 32, 175-199.
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References
Schmall, V. (2004). Depression in Late Life: Recognition and Treatment. Pacific Northwest Extension Publication, No. PNW 347 Retrieved on August 8, 2013 from: http://extension.oregonstate.edu/catalog/pdf/pnw/pnw347.pdf Tanielian, T.; Ramchand, R.; Fisher, M.P.; Sims, C.S.; Harris, R.; & Harrell M.C., (2013). Military Caregivers: Cornerstones of support for our nation’s wounded, ill, and injured Veterans. Rand Corporation. Library of Congress. Retrieved April, 10, 2013 from: http://www.rand.org/pubs/research_reports/RR244.html Vulcan Productions. Everyone Serves: A Handbook for Family & Friends of Service Members During Pre-Deployment, Deployment, and Reintegration. (2013). Retrieved on September 25, 2013 from: http://www.everyoneservesbook.com/ We Honor Veterans Hospice Professionals on a Mission to Serve. Afghanistan and Iraq (OEF & OIF) Health Risks. Retrieved on August 10, 2013 from: http://www.wehonorveterans.org/i4a/pages/index.cfm?pageid=3321 We Honor Veterans Hospice Professionals on a Mission to Serve. Gulf War Health Risks. Retrieved on August 10, 2013 from: http://www.wehonorveterans.org/i4a/pages/index.cfm?pageid=3318 We Honor Veterans Hospice Professionals on a Mission to Serve. Korean War Health Risks. Retrieved on August 10, 2013 from: http://www.wehonorveterans.org/i4a/pages/index.cfm?pageid=3309
We Honor Veterans Hospice Professionals on a Mission to Serve. Vietnam Health Risks. Retrieved on August 10, 2013 from: http://www.wehonorveterans.org/i4a/pages/index.cfm?pageid=3315 We Honor Veterans Hospice Professionals on a Mission to Serve. World War II Health Risks. Retrieved on August 10, 2013 from: http://www.wehonorveterans.org/i4a/pages/index.cfm?pageid=3304.
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
Commonalities & Differences Shed Light on Individuality
Military Caregivers:
Sponsored By Texas A&M AgriLife Extension Service, eXtension Military Families
Learning Network, USDA – National Institute of Food and Agriculture, and the U.S. Department of Defense
Professional development webinars brought to you by the eXtension Military Families Learning Network – Military Caregiving educational initiative.
