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2011 HSR&D National Meeting Abstract

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2011 National Meeting

3102 — Financial Strain Among Family Caregivers of OEF/OIF Service Members with Traumatic Brain Injury and Polytrauma

Van Houtven CH (Durham COE), Friedemann-Sanchez G (University of Minnesota), Clothier B (Minneapolis COE), Levison D (University of Minnesota), Taylor B (Minneapolis COE), Jensen A (Minneapolis COE), Phelan S (Minneapolis COE), Griffin JM (Minneapolis COE)

Objectives:
To assess whether family caregivers of OEF/OIF-era service members with polytrauma, including traumatic brain injury (TBI), experience financial strain from caregiving.

Methods:
Cross-sectional data from a mailed survey of family caregivers. Caregivers were family members of U.S. service members and Veterans (hereafter called patients) (n = 1,046) who had received care for TBI and polytrauma, been discharged for at least 3 months from one of four VA Polytrauma Rehabilitation Centers between 9/2001-2/2009, and who were alive when the survey was fielded. 538 caregivers returned a survey including the financial questions (51%). Measures of financial strain included: leaving the labor force since beginning caregiving; using assets or acquiring debt to help pay for the patient’s care; and, average amount of assets and debt per caregiving year spent on the patient’s care. Bivariate analysis measured whether financial strain differed by tasks provided (ADLs, traditional IADLs, other care specific to polytrauma, and no tasks needed). Logistic regression or general linear models examined the association of caregiver tasks and other caregiver and patient covariates with the three financial strain measures.

Results:
36.8% of caregivers left the labor force and 63% used assets or debt to help pay for the patient’s care. The conditional mean (median) amount of total assets and/or debt was $10,088 ($2,567 ) per caregiving year. Even after controlling for important covariates, logistic regression revealed that ADL or traditional IADL caregivers, as compared to light or non-assisting caregivers, faced increased odds of leaving the labor force and of using assets or debt. More intensive caregivers also spent increased mean amounts of assets and/or debt.

Implications:
Our study found that financial strain is common for family caregivers of severely injured OEF/OIF patients and is higher for intensive caregivers. The recently enacted Caregivers and Veterans Omnibus Health Services Act could help relieve some of the financial strain of family caregivers and severely injured patients.

Impacts:
VA providers should be aware of financial strain faced by OEF/OIF family members. Financial strain could act as a barrier to full recovery of severely injured VHA patients if it impedes the quality of care provided by family caregivers.


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