3034 — Caring for OEF/OIF Veterans with Polytrauma: The Objective Burden of Caregivers.
Griffin JM (Minneapolis COE-CCDOR), Friedemann-Sanchez G
(Minneapolis COE-CCDOR), Jensen AC
(Minneapolis COE-CCDOR), Taylor BC
(Minneapolis COE-CCDOR), Gravely A
(Minneapolis COE-CCDOR), Clothier B
(Minneapolis COE-CCDOR), van Houtven CH
(Durham COE-CHSRPC), Baines Simon A
(Minneapolis COE-CCDOR), Bangerter A
(Minneapolis COE-CCDOR), Pickett T
While many “polytraumatic” injuries (traumatic injuries to multiple organs or body systems, including traumatic brain injury) sustained in OEF/OIF are considered mild, some are severe and clinically complex and survivors often require long-term treatment and care. Care responsibilities for these patients often shift from institutionally provided care to unpaid, family-provided care as survivors stabilize, recover, and work toward community reintegration. Our objectives were to: 1) describe who provides informal care to service members and veterans (hereafter called patients) with moderate to severe polytrauma; 2) assess caregiver objective burden, including time spent caregiving and tasks provided.
Participants included family caregivers of all polytrauma patients with TBI who received multidisciplinary inpatient care at any VA Polytrauma Rehabilitation Center between 2001 and 2009. A cross-sectional survey was mailed to all eligible caregivers and returned by 564 (54%) caregivers. It included questions about caregiver and patient background characteristics, objective caregiving burden (type and quantity of care provided), and patient injury information.
22% of patients continue to require assistance with both activities of daily living (ADLs) and independent activities of daily living (IADLS). An additional 50% require routine assistance with only IADLs. Nearly 25% of caregivers provide informal care > 40 hours/week and 20% provide care 5-40 hours/week. Of caregivers providing assistance with ADLs, 50% provide care > 80 hours/week. Caregivers, even those not providing ADLs or IADLS, commonly reported managing patients’ emotional issues (70%); navigating the health care (54%), benefits (53%), and legal (54%) systems; making medical appointments (44%); managing pain (36%); and aiding with therapies (37%) or assistive devices (33%). The majority of caregivers are women (79%) and most commonly are the patient’s parent (62%) or spouse (32%).
Caregivers of polytrauma patients are actively engaged in providing care. Caregivers of patients with the greatest needs provide more hours of care, but even caregivers of patients with few needs continue to provide some form of care.
The new Caregivers and Veterans Omnibus Health Services Act will provide necessary support to some caregivers, but targeted resources may be necessary to meet the long-term needs of all caregivers and their care recipients.