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2011 HSR&D National Meeting Abstract

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2011 National Meeting

3028 — Why are Caregivers of OEF/OIF Veterans with Traumatic Brain Injury and Polytrauma Financially Strained?

Friedemann-Sanchez G (Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System and University of Minnesota), Van Houtven CH (Durham VA Medical Center HSR&D and Duke University Medical Center), Jensen AC (Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System), Levison D (University of Minnesota), Phelan S (Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System and University of Minnesota), Griffin JM (Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System and University of Minnesota)

Objectives:
To explore the reasons for financial strain reported by family caregivers of OEF/OIF veterans with polytrauma, including traumatic brain injury (TBI).

Methods:
Self-reported cross-sectional data from a mailed survey of 564 family caregivers who returned a completed survey (54%). Caregivers were family members of VA patients (n = 1,046) who had received inpatient care for TBI and polytrauma, had been discharged for at least 3 months from one of four VA Polytrauma Rehabilitation Centers between 9/2001-2/2009, and were alive when the study was fielded. Survey asked what were financially the most difficult times: 1-3, 3-6, 6-12 months after injury, 1-2, 2-3, and/or > 3 years post-injury, and, using an open-ended question, the reasons for the difficulty. 396 qualitative responses were coded according to emerging themes.

Results:
427 family caregivers reported financial strain across all time periods and in multiple time periods. Nearly 45% responded 1-3 months was difficult, over one-quarter had difficulty through the first 2 years, 14-18% had difficulty > 2 years post-injury. Reasons for difficulty include caregivers leaving the labor force or inability to enter the labor force due to caregiving, reduction in work hours due to time pressures of multiple caregiving roles, unreimbursed travel expenses to VA or DoD medical facilities including airfare, hotel, and meals, and relocation costs to be closer to rehabilitation services. Reasons for strain attributed to the care recipient include delay in VA, DOD, and social security disability insurance compensation, lack of or reduced income, household and vehicle accommodation costs, and compulsive spending and lack of concept of money. Family factors specific to parent caregivers include veterans’ divorce, legal fees, and caring for veterans’ children.

Implications:
Caregiver, care recipient, and family factors are sources of caregiver financial strain. Financial strain is experienced at multiple times during the recovery period and may be ongoing.

Impacts:
While the recently enacted Caregivers and Veterans Omnibus Health Services Act will provide financial stipends covering caregiving costs at rates equivalent to home health aides, the study reveals that many of the reasons behind the opportunity, direct, and indirect costs of care are beyond what the Act will likely cover.


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