2012 National Meeting

3117 — Caring for OEF/OIF Veterans with Polytrauma: Health Effects on Caregivers

Griffin JM, Minneapolis VA Health System; van Houtven CH, Durham VA Medical Center; Friedemann-Sanchez G, University of Minnesota; Jensen ACTaylor BCGravely ABaines Simon A, and Bangerter A, Minneapolis VA Healthcare System; van Ryn M, University of Minnesota;

Objectives:
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 describe the relationship between caregiving experiences and poor caregiver health indicators, including caregiver strain, depression and self-reported health.

Methods:
Participants included family caregivers of all polytrauma patients with TBI who received multidisciplinary inpatient care at any VA Polytrauma Rehabilitation Center 2001-2009. A cross-sectional survey was mailed to all eligible caregivers and returned by 564 (54%) caregivers. It included questions about patient background and injury information, caregiver characteristics, objective caregiving burden (type and quantity of care provided), and caregiver reports of financial burden, health behaviors, and health indicators.

Results:
Caregivers were more likely to report caregiver strain if they were spouses, as opposed to parents (OR = 6.87), provided activities of daily living to injured Veterans (OR = 3.10), had been providing care for multiple years (OR = 3.5), and did not feel they had a choice in providing care (OR = 4.06). They were more likely to report depressive symptoms if they were poor (making <$20,000/year, OR = 4.43), caring for another dependent adult (OR = 3.67), or reported not having a choice in their role as a caregiver (OR = 2.21). Those caregivers with poor or fair self-reported health were more likely to have low household income (<$10,000/year, OR = 4.25 and $10,000-$20,000, OR = 2.63) or to care for Veterans who had poor functional measures when admitted to the PRC (OR = 1.02). A lack of choice was also associated with poor to fair self-reported health (OR = 2.28).

Implications:
Spousal caregivers, caregivers with the fewest financial means, those who did not feel they had a choice to provide care, and those providing care the longest may be the most vulnerable caregivers for poor health outcomes.

Impacts:
New services and benefits available to caregivers of OEF/OIF Veterans will provide necessary support to some caregivers, but targeted resources may be necessary to assure caregiver’s optimal health.