Impact of TBI on caregivers of veterans with TBI: Burden and interventions

Abstract

Objectives: Describe State-of-the-Art in practice and research in caregiving with individuals, specifically, Veterans with traumatic brain injury (TBI) and the implications for current practice and future research. Sources: Professional literature and personal experience of review panel. Main Outcomes: Unpaid caregiving for individuals with TBI is most often provided by a spouse, parent or other blood relative; the majority of caregivers are women. Although caregiving can be rewarding, it also may create financial burden and psychological stress. Depression among family caregivers occurs four times more frequently than in the general population. Positive coping can help reduce the impact of stress, and Department of Veterans Affairs (VA) programmes are available to ease financial burden. Group interventions show promise in reinforcing and improving positive coping for both family caregivers and Veterans with TBI. Conclusions: Identifying the specific needs of caregivers and families of Veterans with TBI and other traumatic injuries, including post-traumatic stress syndrome (PTSD), will require further longitudinal research. Currently available group interventions and programmes appear to benefit injured Veterans and their family caregivers financially and psychologically. Increased understanding of characteristics of quality family caregiving and its long term costs and benefits is likely to lead to additional improvements in these interventions and programmes.ARTICLE HISTORY

Exploration of Factors Related to Depressive Symptomatology in Family Members of Military Veterans With Traumatic Brain Injury

“…Considerable research has documented negative sequelae that family members of civilians with TBI often experience: significant levels of depression, stress, and anxiety (Kreutzer, Garvasio, & Complair, 1994;Kreutzer et al, 2009;Nabors, Seacat, & Rosenthal, 2002;Ponsford, Olver, Ponsford, & Nelms, 2003;Riley, 2007); caregiver burden (Knight, Devereux, & Godfrey, 1998;Kreutzer, Serio & Berquist, 1994;Malec, Van Houtven, Tanielian, Atizado, & Dorn, 2017;Marsh, Kersel, Havill, & Sleigh, 1998); social isolation (Marsh et al, 1998;Marsh, Kersel, Havill, & Sleigh, 2002); decreased quality of life (Verhaeghe, Defloor, & Grypdonck, 2005); financial difficulties (Riley, 2007); and worse perceived health (McPherson, Pentland, & McNaughton, 2000). Depression is one of the two most common psychosocial problems reported by civilian family caregivers of persons with TBI (Stevens et al, 2012).…”

“…Our findings underscore the importance of continued research to design and evaluate family-inclusive interventions in both civilian and veteran TBI populations. Consistent with this, Veterans Health Administration priorities now direct increased attention to family well-being, and the VA is systematically expanding family-centered approaches to care (Ford et al, 2014;Glynn, 2013;Malec et al, 2017). For example, a VA Family Care Collaborative has implemented a Family Care Map in five regional inpatient Polytrauma Rehabilitation Centers to standardize and promote family-centered care in this setting (Ford et al, 2014).…”

Advancing Research and Theory on Aging Military Veterans in a Relational Context

“…Across numerous studies, trauma symptoms are negatively associated with relationship quality (Monson et al, 2009; Taft, Watkins, Stafford, Street, & Monson, 2011). Similarly, chronic pain, TBIs, and other persistent postconcussive symptoms may necessitate long‐term caregiving by informal caregivers (typically family; Malec, Van Houtven, Tanielian, Atizado, & Dorn, 2017; Marshall et al, 2019) and may interfere with social relationships. Therefore, it is vital to understand the intersection of relational experiences and veteran status later in the life course.…”

Mastering life together - symptom management, views, and experiences of relatives of persons with CPTSD: a grounded theory study

“…Also dealing with emotional numbing and angry outbursts negatively impacts relationships [ 55 , 56 ]. Providing care and support for relatives with PTSD can create a financial burden and deep psychological stress [ 54 , 57 ]. Findings also show that wives’ sense of caregiver burden was associated with, first, the severity of their husband’s PTSD symptoms [ 58 ] and, second, the degree of impairment in his daily life as well as his occupational functioning [ 59 ].…”