Building Resilience in Caregivers of Trauma Survivors
Abstract
Serving in the US Armed Forces can and often does involve significant sacrifices both in terms of injury and illness and in terms of stress on the family. Since 9/11, hundreds of thousands of injured troops sustain serious injuries that may require continued assistance after returning home. Unlike the Vietnam era, when spinal cord injuries appeared to be the dominant survivable injury, post-9/11 Veterans appear much more at risk for traumatic brain injury, psychological injury, and polytrauma. For those with injuries that limit independent living, the return home commonly involves a loved one taking on a role of caregiving for tasks that cannot be completed independently. While for some families this is a short-term situation, for others the caregiving role may extended for decades. And while most caregivers would not want to hand off the caregiving role, research into the health and quality of life of caregivers also demonstrates that caregiving can also impart a negative impact on functions ranging from psychological (such as depression and anxiety) to the physical (sleep, illness). These findings alone should motivate research into potential treatments that can mediate these effects in caregivers. However, if additional motivation is needed, caregiver health also has a direct effect on recovery, mental health, and long-term physical complications for the patient requiring care. In our military, the added complications provided by traumatic brain injury due to combat and post-traumatic stress have been shown in older samples (Vietnam) to further strain the caregiver. The challenges of being a caregiver appear to be even greater in our post-9/11 military families where caregivers are younger, not having expected to be in a caregiving role, are caregivers longer, and generally have less support around them to provide social and emotional support. The upside is that unlike many other combat-associated outcomes, interventions for caregivers exist and are useful. For example, interventions providing support for caregivers of patients with dementia have resulted in less hospitalization prior to the end of life for the patient and reductions in depression for the caregiver. But, as already indicated, there appear to be different needs and challenges in our younger caregiver cohort. And there are significant challenges for caregivers to find time to attend therapy or group support sessions, find support to cover this time away if they can find the time, and, in many cases, distance. Some of the latter can be addressed with technology, but this still requires a significant time commitment, and these caregivers are only identified once caregiver health or stress declines. It is because of these considerations that we have adapted a novel treatment tool in the form of an adapted diary that is commonly used in intensive care settings where caregivers are encouraged to identify challenges they are facing and then identify proactive methods to address them. This tool leverages the success of one type of therapy, problem-solving therapy, and integrates it into a tool that family members find useful in caring for complex health concerns. If such a diary can provide any significant assistance, it can be deployed with little cost, and the caregiver can use this tool at any time without need for a clinician to provide therapy. The goal of the proposed research is to test whether this type of diary is beneficial to reducing depression, anxiety, and substance use in caregivers. However, rather than enrolling caregivers who are already under burden, we also would like to test the value of introducing the concepts of problem-solving therapy whether delivered in a traditional model with a provider or as part of this structured diary before caregiving results in depression or anxiety. In our military families, this would be deployed soon after a family has learned of a critical injury or immediately after a family member must t
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710690
Entities
People
- Deborah Little
Organizations
- Baylor College of Medicine
- United States Army