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The Needs of Families and Caregivers of
VeteransDan Breglia, PsyD
Heather Cole-Lively LISW-S
The Sacrifice and Service of Military Families
"Our nation owes each day of security and freedom that we enjoy to the members of our Armed Forces and their families. Behind our brave service men and women, there are family members and loved ones who share in their sacrifice and provide unending support."
- President Obama America’s Navy: The Shield (Commercial) https://www.youtube.com/watch?
feature=player_embedded&v=ThImmlN-I8s
The Impact of War and Military Life
The demanding environments of military life and experiences of combat, during which many veterans experience psychological distress, can be further complicated by substance use and related disorders. Many service members face such critical issues as trauma, suicide, homelessness, and/or involvement with the criminal justice system.
Veterans families by the numbers
There are an estimated 21 million veterans in the United States, and over 866,000 of them are Ohioans. Add their family members and a significant percentage of our regional population is impacted by the issues we will discuss today
Their spouses/partners, children, and extended families are subject to increased mental health, school and other adjustment issues
Veterans and their individual family members can feel isolated and misunderstood
The lack of social support from a military community can increase these issues (e.g. National Guard; Reservists; Discharged or Retired/Disabled Veterans)
Veterans experience higher rates of Homelessness, PTSD (18.5 OEF/OIF vs. 1.85 for male civilians), & Joblessness (HUD; Samhsa; Rand)
These issues contribute to increased rates of Suicide, Interpersonal Violence, Divorce, Substance abuse, and Child Abuse and Neglect.
On average, 22 Veterans commit Suicide on a Daily basis. That rate is much higher than the civilian population and has increased at twice the rates of civilian suicides (VA, 2012; News21, 2012).
An Inordinate Sacrifice
Approximately 50% of returning service members who need treatment for mental health conditions seek it, but only slightly more than half who receive treatment receive adequate care (SAMHSA).
Mental and substance use disorders caused more hospitalizations among U.S. troops in 2009 than any other cause.
There is substantial evidence that these increased rates in service members are also seen in the spouses and children.
The Resulting Need
As seen in other trauma populations, a perceived lack of support and an increased sense of stigma, shame, or judgment from others contribute to the challenges that military families face.
We have opportunities to help these resilient families transcend these issues when we demonstrate care and help them overcome their internal and external barriers.
Complicated and multi-faceted issues
Community and VA treatment Resources need to address the unique needs of these service members and their families.
Many government, private, and community organizations and institutions have stepped to offer support.
One example of the complicated problems that have resulted from recent wars include the increasing number of veterans who have suffered devastating physical and emotional wounds that have required caregivers community and VA resources to help them manage daily life.
Families and Caregivers
Caregivers are the chief supporters of people with chronic or on-going conditions and needs for personal care.
This definition of “Family Caregivers” includes spouses/partners, parents, siblings, adult children, and extended family and friends.
Caregiver can vary from support to skilled care. Caregivers often face difficult challenges in maintaining
their own health and mental health. Veterans and their caregivers often have a feeling of
isolation.
Family Caregivers
They are critical assets in a healthcare setting.
They are the eyes and ears at home and can often provide missing information to providers.
They can reduce re-hospitalization rates and cycling of conditions.
Embrace their value.
Value of Family Caregivers
Access to the healthcare and mental healthcare systems.
Training and educational resources for conditions.
Need for identifying the Primary Caregiver to include them in the care planning.
They need to be heard, educated, and trained.
They need support and empowerment in their roles.
Family Caregiver Needs
Seek community support groups Family Treatment Children’s Groups They request effective collaboration with providers of
the care recipient and acknowledgement of the importance of their role on the health care team.
Reasonable expectations for the care provided. Acknowledgement of the financial cost to families. To be free of judgement when Caregivers are no
longer able to provide the level of care required.
Needs of Caregivers
Children endure both “normal” impacts of military life like changing school 6-8 times on average.
They also endure “abnormal” impacts of war that include trauma, injury, and sometimes death for their parent(s).
Most military children are healthy and resilient as are there parents.
However deployments length, type, frequency, and the meaning that children and their parents take from those experiences influences how it affects them.
At-risk groups of children coupled with increased intensity of combat experiences by their parent(s) and decreased social support have increased problems.
Children of Military/Veteran Parents
What is P.L. 111-163, Caregivers and Veterans Omnibus Health Services Act
of 2010?
Requires VA to establish a program of comprehensive assistance for family caregivers.
Requires VA to establish a program of general caregiver support services.
Authorizes VA to provide medical care to certain primary family caregivers through CHAMPVA (under 38 United States Code (U.S.C.) § 1781 (section 102).
Increased respite services for caregivers, including 24 hour care Provide counseling and mental health services for caregivers
(under 38 United States Code (U.S.C.) § 1782 (section 103). Authorize VA to provide the expenses of travel (lodging and
subsistence) for family caregivers during travel to and from a VA facility for the Veteran’s medical exam, treatment or care.
VA Expects Veteran and Family Centered Care
Involving families annually and post inpatient discharge
Family consultation, family education or family psychoeducation for Veterans with serious mental illness
Caregiver Support Program – CHAMPVA Family members of recently discharged
veterans
Family Services Mission
Family Centered Care is at the Core of VHA’s new approach to mental health and has a new emphasis throughout VHA services
The VA intends to continue to utilize a recovery oriented model to improve the health and wellbeing of veterans and their families.
Our definition of family is inclusive and diversity conscious
Special emphases: Interpersonal Violence, Parenting, and Same Sex Couples
Caregiver Support Program
Mission Statement: To promote the health and well-being of family Caregivers who care for our nation’s Veterans, through education, resources, support, and services. Allow the most vulnerable Veterans to remain at home in
the community Address specific needs of Family Caregivers with a menu
of programs and services Promote Veteran & Caregiver health and well-being Reduce isolation with professional & peer support Sensitize health care providers to the role of the family
Caregiver
VA Provides Caregivers With
Powerful Tools for Caregivers Coaching into care line Building Better Caregivers Program Phone Support Groups Caregiver Support Line Easter Seals Training Specialty Trainings Respite Services
Menu of VA ServicesIn-Home Care Skilled Nursing Home Health Aide Home Based Primary Care Veteran Directed Home & Community Based Care Respite Care Services to Address Mobility Issues Equipment Home Modification Automobile Modification Education and Training Financial Support Aid and Attendance Caregiver Stipend (Post 9-11) Information and Referral Caregiver Web site: www.caregiver.va.gov Caregiver Support Line: 1-855-260-3274
Caregiver Support Caregiver Support Coordinators Peer Support Mentoring Program Building Better CaregiversTM Spouse Telephone Support REACH VA Support Groups
Continuum of Family ServiceBriefEducation and Support
In Depth Family Education
Support Family Consultation
Couple FamilyMulti-FamilyTherapy
Services for immediate family (partner, children, caregiver)
VACO ResourcesNAMIVHA Apps
NAMI Family to Family & HomeFront
Vet Center Support Groups
Brief Solution Focused Intervention
IBCTBFTMFGT
CHAMPVA; Caregiver Support
Family Consult/Orientation: Offered Individually Or in Groups
SAFE Need to develop VA based support Groups
On Ward Services
GottmanEFT
Readjustment
Brief Family Skills Education: Single parent education; Moving Forward; W2SM
OEF Assessment and referral for Prolonged Family Intervention
Other Family Therapy
Caregiver General; Vet Center; or in context of other family services
They are critical assets in a healthcare setting.
They are the eyes and ears at home and can often provide missing information to providers.
They can reduce re-hospitalization rates and cycling of conditions.
Embrace their value.
Value of Family Caregivers
Evidence Based Family & Couple Therapy (VHA Rollouts)
Integrative Behavioral Couples Therapy Evidence Based
Behavioral Family Therapy for Serious Psychiatric Disorders
Multi-Family Group Therapy Cognitive-behavioral Couples Therapy for
PTSD
Internet Resources
Making the Connection Veterantraining.va.gov Moving Forward National Center for PTSD Military One Source Yellow Ribbon Reintegration Program VA Apps Crisis Line, Chat, & Text Combat Call Center
Supportive Resources
VSO’s, religious, recovery organizations and community providers
NAMI Samhsa Give an Hour.org Vet Centers: Mayfield Heights and Parma
Offer couples and family therapy as well as support
Sesame Street: Talk Listen Connect
“Changes “ - deals with sensitive subject of an injured parent
Rosita’s family adjust to the new reality of her father’s disability.
Also includes footage of real life injured fathers (amputations, head injury, depression)
Parent should view DVD first Co-viewing is then recommended to talk
about “new ways to a new normal”
National Center for PTSD Resources
Return from WarPage of resources with information about deployment for families and children of service members. Resources include full-color booklets, interactive videos, and fact sheets.
PTSD and Children PTSD in Children and Teens
An overview of how traumatic experiences affect children and teenagers. Provides information on treatment. When a Child's Parent Has PTSD
Explains the common problems experienced by children of Veterans or other adults with PTSD. Provides recommendations for how to cope with these difficulties.
Child Sexual AbuseInformation on the effects of child sexual abuse, and what you can do to help keep children safe.
Community Violence: Effects of Children and TeensDescribes how neighborhood violence affects young people, and gives resources that can help.
Media Coverage of Traumatic EventsLearn how media (news, movies, etc.) can affect your stress level or harm children, and read about how to reduce bad effects.
Terrorist Attacks and Children: Information for CaregiversDiscusses how children respond to events of terrorism, and tips for what caregivers can do.
Very Young Trauma Survivors: The Role of AttachmentDiscusses trauma in infants and young children, with a special focus on the role of child-caregiver attachment.
National Center for PTSD
View the video: Children and Trauma Veteran's families can call Coaching Into Care: 1-888-823-7458 General Information on PTSD and Relationships Effects of PTSD on Family | Efectos del TEPT Sobre la Familia
Common reactions of family when a member has PTSD. Relationships and PTSD
Describes how trauma reactions can sometimes get in the way of closeness and connecting with others.
Help for Family and Friends | Asistencia para Familiares y AmigosLearn about resources to help you take care of yourself while supporting someone with PTSD.
Helping a Family Member Who Has PTSD | Cómo Ayudar a un Familiar que Tiene TEPTWays you can help a loved one with PTSD and ways you can help yourself.
Information for Military Families Help Your Veteran Get Needed Care | Ayudar al Veterano para que Reciba la Atención
NecesariaLearn how you can help family and friends who are Veterans seek care.
Partners of Veterans with PTSD: Common ProblemsCommon problems in relationships where one or both partners has PTSD.
Childrens Books about PTSD
