While nursing homes have been devastated by the COVID-19 pandemic, homes for veterans seem to taking the brunt of the hit. The care of our post-war veterans had been in and out of the headlines before the pandemic, but one missing part of the dialogue was an equally important topic: the family caregivers of veterans.
I have had the incredible honor of serving as a guardian on two Queen City Honor Flights, which recognizes the bravery, determination and patriotism of our nation’s senior war veterans with a one-of-a-kind journey to Washington, D.C. Stopping at the Vietnam Veterans Memorial is emotional for both the vets and the guardians. And it opens memories and wounds, many of which have not fully healed.
I interviewed Terri Tanielian to learn more about this topic. She’s a senior behavioral scientist and nationally recognized expert on veteran mental health. As the former director of the RAND Center for Military Health Policy Research, she spent a decade overseeing RAND’s diverse military health research portfolio.
According to Terri’s research: 9% of the U.S. population meets the criteria for being a family caregiver, and 5.5 million of these caregivers provide care for someone who currently or previously served in the Armed Forces.
Significant Differences in Caregivers
At the time of our interview, Terri’s work concentrated on two segments: those who served prior to 9/11 and those who served after. They found that the caregivers who served in the post-9/11 era were younger, maybe explaining why 25% of current caregivers are millennials. Thirty-seven percent were under age 30.
Something else interesting was that almost 25% of caregivers were parents taking care of their adult child. Twenty-five percent of family caregivers of veterans were friends of the vet. Thirty percent were the spouses of their caregivers.
Pre-9/11 caregivers resembled the typical profile we often read about: middle aged females taking care of parents.
Overall, and surprising to Terri, was that 40% of military caregivers and 40% of civilian caregivers were men — who often don’t self-identify as a caregiver but will do so for research purposes.
Caregiving Could Last Decades
Caregivers of veterans perform the same types of daily-living activities as caregivers for civilians. In the post-9/11 era, military caregivers play a big role in helping care recipients remember things or cope with stressful situations. This is natural when you realize that post-9/11 caregivers are dealing less with the issues of old age and more with mental health issues like PTSD and the consequences of traumatic brain injury. Help with paperwork was also a common task among this post-9/11 group.
The interesting takeaway is that we’re learning more about the relationship between traumatic brain injury and early-onset dementia, indicating that these post-9/11 caregivers may be in this for the long-haul if their care recipient develops other brain-related diseases.
This type of caregiving could last for decades. And people may, as a result, age out of their ability to provide care, instead being the ones who need it.
[Read: Statistics on PTSD in Veterans.]
Post-9/11 Caregivers Have Unique Burdens
As with all caregivers, there is an increased risk of depression and other health issues. And I’ve harped on the statistics that show how many caregivers predecease the one for whom they are caring.
Post-9/11 caregivers are at four times the risk of depression compared to the general population. This is directly associated with the time they spend in the caregiving situation. Often, caregivers lack the support network or access to respite services they need. Terri’s research suggests most programs are focused on the care recipient, rather than on the caregiver.
1. Empowering caregivers to identify themselves is crucial.
We need to raise awareness and call attention to those who are caregivers for active duty military and veterans. This includes making sure education and training is available to them to become better caregivers.
2. We need additional programs in respite care.
The situation a post-9/11 caregiver faces is different than what most traditional family caregivers face. Particularly, mental health issues are now driving the circumstances of care. Programs need to be adapted as a result.
3. We need to consider future care.
A key area Terri and her team explored was whether we could continue with our societal preference to age in place when the number of caregivers continues to dwindle. What will that mean in terms of caregiver substitutes who need to step in? And how will senior living adapt to this new population of people who don’t need a memory care unit, but do need full-blown mental health assistance?
4. Additional research is needed.
Since some programs have been implemented from Terri’s research, it’s important to understand which programs are working and which are not. This insight can help determine necessary adjustments and identify further programs to be developed.
Advice for Caregivers
Since many caregivers don’t self-identify, it’s important that they start doing so and reach out to the community to understand what resources are available.
One resource Terri suggests is Hidden Heroes, which has created caregiver-friendly cities and caregiver-friendly environments.
Part of the Elizabeth Dole Foundation, Hidden Heroes brings vital attention to the untold stories of military caregivers and seeks solutions for the tremendous challenges and long-term needs they face.
The economic value of the care of post-9/11 caregivers is estimated at $14 million. Military caregivers miss an average of 3.5 days of work per month. When you add on the increased risk of depression and other burdens, you can see the cost of inaction if we don’t try to help our military caregivers.
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