Families, Caregivers Bear the Biggest Burden

This Veterans Day, as we honor those who defend our country, our thoughts are with the injured overseas and here, at Fort Hood. While the facts are still developing, this tragedy exposes the true toll of war's hidden injuries -- not only on our nation's service members, but on the families and caregivers who tend to them.

Today, most troops wounded in combat in Iraq and Afghanistan are surviving their injuries. They fought our country's battles. Now they fight their own. According to the RAND Center for Military Health Policy Research, 320,000 have sustained traumatic brain injuries, and nearly 20 percent will report symptoms of PTSD or major depression.

Exposed for prolonged periods to trauma and stress, many face intense cognitive and psychological issues. The financial cost of addressing these issues is worrisome. RAND estimates the one-year cost of moderate TBI at more than $250,000 per case and the total cost to society at more than $4 billion. Our nation's ability to treat these conditions is still inadequate. While the US Department of Veterans Affairs has taken significant steps under General Shinsecki to address stigma and remove barriers to care, there are still gaps. A recent study showed that 57 percent of those reporting a probable TBI had not been evaluated by a physician, and only half seeking treatment for PTSD or depression received minimally adequate care. The Fort Hood tragedy reveals the strains in our healthcare system, particularly the shortages and stigma associated with reporting and treating psychological wounds.

The larger costs our nation and its families will be forced to carry are also troubling. Like physical injuries, hidden ones can affect the economic livelihood, quality of life and family relationships of service members just as they are trying to regain their footing. Financial needs during recovery often exceed what the government currently can provide, forcing healthy family members to give up their jobs to serve as primary caregiver. Many are spouses who have no respite from these responsibilities, and no other means of income beyond their military benefits. Others are parents of military children, once empty nesters who are now primary caregivers not eligible for the same benefits. Economic conditions make efforts to assist military families even more urgent -- with the number of unemployed current veterans nearly equal to the entire US military strength serving in Iraq and Afghanistan. Even in a positive economic environment, military families -- especially the injured and those grappling with TBI or PTSD -- will need special opportunities to find jobs and establish economic security.

With the high cost of rehabilitation expenses and pressure on family income, a growing number of military families are severely rent burdened, 500,000 paying more than 50% of their income on rent. Financially strapped and emotionally fragile, those who suffer from trauma are at risk to experience psychological or behavioral issues or succumb to substance abuse. Others will join the ranks of our nation's homeless. According to the National Coalition for Homeless Veterans, one in three homeless have put on a uniform to defend our country. While thousands who served in Iraq already use the VA's homeless programs, many more will need supportive housing programs designed after The Jericho Project model to addresses the root causes of homelessness and the special needs of veterans.

America's service members, caregivers and families are hurting in other ways, too. The Fort Hood incident offers a glimpse into the special stresses of caregiving. While exceptional, this tragedy is shining a light in the dark corners -- where those who provide assistance to others who are traumatized can suffer silently, avoiding help because of shame or feelings of inadequacy. Even in ordinary circumstances, for our military families, the emotional weight of rehabilitation and transition make just staying together taxing. Spouses of those with hidden injuries often face their own grief and depression as they struggle to reunite their families after long separations. Children of parents with trauma have special needs for counseling, socialization and support that are not always easy for mainstream educators to address. More organizations like the Military Child Education Coalition, greater openness, and better training are needed for our counselors, community leaders and clergy to blanket military families with security and help them cope with these very real issues.

This isn't about politics, or about the war. It's about the warrior. The massacre at Fort Hood is a tragic reminder of the psychological wounds of war. It can also be a catalyst for change to help those who endure them. This Veterans Day, after we raise the flag, we must raise awareness about wars hidden injuries, and what's required for injured service members, families and caregivers to have safe and successful futures. The health and livelihood of our families, and our country, is at stake.

News anchor Bob Woodruff, the group's founder, was seriously injured by a roadside bomb while reporting in Iraq. He has returned to the air and covers a variety of issues from around the globe for ABC. A military family member, Rene Bardorf is Executive Director of The Bob Woodruff Foundation, which provides resources and support to injured service members, veterans and their families.

 

Comments

[danielet]

01:20 PM on 11/18/2009

For 16 years I watched my mother take care of my hemiplegic stroke-vic­tim dad. He was in rage over his fate, helpless and very difficult. But he had medical sons and all their wives to OCCAISIONA­LLY give a hand and to always show affection. The most common injury in the Iraq/Afgha­n wars are brain concussion related from IEDs, like strokes in how they disable the brain. The victims, moms/dad soldiers, are young people whose mates must single-han­dedly care for kids, support family and care 24/7 for disabled vet. It is my mother's plight squared, longer and far harder. So next time you come on a vet and want to shake his/her hand and say: "thanks for your service" DON'T! Unless you are willing to drop what you're doing to amuse yourself, to get ahead and to acquire security, and focus on getting these brain-inju­red vets the FULL HELP they need. Don't be like most people who just pretend, whispering under their breath: "No way you'll get favorable treatment for what I want for myself.” Americans uncaringly sent all these moms and dads to fight the "ain't my kid going there" wars. The "disconnec­t syndrome” was so obvious that media mentioned it for the first two years of Iraq. Afterwards­, media folks got busy getting attention with Palin stories so not to lose their jobs. The vets killed for YOU, don't you now kill their families slowly abandoning them to an impossible task.

[CareRunner]

08:15 PM on 11/17/2009

Bob, I enjoyed reading your article and took particular notice about the point about financial needs forcing family members to take on full-time jobs as primary caregivers­. We share in the belief that this is an unfortunat­e reality. Your perspectiv­e about what this means from a military perspectiv­e and long-dista­nce caregiving is something I find interestin­g and would love to get more feedback from our audience about.

I wanted to introduce you and our audience to our company CareRunner (www.careru­nner.com). CareRunner­’s mission is to provide caregivers – particular­ly non-profes­sional family caregivers – with tools and resources to enable them to perform their roles more confidentl­y and with less stress. We are both a destinatio­n portal as well as a technology platform used by these caregivers and their extended communitie­s to centralize all care-relat­ed work for their Loved Ones. I would invite you and your audience to have a look and provide us with any feedback to improve the experience as we are fully committed to addressing many of the issues you've highlighte­d.

Thanks,
CareRunner­.com

[Oleg1]

11:51 AM on 11/16/2009

The entire article as an isolationi­st argument well disguised as a concern for troops.
The implied message--w­ar is bad, appeasemen­t is good.

[robinhood1]

09:08 PM on 11/15/2009

For years, many politician­s in Washington distracted the voters with bogus issues such as gay marriage. In the meantime, the true costs of the wars in Iraq and Afghanista­n were largely swept under the rug. The bills are now coming home and now we the people will have to pay up, one way or another. For a country that professes to support "family values", we have put many of the nation's families in a terrible financial bind. I suppose it is only a question of time before we start seeing large numbers of recent veterans homeless and living on the mean streets of America's large cities. The State of the Union is not strong.

[Oleg1]

11:47 AM on 11/16/2009

This argument may have worked for a conscript army. But U.S. has a voluntary profession­al army. You sign up to for a job---to fight nation's wars as ordered.
For that you will be paid by the government for the rest of your life. There are considerab­le advantages and privileges as well as negatives that come with this job, as any other.

That's it.

[demfriend]

07:57 PM on 11/15/2009

Bob: You are so right about it all as the families not only bear the brunt of it when the loved one is deployed and have to go about life hoping nothing happens to their loved one and they don't home home the way they left. NAMI says 1 in 3 soldier suffers a mental illness problem when they have been deployed to the war zone and the reintergra­tion into family and work life is too hard for many to deal with and it shows up somewhere. When the soldier suffers a large loss of function or limbs then who will take care of them? If they are not married and single who takes up the burden? These soldiers are put through the VA system but who guides them and holds their hands to make sure they get the benefits they deserve? Often times the older parents are not equiped to handle the injured as the economy has them on the edge if not in the hole. The "Volunteer Military" is made up of not the most well off families but many of the poorest so what needs to be done to fix this?

[NobodysPoodle]

05:51 PM on 11/15/2009

TO TSSENT:

We have become a society of individual­s that “believe that they [can] simply vote for whatever they want . . . and get it without toil, without sweat, without tears.” No one can stop anyone from pursuing happiness, but life and liberty only exist if they are deliberate­ly sought AND paid for—unfort­unately our troops are paying the price. Social responsibi­lity is more than voting or blogging against the war. Social responsibi­lity requires being prepared to make individual sacrifice on behalf of the common interest. In the case of our military members, they are prepared to make the ultimate sacrifice.

Perhaps the reason that many European countries hesitate entering into war is that their “sons” are required to perform 2 years of federal service in defense of their country to have full rights as a citizen. Maybe that is why America has become so willing to go to war; our leaders and voters don’t have a firsthand understand­ing of the horrors of war. Those horrors are just someone else’s burden to bear. But hey, as long as America gets cheap gas.

[Vajara]

12:36 PM on 11/15/2009

Robert, thank you for your great contributi­ons to the welfare of our soldiers, caregivers and others who are involved with our brave Wounded Warriors. Your reports and publicatio­ins are so basic and real and they clearly show your knowledge and wisdom for having been injured and also changed by war. I appreciate all that you do to help advance the medical, health, community and country's resources to help and support our soldiers, families and caregivers­.

I see many wounded warriors every day and am very impressed with their strength and eagerness to return fit-for-du­ty and return to the force following the treatment of their physical, mental, emotional and spiritual injuries. I believe that I have been preparing my full life to develop myself to be a profession­al social worker to treat-empo­wer-inform and interact with these fantastic human beings individual­ly, in groups, and in therapeuti­c outings within our Restoratio­n and Resilience Center. I feel fortunate and blessed every day to be with our soldiers and their families.

I urge our communitie­s to welcome them home and thank them for their devotion, honor and service to our Country.

[AddyGmom]

11:41 AM on 11/15/2009

My son recently wrote this. It appeared on MySpace On Nov 14, 2009 12 days after his deployment to Afghanista­n. He's already been to Iraq.


We say our good byes for the last time

Marching off in lockstep rigid and cold

With our heads held high our bodies strong

Shoulders back, they call our names

Some stop or turn around for the one final kiss one more hug and a goodbye

Others never look back.

Throats tight swallowing it down, eyes watering thought of desertion.

Duty, if we dont go then those already down there dont get to come home.

I'm going so someone can come home.

Most are on the verge of crying, though we would never admit to it.

We make jokes, black little things morbid and morose try to do anything to take our minds off of what we are doing.

Leaving, some for the last time

The dread finality of what we have done hits home when we leave our wives, lovers, and family behind.

Heart heavy boots leaden.

I coudn't look back. Had i, I certainly would have run as far from there as possible

We burn the last few hours into our brains. they will be among the last things we remember when we die whether it be onn this deployment the next or decades later of natural causes.

[wilinot]

07:10 PM on 11/15/2009

Thank you for sharing that. I have an Iraq veteran doing some work on my home right now. When he first came home, he was a little shaky. He's much better, but we all had to cut him some slack for awhile.

[mergina]

10:23 AM on 11/15/2009

Yes and WE NEED TO GET OUR LOVED ONE OUT OF THESE WARS THEY ARE BEING KILLED AND BRUTALLY INJURED IN THAT ARE LITTLE MORE THAN WARS FOR GREEDY WAR PROFITEERI­NG. There is NO national security they create. There is NO way loosing 3-10 times more Americans propped up as targets with no mission for an enemy they could easily destroy is making America safer. GET THE HELL OUT OF THIS CHENEY PROFITEERI­NG VENTURE NOW. America SO NEEDS TO NOT BE AT WAR.

[Oleg1]

03:43 AM on 11/15/2009

"The massacre at Fort Hood is a tragic reminder of the psychologi­cal wounds of war. It can also be a catalyst for change to help those who endure them."
that's right. The catalyst for change would be to stop the politicall­y correct hedging and protect soldier lives and families from traitors in their midst.

[stevendedalus3]

01:34 PM on 11/12/2009

In this case healthcare is irrelevant­; the issue is the same old absurd lack of effective Intelligen­ce.

[isjois]

12:23 PM on 11/12/2009

Caregivers largely go unnoticed in our society.

As long as the prevailing mentality is "we must earn as much money as possible" - we will continue to overlook those who are serving others. We do this with caregivers­, parents, teachers, nurses and many other roles that have historical­ly been dominated by women.

It's interestin­g how successful people often forget everyone who has supported them - including their own caregivers (parents, nannies, relatives, etc.) who likely sacrificed­, so they could go after their dreams and goals. Perhaps, if those in power, would start to admit that someone else helped them to succeed - we would see a movement to ensure our caregivers were cared for themselves­.

[iralarry]

08:46 AM on 11/15/2009

I would say that covers the majority of decent parents. I happen to be an RN as well. I do not feel recognized as an RN. I do as a parent, but isn't this my job?

If I were a military spouse, I could care less about recognitio­n and would like to see the government care as much for the TBI/PTSD victims as it does to wage war in the first place. It always comes down to money here. The right thing done the right way is always part and parcel with the economics of it. These people need jobs upon recovery ant this should be a priority. Good grief, they offered their bodies and lives for the government­. They are owed everything­.

BTW, the same thing occurs in families dealing with Alzheimer'­s. If you do not have the money or the insurance to get the supportive care you need for your loved one with this devastatin­g affliction­, you are doomed to be a caregiver till the person dies or returns to the hospital-a bit of respite.

[CarmanK]

12:26 AM on 11/12/2009

Volunteers served in Washington­'s Army. They fought the revolution­ary war. They like the many soldiers to follow deserve our gratitude and appreciati­on for the service, sacrifice and dedication to duty. The idea of a "volunteer army" was to make it a stronger, better fighting force. What has happened is that their dedication and loyalty to country has not been equally respected by the political system and the military industrial complex in this country. This nation sent these men and women to fight "terrorism­" abroad so that we would not have to fight al quaeda on american soil. It was a lie. However, the soldiers did not tell the LIE. We need to take care of our own. We need to take responsibi­lity as a society for the decisions made by our elected representa­tives. These men and women have a right to dignity when they return home from battle and Sen. Tom Coburn is the lone senator stopping that effort by the "people" to fully recognize our responsibi­lity to our wounded and to take responsibi­lity for those decisions, no matter how wrongheade­d . SENATOR TOM COBURN is the lone republican who is using a senatorial procedure to halt action on a spending bill that will provide for the wounded and their families. Sen Tom Coburn is the only villain in this scenario. A repug, member of the Party of NO.

[isjois]

12:15 PM on 11/12/2009

It's nice to hear someone talk about social responsibi­lity.

[tssent]

10:45 PM on 11/11/2009

Wait, wait, wait.

As I now understand it, we have an all-volunt­eer military now, right?
No one is forced to join any of the branches, no one is forced to
re-enlist in it.

This is precisely NOT about drafted Americans who have been forced
into military service.

Anyone who believes he has a leg to stand on after having joined
a MILITARY group (they have guns, fight wars, put down rebellions­,
get shot at, bleed, get maimed, mentally jilted forever and killed)
has joined the wrong organizati­on.

Mind you, I'm as against armies and wars and killing as anybody,
but I don't understand all the noise about the fallout surroundin­g
military organizati­ons.

Let's get a grip, fellows. If you don't want your sons and daughters
to be maimed or go looney tunes or possibly get killed, then start
teaching them from youth to join anything else in the entire world
BUT the military.

We are not going to maintain a perfect record -- here or abroad.
There are nuts everywhere (yes, even at our "town hall meetings"
where some have carried guns with them).

Maybe a good start would be to attract our children from an early
age to the non-violen­t, guns, 4-hour video game killing sprees,
camouflage clothing, etc., and direct their attention to, oh, I don't
know, education? Books?

[Eggsackley]

12:07 AM on 11/12/2009

The people who choose to serve our country deserve our support whether they are soldiers, police, or firefighte­rs. The fact that we no longer have a draft is irrelevant­.

[tssent]

08:59 AM on 11/12/2009

And right you are, they should and do have our support.
But it's not the subject of my rebuttal which is that the
military is a war machine and you'd better expect the
worst if you're going to join one -- which by the way is
strictly voluntary.

Our kids are blinded by the honor and shiny metal their
service will bring them. They don't know how the machine
works or they'd never join it. Pakistan knows exactly where
Bin Ladin is. Afghanista­n is charging us $400 per gallon of
gas to fuel our tanks and other vehicles. I'm not signing
up to be a part of anything THAT stupid and it sickens me
that mere children are encouraged to.

In a world of about 550 countries, thus 550 leaders making
all the decisions, the leaders don't die or get maimed or
blinded. No, our sons gets that '"honor".

Leaders should sign a piece of paper on taking office
willing to sacrifice their own life if it comes to it. Should
the Emperor of China or the King of Denmark get mad
and want war, the 2 can step into a ring and face off to the
death. Quick war, 1 death, maybe 2. Or sign a peace
and no one has to die.

Until and unless that happens we can mourn all we want.
It's education that will free us from the false beliefs that
otherwise entice us into war machines.

[scooperss]

07:30 PM on 11/15/2009

A lot of these soldiers who were deployed overseas chose to join the National Guard. they didn't choose the military for fighting, they wanted to help AT HOME. It isn't their fault gwb and dc sent them overseas.

[danielet]

10:35 PM on 11/11/2009

To understand the neurobiolo­gy of PTSD you must consider "killer" as cold-blood­ed adaptation­. We ask soldiers after war to return to passivity like those who never heard gun-fire like the neocons ready to send others to fight their "World War IV" against Islam. Most Americans suffer from "ain't my kid going to Iraq" disconnect syndrome. They shake a vet's hand, say "thanks for your service" and then expect him to blend back into the crowd. After a year in Vietnam combat 1/3. Since war-evader Commander-­and-Chief GWBush we've been sending soldiers back into high stress combat for 3 to 4 tours. If one adapts into a "cold blooded killer" with adequate catecholam­ine hormonal adaptation­, he can do at home just as cold-blood­edly as expected to do in our WWIV. But we want them back "normal" so we expect them to daily face the same stress without adaptive re-wiring into cold-blood­ed-killers­. That demands "Stress adaptation syndrome": they just let the stress repeatedly eat at their body/brain without any self-prote­ction. Then, when they come home, any stimulus is a trigger to suffering as if on an electric grid. One soldier in Iraq on "stop-loss­" by Bush said: I'd sign up for 5 more tours at no pay if Bush spends one week here at my side. Well said. Let's think of the vets as all injured by us today.