Views from the Health Providers
In the United States, there are 5.5 million men and women who support a current or former member of the military with a disability or disabling condition. These individuals – we call them military caregivers – are often unpaid and often have other work and family responsibilities. They are our nation's unsung heroes, whose support keeps veterans out of institutions and alive longer and with a better quality of life.
Sister nurses provide vital support to service members and veterans in everyday activities such as bathing, dressing, administering medication and helping the disabled climb stairs. Health care personnel play an important role in the recovery and reintegration of wounded, ill or disabled service personnel, but nursing sisters also help veterans receive and follow necessary treatments.
Reducing the burden
Caring for a loved one is a demanding task. Caregivers of military personnel are consistently in poorer health, have more stressful family relationships and face more work problems than others.
The situation is even worse for caregivers of those who served after September 11, 2001. Military caregivers are also at greater risk for depression; those who spend more time caregiving and those with behavioral problems are more likely to develop depressive symptoms.
All sectors of society can play a role in supporting military nurses to mitigate these negative effects. Health care providers can play an important role in recognizing the role of caregivers and addressing their health issues.
We examine how health care providers can best support military caregivers, based on RAND's extensive research on this population and their supportive environment.
The following describes what health care providers can do to support military caregivers:
Periodically assess caregiver needs and the availability of caregiver support
Health care providers caring for wounded or ill veterans should be trained to assess caregiver needs, including assessing and documenting whether the patient has a caregiver or other types of caregiver support. Caregiving needs depend on several factors, such as the caregiver's condition, age, and recovery. Therefore, these assessments should be repeated and, if necessary, updated during the course of the person's care.
Recognize caregivers as part of the care team
Caregivers assume responsibility for maintaining and managing the health of the person they care for: 50% of caregivers report providing physical or medical care or treatment, but they also help the person manage pain, maintain emotional stability, and engage in healthy behavior.
To perform these tasks effectively, caregivers must interact regularly with health care providers: doctors, nurses and case managers. Involving and engaging nurses in the care of military personnel and veterans helps them understand the importance of their role and can help support care compliance and healthy behavior at home.
Integrate military nurses into the culture of health care providers
For military and veteran health care providers, particularly those with mental health and disability issues, increased efforts to educate staff about the role and needs of military nurses can help create more respectful and trusting interactions. If specific programs can be developed to educate providers, professional meetings, continuing medical education (CME), and professional literature can provide opportunities to change the culture of care.
Providers have access to more information about caregivers on the Internet and in trade journals. Providers can also benefit from tailored information and briefings provided by professional associations, professional training or care management initiatives.
Establish appropriate documentation requirements for caregivers to facilitate their participation
When a health care professional detects the presence of a caregiver, he or she should try to involve the caregiver in care planning to facilitate adherence to care. In some care settings, special documentation (such as a power of attorney or official ID) may be required before the caregiver will allow the caregiver to attend care sessions.
In other care settings, caregivers may already be involved and special arrangements may be made to facilitate their participation that are less restrictive (e.g., simple patient consent).
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.