Author: Mary Brintnall-Peterson, Ph.D., Owner of MBP Consulting & Professor Emeritus, University of Wisconsin-Extension
As someone caring for a wounded, ill, or injured service member, you are among nearly 1.1 million individuals with the title of military caregiver because you are a spouse, partner, parent, relative, or friend to a service member who was wounded in Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF) (Tanielian, T. et al., 2013). As a military caregiver, you have taken on a new role with responsibilities ranging from providing personal care and transportation to being an advocate. These responsibilities are common to all caregivers, but as a military caregiver, you have the additional challenge of providing care to someone who may be dealing with an "invisible wound.” Such wounds are not seen by the human eye but can appear at any time. They include posttraumatic stress syndrome (PTSS) or traumatic brain injury (TBI). Caring for someone with PTSS has been found to be as burdensome as caring for someone with dementia or chronic schizophrenia (National Alliance for Caregiving, 2010).
As a military caregiver and advocate, you will navigate multiple health care systems, often in different locations on the same military installation and sometimes in different cities. You will also come across numerous military or government policies, eligibility requirements, information, and resources about your service member’s medical condition. Your caregiver journey could last for decades because your warrior was wounded at a young age. It is estimated that military caregivers will provide care for longer than 10 years, which is two times longer than other caregiving populations (Tanielian, T. et al., 2013).
As a spouse, partner, family member, or good friend, you may have felt obligated to become a caregiver because of your relationship to your service member. You didn’t realize that caregiving would require you to become a nurse, pharmacist, driver, companion, financial manager, advocate, and much more. On top of all these responsibilities, you provide emotional support, companionship, and love. Although you may be surprised at how capable you are at managing caregiving along with handling your other responsibilities, at times you feel overwhelmed and not certain what to do next, who to turn to, or how you will continue. Your health may be suffering because you are not exercising, eating healthy meals, and taking care of yourself. But to continue being a caregiver, you must make time for yourself. Respite may be the answer to creating time for you.
Respite care is a term used by professionals who work with and counsel caregivers on ways to care for themselves. The term can be confusing because not only is it a label for a particular type of service, but it also defines time away from your caregiving responsibilities. The term respite means taking time for you. Respite can be as simple as having one of your wounded warrior’s friends come over to watch a movie or sporting event or to take him or her fishing. It can mean taking your solider or veteran to an adult day care program or a nursing home for a short period of time. Your first reaction may be that you can never get away from being a caregiver, which is probably true. You can, however, find ways to lessen your caregiving burdens by turning them over to others for a short period of time.
Respite programs are not the same from community to community or program to program, so exploring what’s available in your community is critical. First, identify the type of respite most appropriate for you and your service member and then find out what’s available in your community. Once you have zeroed in on what you need and the type of respite program most appropriate, secure recommendations from others who have used the program, evaluate costs, interview program staff, and then select the one best for you and your warrior. As you start your exploration process, you’ll find there are two broad categories of respite programs: in-home respite and out-of-home respite.
In-home respite is provided in your home, which may be easier for many families because your wounded warrior is comfortable in your home and won’t have to adjust to another setting. Your home already has the equipment needed to care for the wounded warrior, plus you don’t have to transport equipment to another location. In-home respite programs can be provided by an agency or organization, such as a social service or human services organization, private or nonprofit homemaker service, or home health agency, all of which have trained staff. You can also contract individually with someone you know or who has a business that provides in-home respite. If you hire someone individually, it's a good idea to secure recommendations and do a background check. Consult the fact sheet Hiring In-Home Help for additional suggestions on what to consider when hiring someone to provide in-home respite.
Out-of-home respite programs are just that—respite provided at another location rather than in your home. These types of respite programs include a camp experience, a short-term period in a hospital setting or nursing home, volunteer programs located in churches or senior centers, or care in an adult day care setting.
The most common form of out-of-home respite is adult day care or adult day services, which typically provide care daily except for weekends in a facility specially designed to provide care to adults or older disabled children. Some adult day care centers provide health services, therapeutic services, and social activities designed for different types of illnesses or conditions. Some programs are strictly social or recreational and focus on engaging participants in activities and provide a meal.
In some instances. you may need overnight or short-term respite due to your health needs, family obligations, or your service member’s needs. Some local hospitals (including VA hospitals) or nursing homes provide short-term respite.
When considering an out-of-home respite program, recognize it may take time for some care receivers to adjust to a new environment and routine especially if they are used to a calm and consistent routine. For more details about various types of respite programs, read the fact sheet, ABCs of Respite: A Consumer Guide for Family Caregivers provided by ARCH National Respite Network and Resource Center.
A disproportionate share of service members come from rural areas, so it is natural for them to return to rural America when they are discharged. Over six million (28 percent) of the 22 million veterans nationwide live in rural areas with almost half of them getting benefits from the Veterans Administration. Of those obtaining benefits currently, one-third served in OEF/OIF. Research shows that veterans living in rural areas have greater healthcare needs than veterans in urban areas. Rural communities lack health and social services, which put their communities at risk for poor health and provide limited support for caregivers (ARCH Fact Sheet Number 35, 2012). A 2010 survey of caregivers of veterans found that rural caregivers are more likely to experience depression as a result of caregiving than caregivers in urban or suburban areas (National Alliance for Caregiving, 2010).
Military caregivers need to be creative and to seek out respite from other family members, neighbors, and friends. Think about who your wounded warrior spent free time with and what activities they did before his or her disability. Explore ways those individuals can be involved again in the same activities with your service member. You may need to train those willing to spend time with your warrior so they are comfortable providing care and know what to look for or avoid. Building your own team of respite providers will be worth your time and effort because you’ll be able to take time to rejuvenate yourself so you can be a healthy caregiver.
For more information on respite care and resources available, go to Respite Resources.