Caring again: Support for parent caregivers of wounded, ill, and/or injured adult children veterans

Issue title: Thematic Issue: Setting a Research Agenda for Caregiving after Neurotrauma and Neurological Disability

Guest editors: Paul B. Perrin

Article type: Research Article

Authors: Martindale-Adams, Jennifer Lynn^{a; b} | Zuber, Jeffrey^{a; b} | Burns, Robert^{a; c; d} | Nichols, Linda O.^{a; b; d; *}

Affiliations: [a] Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA | [b] Caregiver Center, Veterans Affairs Medical Center Memphis, Memphis, TN, USA | [c] Department of Internal Medicine, Oak Street Health, Memphis, TN, USA | [d] Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, USA

Correspondence: [*] Address for correspondence: Linda Olivia Nichols, VA Caregiver Center, Memphis, TN, USA. E-mail: Linda.Nichols@va.gov.

Abstract: BACKGROUND:Parents often provide care to adult children veterans with polytrauma, traumatic brain injury, and/or post-traumatic stress disorder. OBJECTIVE:This two-arm randomized clinical trial compared interventions to help parent caregivers improve their depression, anxiety, and burden and manage care by decreasing troubling and concerning behaviors. METHODS:Interventions were six one-hour structured one-on-one behavioral sessions (REACH) or six 30-minute prerecorded online educational webinars. Both focused on knowledge, strategies for care, and coping, but REACH sessions were targeted, interactive, and skills-based. Quantitative and qualitative data were collected by telephone. Quantitative analyses included chi-squared test or independent samples t-test and repeated measures mixed linear modeling, with theme development for qualitative data. RESULTS:There were 163 parent caregivers, mostly mothers. During six months, participants in both arms improved significantly in depression, anxiety, burden, and reported veteran troubling and concerning behaviors. REACH caregivers showed a group by time improvement in concerning behaviors. Benefits included resources, self-reflection, not feeling alone, new skills, improved self-efficacy, and helping others. Specific concerns include exclusion from military and veteran care briefings and concern for the future. CONCLUSION:The positive response to both interventions provides opportunities for organizations with varying resources to provide support for parent caregivers. Interventions need to be targeted to parents’ particular concerns and needs.

Keywords: Military, veterans, parenthood/parent-adult child relations, caregivers, families <education, cost/financing <long-term care, PTSD, TBI

DOI: 10.3233/NRE-220126

Journal: NeuroRehabilitation, vol. 52, no. 1, pp. 93-108, 2023