In 2012, 1.3 million veterans who were wounded in action had a severe service-connected disability—nearly triple the number in 2001 (482,000).1 Given the increased number of wounded veterans, the need for caregivers also increased.
The act of caring for an individual with a chronic disability can be a daunting task for the caregiver. However, what is not so commonly recognized is the need for caregiver awareness of the available support resources. Caregivers who do not receive necessary support experience physical and emotional consequences that interfere with their ability to care for veterans with disabilities. Therefore, there is a significant need to provide adequate support for the caregiver to maintain optimum care of the veteran.2
Increased caregiver strain among family caregivers of veterans with long-term disabilities and their lack of knowledge of support resources is a clinical concern. A comprehensive review of the literature provided evidence that access and use of caregiver support resources improved caregiver quality of life.
The purpose of this project was to provide an educational intervention of caregiver resources that were available at the Durham VA Health Care System in North Carolina and in the surrounding community. The desired outcomes included (a) increasing the caregiver’s knowledge of resources available at the VA and within the community to decrease caregiver burden; and (b) assisting the caregiver in determining the best resources for the caregiver and patient. This project was deemed to be a quality improvement project and did not require institutional review board (IRB) approval.
Background
The term strain is used to describe the burden, trouble, or burnout that a caregiver encounters when caring for a person with a long-term illness or disability.3 Caregivers of veterans remain in their role longer and have a heavier burden of care than that of all other caregivers: 65% are in a high-burden caregiving situation compared with 31% nationally.4 The consequence of providing care without assistance has all the features of chronic stress.2 Moreover, the decline of the caregiver’s health can significantly compromise the ability to provide care.3
Empirical observations of the negative health effects of caregiving noted over the past 2 decades have helped convince policymakers that supporting caregivers is an important public health issue.2 To this end, Congress mandated legislation that required the VA to provide a support program for veteran caregivers. In May 2010, President Obama signed the Caregivers and Veterans Omnibus Health Services Act of 2010 into law.1
Supporting Literature
The VA caregiver resource program offers a variety of support resources.1 A better understanding of caregiver needs is necessary to provide the right support resources, improve the health and well-being of caregivers, and make decisions regarding individual caregiving situations.5 For example, respite care offers temporary or periodic relief from caregiving, allowing caregivers to attend to personal tasks, such as shopping, running errands, relaxing, and socializing. This service can increase the physical and mental well-being of the caregiver.6 Studies show that early use of support services is paramount in order for caregivers to receive the greatest positive impact.5
Chen and colleaguesconducted a study of 164 caregivers. The study showed that caregivers who received assistance with accessing the correct support resource exhibited considerably higher satisfaction with the services they received.7 Determining which support therapy was best for the caregiver and the patient for whom they were caring was seen as the initial step. Providing a tool that supplies all the information caregivers need as well as assisting them with accessing services more efficiently is beneficial.
The National Alliance for Caregiving conducted a study to evaluate the needs of caregivers of veterans of various conflicts.4 In the study, caregivers reported that a resource guide would be beneficial. Some of the services they wanted to include in the directory were VA disability benefits, respite care, home health care, hospice services, assisted living, rehabilitation therapies, caregiver support group information, and community resources.
Based on the literature, the author believed that better knowledge of support resources was needed for caregivers. The literature included detailed descriptions of how knowledge of support resources improved caregiver’s well-being by increasing his or her ability to cope with stress related to providing care. However, the literature could have provided a more elaborate discussion on this topic. That was the only weakness identified in each of the studies. Nonetheless, it was clearly noted that resource knowledge yielded a positive effect.
Methods
The project took place at the Durham VA Health Care System and was implemented from August 2015 to October 2015. The participants targeted were caregivers of veterans with disabilities who were considered the veteran’s primary caregiver. Participation was voluntary.