Caregivers of veterans with “invisible” injuries: What we know and implications for social work practice

Jan 9, 2015

179266343The two longest volunteer-fought conflicts in US history have resulted in large numbers of veterans coming home not only with post-traumatic stress disorder (PTSD), but also traumatic brain injury (TBI). These “signature” injuries of the Iraq and Afghanistan wars have been called “invisible” since they are not necessarily accompanied by physical scars or injuries. Yet PTSD and TBI can cause major problems for the sufferers and their families. Most often the caregivers for those suffering from PTSD and/or TBI are the spouses. Social workers are uniquely positioned to help the sufferers of PTSD/TBI and their caregivers.

In a recent issue of the journal Social Work, Bina R. Patel, MSW, LCSW, summarizes the recent literature on caregivers of veterans who suffer from PTSD, TBI, or both, and discusses the implications for social workers who assist caregivers and their families.

The article discusses the unique burdens of a caregiver dealing with a family member suffering from an “invisible” injury such as PTSD or TBI. In addition to the usual stress of dealing with an injured or disabled family member, these caregivers may deal with behavioral changes, cognitive disfunctions, mood swings, etc. Many persons suffering from PTSD and/or TBI cannot drive themselves, nor do other daily tasks. Yet since their injuries are not visible, people may not be aware of the extent of the injuries. Stigma may attach to caregivers as well as sufferers due to public misunderstanding. All these are often added to the usual burdens of caring for a family, raising children, etc.

Patel calls on the social work profession to develop appropriate assessments that incorporate all the potential issues of caregiver burden, such as marital strain, substance abuse, effects on children, resources and coping. She says:

With families, social workers can take the lead by providing family counseling and assisting with reintegration into civilian life. Children’s services are not available at most VHAs, so incorporating groups and support for the whole family system would be a unique challenge that social workers are well equipped to deal with. Today’s caregivers are also very computer savvy, so incorporating online services would be ideal, as leaving the home can be very challenging for full-time caregivers.

The increase in veterans with “invisible” injuries, and the needs of caregivers for those veterans presents a unique challenge to the social work profession, one demanding innovative thinking and greater study and assessment in the coming years.


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