News Story

Monday, June 01, 2009

By Sandra Basu | U.S. Medicine, June 2009
Used with permission from U.S. Medicine

More support for the family caregivers of those injured in war is needed, a panel of wounded servicemembers and family memb

ers told Congress. Dealing with severe injury and trauma is not easy,” Army Lt. Col. Gregory Gadson, an amputee told a Senate subcommittee. “When we consider the myriad of injuries, as well as the unfamiliarity a typical family has in dealing with an injured servicemember, it is easy to understand how difficult a task it is for recovery.”

At a hearing in late April, members of the Senate Armed Services Subcommittee on Personnel asked the witnesses testifying to identify the issues that they were facing. The subcommittee wanted to know what more the Department of Defense and the Department of Veterans Affairs could do to improve the care and treatment of the injured. “Only after we identify problems can we work to find answers and provide the highest quality of care for our wounded, ill and injured servicemembers and their families,” Senate Armed Services Subcommittee on Personnel Chairman Ben Nelson, D-Nebraska, told the panel of witnesses testifying.

Caregivers Face Challenges

Kimberly Noss, the wife of a servicemember who was severely injured in Afghanistan and remains minimally conscious at the VA’s polytrauma center in Tampa, FL, said that family caregivers can have a tough time making ends meet financially. Often, the spouse quits working to care for their injured loved ones. “If this individual requires 24-hour, 7-day a week care, how can their families who are most likely in the prime of their career afford to quit their jobs and forgo their retirement benefit to take care of their loved one?” she said. “What about the 18-year-old wife who didn’t have an opportunity for education and chose to take care of her severely injured husband instead of putting him in a nursing home?”

She said she plans to care for her husband full time once he leaves the polytrauma center, rather than putting him in a nursing home. Noss said her husband will receive a monthly benefit package and it is “a substantial amount of money,” but that her bills will also be large. “The special care that Scott’s going to have to receive because of his injuries is significant. But what we will pay for bills is large as well, so the net is going to be small,” she said.

Lt. Col. Gadson also raised the point about financial difficulties that the families of the injured faced. He said that current policy allows that non-medical attendants for the injured to receive some compensation. While he was receiving care at Walter Reed Army Medical Center, his wife was assisting him as a nonmedical attendant and received compensation. Their household was located at Fort Riley, KS. However, once the family relocated to the Washington, DC area in closer proximity to Walter Reed Army Medical Center where Lt. Col. Gadson was receiving care, her nonmedical attendant assistance was discontinued.

There should be a set rate given to nonmedical attendants, no matter where they are located, Lt. Col. Gadson said. “I believe that there should be a set rate for nonmedical attendants, as well as per diem and lodging,” he said.

First Lt. Andrew K. Kinard, USMC, a double amputee, said in his case his father left his practice as a physician for two months and his mother came for seven months to care for him until he could care for himself after his injury.

Colleen Rivas, whose husband sustained a Traumatic Brain Injury while serving in Iraq, and will likely need some type of long-term care in the next five years, said she was not aware of any income streams available for the family caregivers of injured service-members. “I am not aware of any of this. We lived off his retirement pay and savings, so this is new information to me,” she said.

Sen. Lindsey Graham, R-SC, said that more attention needs to be given to the financial difficulties families face when they care for an injured servicemember of the family who can no longer work. “The country needs to come to grips with the fact that the moment the person is catastrophically injured, the family changes. I think that most Americans would like an income stream available for family members who provide that support that otherwise would be given by the government,” said Sen. Graham.

VA and DoD Address Challenges

The committee also heard from DoD and VA officials. Acting Director of Transition Policy and Care in the Defense Department Maj. Gen Keith W. Meurlin, USAF, told the committee that DoD is proposing legislation for FY 2010 to allow caregivers, such as Gadson’s wife, to be compensated at the monthly rate that home health care aides are in a locality. “What we are looking at is compensation for caregivers that will provide for a benefit for caregivers equal and approximate to what a caregiver commercially would be earning,” he said. Sen Graham called this a “great idea.”

Overall, DoD and VA officials who testified said that progress had been made in the care, management, and transition of recovering servicemembers. A recent GAO report found that as of April 2009, VA and DoD had implemented 60 of the 76 requirements required by Congress to enhance care for wounded servicemembers, with 16 in progress.

Still, officials said that there is much work that needs to be done. “It’s obvious that we have a ways to go, but we are headed in the right direction,” said Roger Dimsdale, executive director of the Department of Veterans/Department of Defense Collaboration in the Office of Policy and Planning in the VA.