By Kristine Dwyer, Staff Writer
Armed Forces continue to be prepared
for lengthy overseas deployments, often serving
multiple or extended tours of duty. This has
created unparalleled stress and trauma; not only
on those who serve, but also on their families
during these deployments and upon their returns.
Families make tremendous sacrifices so that
these men and women in uniform can provide
military service and advance the cause of
freedom throughout the world. Families are also
a vital support system to these service members
and their roles can not be underestimated.
When service members go to war, the nuclear and
extended families also “go to war” and are
impacted by the outcomes. Unfortunately, combat
can result in severe injuries, disabilities and
casualties. Many veterans have now returned home
to thousands of families who face daunting
challenges and may be unprepared to care for
them. Lives are altered and rearranged at all
levels to care for the physical injuries and
emotional needs of loved ones. Many of these
family members, including children, experience a
change in their roles and have become
“caregivers.”
Fortunately, in this day and age, caring for our
military members also includes tending to the
well-being of their families and caregivers. A
multitude of programs and resources are now
available or are being developed to assist our
Armed Forces members as they return to duty or
civilian life and to assist their family members
as they face new roles and expand their capacity
to provide care.
Family Transitions and Support:
Upon a veteran’s return from the battlefield,
the entire family will go through a period of
transition that includes restoring trust and
wholeness in the family circle. This is the most
important time frame to seek support and gain
knowledge about the changes and difficulties
that may be present.
In recent years, the VA (Veterans
Administration) identified a six-phase “Cycle of
Reintegration.” The phases also directly involve
and impact caregivers and family members as the
veteran reunites with them.
Phase One: “The Honeymoon”:
elation and joy, relief and celebration
Phase Two: “Disillusionment”:
role changes, life at home doesn’t feel the
same, pace of life is different, new stresses
may emerge
Phase Three: “Alienation”: no
one “gets it,” “I want to go back,” risk of
drug/alcohol abuse, frustration, boredom, feels
distanced from the military routine and comrades
Phase Four: “Engagement”:
intervention by the family, motivation to
change, counseling/support groups, return to
work, seek new routines and connections
Phase Five: “Acceptance”:
realization that life is different, “I am
different,” “you are different,” relearning
takes place, negativity is replaced by gratitude
Phase Six: “Finding a New
Normal”: aiming for stability and lifestyle
balance, prioritizing life issues, working
together to set new goals
Understanding these phases and utilizing
counseling support services through the military
or local programs will be a key to a positive
adjustment for the veteran and the entire family
system.
The need for family support during times of
deployment and upon the return of service
members has always existed. Family Readiness
Groups (FRGs) and support groups are available
through each branch of the Armed Forces to
provide social and emotional support, outreach
services, and information prior to, during, and
in the aftermath of military separations. The
camaraderie and strength that develops between
military families that face uncertain times
together is priceless.
Military family retreats, provided through many
military branches, are another example of
support for families and caregivers. They
provide combat veterans and their families with
the education, training and skills needed to
manage their lives after serving in a war. The
retreats are often held in a rural, private
area, are staffed by trained volunteers and
counselors, and are usually free. Youth and
children’s activities are provided along with
educational and support sessions for veterans
and their spouses. These topics may include:
self care, relaxation techniques, stress
reduction, sleep solutions, problem-solving
skills, money management, intimacy issues,
communication, VA services and more.
Positive results have come from these retreats
as families have attested: “This experience has
pulled our family from the brink of
destruction,” “The retreat gave our family a
boost of self-worth,” and “Everybody faces
challenges with the aftermath of war. It is good
to know, see and feel that it is normal.”
Taking Care of the Caregiver:
Family members may face the prospect of starting
a new chapter in their own lives if their loved
one returns from military service with an injury
or disability. Many have had to put life on
hold, leave jobs or change residences to care
for a spouse, adult child or significant other.
Caregiving can be overwhelming as one tries to
meet all of the emotional, physical and medical
needs of a veteran. Mourning the loss of a
“normal” life and relationship prior to the war
may also occur. At this point, it’s important
for caregivers to accept that things have
changed and to surround themselves with their
own spiritual, emotional and physical resources.
The health and emotional well-being of the
veteran’s caregiver also needs to be a priority.
If not addressed, caregiver fatigue, illness and
impatience can directly reflect on and impact
the quality of care that one is able to give. An
important analogy can be found in our airline
industry. Just as the flight attendant instructs
passengers to use the oxygen mask on themselves
first and then assist the person next to them,
so must the caregiver follow the same important
instructions.
Caregivers who learn what help is available to
veterans and how to access that help will feel
more in control of a complex situation. Some
ideas are:
Become educated about the veteran’s medical
condition, whether physical or emotional.
Learn to communicate with members of the health
care profession. Write down questions prior to
appointments and, if needed, have an additional
person attend appointments to gather important
information.
Keep good medical records and summaries of
office visits. Bring identification and health
insurance cards, plus names and doses of the
veteran’s medications to the appointments.
Learn the routines and points of access with the
medical facilities used by the veteran. This
includes office hours and how to reach health care
providers, schedule appointments and transportation.
Inquire about assistive technology devices and
utilize home care and skilled-care services.
Find out about benefits that are available through
the military and Department of Veterans Affairs.
Additional Caregiver Keys Include:
Asking for help (it is a sign of strength)
Taking breaks to restore energy
Making one’s own health needs and medical
appointments a priority
Learning proper caregiving techniques such as
lifting, transferring, or wound care from medical
professionals at the VA or other medical facilities
Connecting or reconnecting with a faith-based
community for support
Establishing a circle of support around the family
that includes professionals, relatives and
(military) friends who are able to share the care
and reduce stress
Community Support is Priceless:
Fostering community support for veterans and
military families is essential to their readjustment
and stability. If the community is committed to
helping and supporting them, the period of
readjustment will be more successful. This support
can take many forms, and state governments and
citizens across the nation are proposing new
initiatives and partnerships to help speed up and
expand services to veterans and their families.
The Minnesota National Guard, for example, has been
heralded for a program that hopes to change how
soldiers and airmen are reconnected to their
families and communities. “Beyond the Yellow Ribbon”
is named as a reminder that the support of soldiers
and their families must not end when they return
from their deployment and the yellow ribbons are
removed. The program offers a roadmap of important
steps to take care of the soldier’s physical and
emotional health, personal business/benefits,
health, education, legal issues, employment, and
family needs including marriage enrichment and
parenting.
Chaplain Major John Morris of the Minnesota “Beyond
the Yellow Ribbon” campaign made this analogy.
“Going into combat is a little like canoeing across
the lake of life. When you leave for war, it’s like
standing up in the canoe and upsetting the balance
of family life. While you’re gone, your family takes
over the paddling and tries to survive. When you
return, you climb back into the canoe, and flip it,
swamping it. Many families have been faced with
bailing out that canoe, and they suffer extreme
duress over something they thought would be joyful.
A lot of families can become exhausted from paddling
that canoe through life.”
Chaplain Morris encourages returning veterans to
seek whatever help they need to make a successful
adjustment back into their families, relationships
and community lives.
Another example is a program developed by Mary
Pawlenty, wife of Governor Tim Pawlenty of
Minnesota, called the “First Lady’s Military Family
Care Initiative.” She has brought together service
groups, community organizations and faith-based
groups throughout the state, all of whom have
expressed a strong desire to provide a wide
selection of volunteer services to military
families. A simple task like mowing the grass,
assisting with chores or preparing a meal can go a
long way toward helping a family in their time of
need.
“Homes for our Troops” (part of the Defense
Department’s “America Supports You” program) is yet
another option available to wounded service members
and their families. The program builds or remodels
homes (at no cost) to accommodate the specific needs
of the severely wounded soldiers who are returning
from Afghanistan and Iraq. Their goal is to adapt,
build and remove obstacles in the homes to meet the
needs of a veteran who is in a wheelchair or who
faces injuries that hinder mobility. The
organization provides services specifically to
troops who are double amputees, paraplegic,
quadriplegic, have severe post-traumatic stress
disorder, or are severely burned. “Homes for Our
Troops” has successfully partnered with the
communities where veterans live to help fund the
projects by holding benefits/fundraisers, donating
materials and utilizing local professionals.
Veterans Administration Role:
The VA supports caregivers as they support our
veterans, including those who care for recently
wounded or ill veterans as well as aging veterans.
Although the VA system has been inundated with
requests for care and is often criticized for their
service limitations, strides continue to be made
toward greater care options and contracts with
existing programs.
For example, in December of 2007, the VA announced
that $4.7 million was allocated to help caregivers.
Since family caregivers are on the front lines to
care for veterans, the goal of the VA is to form a
partnership between family caregivers, the VA itself
and community-based agencies.
The VA is now funding “caregiver assistance pilot
programs” to expand and improve health care
education and provide needed training and resources
for caregivers who sacrifice to care and assist
disabled and aging veterans in their homes. The
eight pilot programs across the nation will explore
opportunities for providing social work services,
extended care, home safety evaluations and volunteer
support. The VA plans to contract with local
programs such as home health agencies, medical
equipment companies and adult day programs for
respite care. Many of the projects will also use
technology to offer support through computers, video
conferencing, and teleconferencing, especially for
caregivers that live in remote areas or are unable
to leave home to participate in support activities.
The majority of our service members are extremely
strong and resilient; however, the emotional
battering and stress of war can ultimately lead to
mental health consequences. Veterans from Operations
Enduring and Iraqi Freedom, who have accessed VA
health care, have reported mental health concerns
including PTSD (post traumatic stress disorder),
substance abuse and mood disorders. Living with and
caring for veterans with these issues is difficult
and can change the way that family members relate to
one another. That’s why it is crucial for those who
care for our veterans to become educated about these
obstacles and learn how to recognize when help or an
intervention is needed.
Veterans’ Centers around the country offer support
for mental health needs, readjustment issues,
marriage and family problems, and medical caregiving.
Support groups are also offered at many of these
centers to help caregivers understand the veteran’s
personal challenges such as anxiety, depression,
difficulties with their work/life balance, and grief
and loss issues. For those who reside in rural
areas, the VA is now networking with county and
private human service providers to offer education
and counseling, including bereavement support for
families of fallen service members.
Military OneSource is yet another support option.
This free 24-hour service, provided by the
Department of Defense, is available to all Guard,
Reserve and active duty members and their families.
Consultants provide information on a wide range of
issues that affect daily life and offer counseling.
The program can be reached by telephone at
1-800-342-9647 or through the Web site at
www.militaryonesource.com.
Providing care and support to our veterans can be
challenging, yet options and solutions are more
readily available than ever before. The VA and
communities across the nation are forming
partnerships and working diligently to support
veterans, their families and caregivers. Military
institutions recognize the sacrifices made on the
home front while we are at war and pledge to support
family programs while keeping the well-being of our
servicemen and women at the forefront.
This article is written in honor of my husband, Col.
Patrick Dwyer who served in the Gulf War, and all
members of our military who serve bravely and make
personal sacrifices for peace and freedom.
Helpful Websites:
www.militaryonesource.com
www.aarp.org
www.guardfamily.org
www.disabilityinfo.gov
www.operationmilitarykids.org
www.pva.org
www.va.org
www.usa.gov
www.tricare.osd.mil/cap
www.dma.state.mn.us
www.remind.org
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