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Traumatic Brain Injury – Soldiers and Spouses together

July 1, 2010

Recently, a reader of ours asked if we would be interested in a guest post about TBI.    We jumped at the chance, especially since Chelsea works for a healthcare provider specializing in brain injuries.  LeftFace and its authors are not endorsing any particular care provider, we are providing a gateway for  information.

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Traumatic Brain Injury Can Victimize Soldiers and Their Spouse’s

[Traumatic Brain Injury (TBI) is all too commonly associated with modern warfare, particularly the War on Terror. Many veterans suffer from these injuries without realizing it, until serious problems develop. Through awareness, we can help our military friends and family members avoid the serious implications of a traumatic brain injury.]

Military men and women are continually involved in situations where risk of injury is high. One silent war wound that often goes unnoticed is a traumatic brain injury (TBI). A TBI affects the function of the brain and can often cause life-altering damage ranging from personality and behavioral changes to complete loss of brain function and the ability to communicate. Therefore, some of the affects are not just life-altering, but also life threatening, and wind up requiring, long-term, specialized traumatic brain injury rehabilitation.  According to the Veterans Health Initiative, active male members of the military were hospitalized due to TBI related injuries at a rate of 231 per 100,000. The rate for female members of the military was 150 per 100,000. Based on these statistics, over 4,000 military personnel are hospitalized on average each year for traumatic brain injuries. Some are diagnosed as a mild TBI (aka concussions), while others result in moderate to severe TBI.

Mild TBI refers to loss of consciousness, confusion and/or disorientation for a duration less than 30 minutes. They are often overlooked at the time of injury but in at least 15% of cases can still have effects that last longer than 1 year. Symptoms associated with a mild TBI are fatigue, headaches, impaired vision, memory loss, inability to focus or pay attention, impaired sleep, dizziness, emotional impairment, depression and seizures. They are not always experienced right away and behavior changes are usually noticed by friends and family members before the victim realizes there is a problem. Therefore, it is important that any soldier suffering a physical blow to the head get examined immediately even though they might feel fine at the time of the injury.

The spouse of a veteran returning home from war can play an instrumental role in preventing long term damage stemming from a mild TBI by recognizing the difference between the “normal behavior” of their significant other and the occurrence of the abnormal symptoms listed above. Since spouses often spend more time together on average, they could be considered the first line of defense against long term damage from a TBI. If they understand the symptoms and know what to look for, when they recognize them, they can encourage their husband/wife to seek treatment immediately. Likewise, soldiers returning home should not dismiss any health concerns pointed out to them by those closest to them. Early treatment of a mild TBI will allow a patient to have the best chance at a full recovery and give the entire family an opportunity to maintain (or return to) a normal lifestyle as it was prior to the victim suffering the injury.

Moderate TBI refers to loss of consciousness, confusion and/or disorientation between a range of 30 minutes and 6 hours with a Glasgow Coma Scale (GCS) of 9 to 12 (15 being the least severe). Severe TBI refers to a brain injury resulting in loss of consciousness, confusion, and/or disorientation for a duration longer than 6 hours and a GCS of 3-8 (1 being the most severe but 3 being the lowest score achievable while considered non-vegetative). The GCS is a cumulative point system that combines three different scores determined by a patient’s eye, verbal and motor responses.
In cases of severe TBI, patients suffer cognitive damage including all of the symptoms of a mild TBI with the additional difficulty with impulsiveness, language processing and executive functions. Severe TBI patients may have difficulty speaking, understanding words, reading or writing and may alter the speed at which they try to communicate. Impairments to their sense of sight, touch, hearing, smell, and taste are likely. Seizures can ensue and damage to the individuals’ physical and emotional health can be devastating, including physical paralysis, chronic pain, bowel disorders, malnutrition, menstrual difficulties, anti-social behavior, lack of motivation, aggression, depression and denial.

With all of the short and long term effects resulting from traumatic brain injuries, the patient is not the only person to suffer, especially in severe TBI cases. Prior to seeking medical treatment, as the condition worsens, unexpected changes in behavior from a soldier returning home to their family can create a lot of stress, pain and suffering for everyone else around them. It’s difficult for family members to be separated from their loved one while they are off fighting a war. Usually a spouse anxiously awaits the safe return of their military husband/wife wanting nothing more than to spend time with them and to move forward with their relationship and their lives. Unfortunately, the reunion may be troublesome if a soldier returns home with a TBI that they are unaware of.

If the injury is not recognized, the increase in irritability that the soldier experiences could spark constant feuds, thus creating distance between them and their family members. An inability of a TBI victim to control their motor functions would further divide them. Whether the victim has trouble speaking, reading, processing words or connecting with their loved one physically, the change in the relationship would be devastating. Showing affection simply by holding hands or sharing a relaxing meal together would be exponentially harder to physically execute by a patient suffering a severe TBI and could promote frustration. The inability for a victim to return to work or be an active member of the household could cause emotional, physical and financial burdens down the road. For spouses trying to manage a full time job and/or care for children and maintain a home while their loved one experiences these changes, the tasks may be overwhelming. Even if the injury is recognized, during the treatment phase a spouse or other family member/friend would likely need to provide constant emotional and physical support to the patient, possibly leading them to overextend themselves and/or ignore their own health and well-being. Ultimately, those that support the victim may find themselves emotionally and physically drained, struggling to keep up with day to day tasks – regardless of their desire to do anything it takes to get their loved one on the road to recovery. The ability of a spouse to perform everyday duties while their husband/wife recovers may be impossible without further assistance from other family members, friends, or the long term care of a skilled nursing facility. The spouse, children and other family members/friends of a patient who does not recover will be affected by the completely different role or absence that their mom/dad, brother/sister, child, etc has in their life.

A patient and the friends/family members of a patient suffering (and/or unable to recover) from a TBI will undoubtedly experience significant changes to their lifestyle. The best way to prevent TBI is through awareness. Recognizing and responding to the early symptoms of a TBI can often aid in preventing further damage caused by the injury. So it is vital that serviceman and their families are aware of TBI so that they can recognize the symptoms and help the victim seek medical treatment if symptoms are present.

Written by Chelsea Travers
Chelsea is a communications representative for CareMeridian, a well-known subacute care facility located throughout the western United States for patients suffering from traumatic brain injury, spinal cord injury, or medical complexities such as neuromuscular or congenital anomalies.

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3 Comments leave one →
  1. July 2, 2010 12:16 am

    Who is taking care of the caregivers?

    I appreciate the infomercial, and anyone attempting to assist our wounded troops has my full support. But: Who is caring for the caregivers? The article presents multiple statements/expectations pertaining to the critical – yet unpaid, unrecognized, unsupported – role of the mil. spouse. With no regard nor awareness of the profound wounds suffered in silence by wives of combat wounded veterans, whose psychological and physical ailments are significantly greater than even the wives of non-combat vets. Of the very few studies conducted on the health of wives of combat veterans, virtually every one revealed that those women had extremely high rates of psychological distres up to and ncluding suicidal ideation, and markedely lower baselines of physical health i.e. blood pressure, weight, et. al.
    I understand that parents also take on the responsibilities of caring for their wounded veteran child, but it’s a very different dynamic, as that caregiving does not interfere with the marriage bond, sexual relationship, income, etc. Spouses must become adept at navigating the VA and Military terrain, while also fundamentally revising their roles and expectations for their marriage and economic family support, and partnership. Theoretically, by the time someone is old enough to enlist, s/he’s typically not living in the household, so it doesn’t fundamentally change the daily routine and avenues of support for the parents. For the spouse/mil.fam. EVERYTHING changes, and the cultural and social expectations of caregiving are much more stringent. Again, who’s caring for the caregivers? If the author, who presumably gets paid for her work, (which begs the question of whether or not she would be doing it for free, and invites a discussion of the moral and ethical implications thereof) and her company, are THAT concerned, perhaps they might consider financial, emotional, and practical support for the troops who were drafted to serve without pay e.g. the wives- how about sponsoring a Sanctuary Weekend for Wives of Wounded Veterans? Common sense, personal experience, years of research , and anecdotes tell me that the military spouse is the hubnut of the family – military kids’ experience of deployment is greatly affected by the psychosocial health of the civilian provider at home, and yet there are few programs for them. We know what the problem is. We live with it every day, If you want to volunteer at a veteran’s shelter, come to my house. If you want to s upport veterans and military families, for the love of Christ, take care of the caregivers. And quit asking us to do for free what you won’t do for money. Period. End of sentence.

  2. July 2, 2010 5:36 am

    Hear Hear!! Thank you Stacy – you are so right. is there anyone out there providing any sort of respite care, any support to caregivers? anyone? If YOU know anyone, let US know.

  3. Jess permalink
    June 25, 2011 9:11 pm

    I agree. My husband was wounded at war and came home with TBI. Being the care giver,wife and mother all at the same time is a very Difficult Job. It is hard to calibrate what is will disrupt the TBI patient at any given time. Whether it be a look, a tone or body language they don’t like that may set them into a major mood swing. The caregiver/wife/mother gets the blunt of all the responsibility and the abusive treatment. HOWEVER, they do have a program now that does pay the care givers/spouse to take care of the soldier and they offer health care so that YOU are taken care of too. IF they are discharged and are disabled through the V.A. they can get paid through the Easter Seals administration. It is worth checking into and I strongly suggest it for you spouses out there 🙂

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