RAND Researchers Identify Gaps in Support for America's Military Caregivers | Web version

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April 1, 2014


RAND Researchers Identify Gaps in Support for America's Military Caregivers

a soldier and his wife

Since 2001, thousands of U.S. service members returning with disabling injuries or illnesses have required long-term support beyond what the formal health care system provides. Many of these injured or wounded service members or veterans rely on the support of caregivers -- family or friends who provide unpaid care or help coordinate services for the wounded, ill, and injured.

While much has been written about the role of caregiving for other populations -- like the elderly, chronically ill, or children with special needs -- little is known about "military caregivers." Military caregivers play an essential role in caring for injured or wounded service members and veterans. Yet playing this role can impose a substantial physical, emotional, and financial toll on caregivers.

Today, RAND released a new report, "Hidden Heroes: America's Military Caregivers" that sheds light on the magnitude of military caregiving in the United States and identifies gaps in the array of programs, policies, and initiatives designed to support military caregivers.

The report finds elevated risks of poor health outcomes, strained family relationships, and financial losses from missed work for all military caregivers, with post-9/11 caregivers facing higher risks. It also identifies key differences between pre-9/11 and post-9/11 caregivers and makes recommendations to policymakers to improve support for military caregivers.

Key Findings

  • There are an estimated 5.5 million military caregivers in the United States. Almost 20 percent of these caregivers are caring for post-9/11 veterans, a group for which a third are spouses, a quarter are parents, and another quarter unrelated friends of the veteran or service member.
  • While caregivers for veterans from earlier eras tend to resemble caregivers of civilians, post-9/11 military caregivers differ in several important ways. In general, post-9/11 military caregivers are:
    • younger and lack a support network
    • caring for a younger individual with a mental health or substance use condition
    • more likely to juggle the demands of work and the responsibilities of caregiving.
  • Military caregivers consistently experience worse health outcomes, greater strains in family relationships, and more workplace problems than non-caregivers, and post-9/11 military caregivers fare worst in these areas.
  • Most programs offering services to military caregivers often do so incidentally. Programs either offer services for veterans that caregivers may be invited to attend, or to military and veteran families of whom caregivers are a subset. Few services are designed specifically for military caregivers.
  • Few caregiver programs provide respite care, health coverage, and financial support, which may be the areas of greatest need.

What Can Congress Do to Help?

Congress has previously taken action to help support military caregivers, but more can be done to fill the gaps between the support military caregivers need and what is currently available to them.

  • Fully Fund the Lifespan Respite Care Act -- Currently only nine organizations in the U.S. provide respite care services for military caregivers, leaving many without access. The length of time spent each week giving care is associated with higher risk of adverse outcomes, such as depression. Enhancing support for respite services could help reduce this time burden of caregiving for military caregivers, thereby reducing a risk factor for depression and mitigating an important adverse consequence of caregiving.
  • Reconsider eligibility requirements for caregiver support programs -- Most caregiver support programs determine eligibility based on the age of the care recipient (most target people over the age of 60) or relationship to the caregiver. Over 80 percent of post-9/11 caregivers are under 60 years of age and one third of post-9/11 care recipients receive help from extended family or friends, leaving many of our more recent military caregivers ineligible for these programs.
  • Ensure military caregivers have health care coverage -- Twenty percent of pre-9/11 military caregivers and almost 40 percent of post-9/11 caregivers lack health insurance. Special education and outreach efforts may be needed to help military caregivers access coverage.
  • Promote integration and coordination of programs and services -- The Departments of Health and Human Services, Labor, Veterans Affairs, and Defense each support caregivers in some way. While collaboration efforts do occur, gaps and inconsistencies in eligibility criteria and program definitions remain. Establishing a centralizing body responsible for overseeing federal efforts to support military caregivers could enhance alignment and quality of services available.

Read the full report, research brief, and other supporting materials »

If you have questions about this report or want to speak to the authors to ask questions, please contact me at Jayme_Fuglesten@rand.org or at (703) 413-1100 ext. 5363.


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