• caregiver burden [ Time Frame: study endpoint ] [ Designated as safety issue: No ]
  

• caregiver depression [ Time Frame: study baseline and endpoint ] [ Designated as safety issue: No ]
  

Impacts on Veterans' Healthcare. This project will evaluate the feasibility of volunteer support teams for OEF/OIF traumatic brain injury (TBI) caregiving families. TBI is the signature injury of the Iraq war. Just as with other conditions that require extensive rehabilitation and support, caregivers of persons with TBI become the "other" victim, overwhelmed with care. Family caregivers cannot sustain care alone. The support team model leverages volunteers' work to provide practical support, based on the family's needs and each volunteer's time and abilities.

Project Rationale. Volunteer caregiving teams to support caregivers have been used in other chronic conditions (e.g., HIV, MS), which require intensive supportive care. These teams provide a method to support caregivers, linking practical needs to volunteer interests and abilities. Coordination of tasks and volunteers eliminates redundant assistance, missed commitments, and excessive administrative labor, while allowing volunteers to provide assistance without being overwhelmed. This model of support is particularly relevant for caregiving families who do not live near TBI centers or in resource-rich urban areas. Rural areas are more likely to be under-funded in home and community services.

Objectives. This primarily qualitative pilot project will work with TBI families receiving services through Memphis VAMC to assess the feasibility of volunteer teams in assisting the caregiving family. The main objective is to determine the feasibility of implementing volunteer support teams and the obstacles and opportunities in implementation, specifically participation of TBI families and identification and participation of coordinators and team members. Satisfaction of the TBI family and team members and caregiver depression, burden, self-care, healthy behaviors, and participation in social activities will also be evaluated. The long term objective will be to develop a model that can be used for other TBI families and communities.

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Methods. This project will work with 2-7 families, who will be contacted by their primary clinician. A project coach will call and discuss the project.

After explanation and informed consent in the home, the coach will work with the family on a needs assessment, focusing on practical help needed; hours per day help is needed; and who may help. Team members and a coordinator, all volunteers, will be identified by the family. After team formation, the coach will provide training for the coordinator and team members on TBI and on working with the family. Scheduling can occur through telephone calls, meetings, or a free secure website. Monthly check-ins with family and team members will identify concerns or questions.

After three months, program evaluation data will include participation of families and team members and completed and missed commitments. Satisfaction data for family and team members will be both quantitative and qualitative and include general satisfaction, positive features and facilitators, barriers, obstacles, and perceived match between needs and abilities/support provided. Primary caregiver depression, burden, self-care, healthy behaviors, and participation in social activities will be measured at beginning and end. CPRS data will be used for VA health care use. A final team meeting focus group will discuss how to implement this model into the community for future TBI families.