Graduation Year

2016

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Social Work

Major Professor

Nan Sook Park, Ph.D., M.S.W.

Co-Major Professor

Mary Armstrong, Ph.D.

Committee Member

Manisha Joshi, Ph.D., M.P.H., M.S.W.

Committee Member

William S. Rowe, D.S.W.

Keywords

Caregivers, PTSD, TBI, Veteran Caregivers, Iraq, Afghanistan, Caregiver Burden

Abstract

Currently, there are approximately 1.1 million caregivers who are caring for veterans who have served in the military following September 11 (9/11), 2001 (Ramchand et al., 2014). In this study, a mixed methods analysis of post 9/11 caregivers enrolled in the North Florida South Georgia Caregiver Support Program was completed with a convenience sample of 172 participants for quantitative analysis which included 16 participants for the phenomenological query. Correlations, t-tests, and ANOVAs were used to determine the associations among race, gender, age, caregiver type, diagnosis, tier level, and the presence of children in the home with caregiver burden as measured by the Zarit caregiver burden inventory (ZBI). T-tests resulted in a significantly higher ZBI with caregivers who had children in the home (M = 6.84; SD = 3.21) versus those who did not (M = 5.57; SD = 2.75), t (160) = -2.36, p=.02. An ANOVA was conducted across caregiver role (parent, spouse, significant other and other) and the ZBI and a significant difference was found (F [3, 159] = 1.59, p < .01, with spousal caregivers having a significantly higher ZBI score (M=6.83; SD=3.10) than parental caregivers (M = 4.46; SD=2.70).

The phenomenological research focused on shared lived experiences of post 9/11 caregivers of seriously injured veterans, including their experiences with the Caregiver Support Program, the impact of having children in the home, and the utilization of technology and online support with caregiving. Differences between spousal and parental caregivers were also explored. The caregivers’ shared experiences resulted in 22 major themes which included family adjustment, subjective demands, coping techniques, social support, Veterans Affairs (VA) and Department of Defense (DOD) services, self-care, intimacy, role strain, financial resources, and life course changes as the most prevalent. Caregivers and their families had a difficult time adjusting post injury, particularly with subjective demands. Caregivers relied mainly on their own coping mechanisms to adapt to their new role and did not find social support to be helpful with caregiving. Spousal caregivers tended to have more difficulty adjusting than did parental caregivers, which was also found in the quantitative study. While the Caregiver Support Program provided many services that were helpful to the caregivers, including a financial stipend, they wanted additional services which included additional financial support and services while citing issues with program implementation and staffing as major barriers. Children added complexity to the caregiving relationship and increased burden. Children displayed behavioral changes, mostly negative, but some positive such as giving both the caregiver and the veteran a sense of purpose. Lastly, technology and online support with caregiving was used more often than not with mixed feelings about the technology and its trustworthiness; with parents not utilizing these resources as much as spousal caregivers. The study concludes with implications for current and future social work practice and research, as well as the study’s strengths and limitations.

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