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Getting Help with Caregiving

Getting Help with Caregiving

Okay, our next topic is one of the key elements of being an effective caregiver at home. Now I know that I’ve mentioned this several times over the past few weeks, but I can not stress enough the importance of getting help. Whatever your situation, whatever the condition of your loved one with TBI, you will need help from friends, from family, from neighbors, from all kinds of other people. The first step is to find your helpers. Okay.

I have to admit that I’m not very good at asking for help.

You’re not alone, Megan. Many people find it really tough to ask for help. But think about this. I mean if the tables were turned, and someone you knew needed help, wouldn’t you help them if you could?

I would.

Okay. I’ve found that when people offer to help, they usually mean it. So take them up on the offer. You know, Megan, if it’s too difficult for you to ask for help, or if you just don’t have the time, ask a friend or a family member to get the word out for you.

But do keep in mind that it’s important that you feel comfortable with the members of your home care team, in terms of their capabilities, and what level of responsibility you’re comfortable giving them.

There are some specific tips for building your home care team you’ll find that in your Guide for Caregivers. And you’ll also find a Home Care Volunteer form that should come in handy.

Okay, so now you’ve identified your helpers. That next step is to make a list of tasks. Now remember these are not just responsibilities relating to the care of your loved one with TBI, but things that lighten the load for you and other members of the family. And after you’ve made the list, determine whose skills best match each of the tasks. Now if you ask your children for help, make sure that the tasks you give them are age-appropriate. 

I used to always just do things myself, but since Tom got hurt, I’ve gotten better at asking other people to help. I just don’t have the time that I used to, and with Tom coming home, I know I’ll have even less time.

I’m afraid you’re right, Michelle. As Tom makes that transition home, you’ll find that both your time and your emotional energy may be in short supply. That’s why time management is so essential.

There are times you may feel there’s more to do than you have time and energy for, so you’ll need to do some prioritizing. Decide which tasks need to be done right away and which tasks can wait until later. That way, you can focus on what absolutely needs to be done, and then you can delegate other tasks to your Home Care Team. 

Okay, so our next topic is home health care, which is when a qualified aide, a nurse, or a therapist provides care for your loved one right there in your home. For example, an aide might assist with bathing and hygiene. A nurse might provide skilled care like changing dressings or reviewing medications.

Yeah, when Sam first came home, his home care nurse and physical therapist were at the house fairly regularly.

Physical therapists, speech therapists, occupational therapists they’re often an important part of that recovery at home. Your case manager can help you determine if you’re eligible for assistance with home health care from TRICARE, or from the VA.

Another valuable resource for caregivers is called respite care. You know, no matter how organized you are, over time, those demands of being a caregiver can be exhausting. It can be really important to take a break, and respite care is one way to do that. It offers a break from the demands of caregiving, and it allows you to get things done and to take some time for yourself.

Respite care is available in a variety of forms. In some cases, a companion or a sitter might provide some respite at home. Respite can also be provided outside of the home in an adult day care situation or assisted living or a nursing facility. It can range from just a few hours per day, a week, or short-term placements in residential facilities.

Are respite programs expensive?

Well, that depends on the program, and the benefits you’re eligible for. TRICARE provides respite care for homebound service members on active duty, if they meet specific criteria. But your care coordinator can help you find programs that can help cover any costs.
Information on respite resources can also be found in The National Resource Directory. Military OneSource’s Wounded Warrior Project and other programs are also available to help you find the right respite care for you and your family.

Our case manager told us about the Exceptional Family Member Respite Care Program. It turns out that we qualify. 

Oh that’s great, Julie. Another option that some caregivers consider is temporary or more permanent residential care for their family member with TBI. There are different types of residential facilities, ranging from assisted living to those that provide 24-hour skilled nursing care.

If you explore the possibilities of residential care, be sure to check with your case manager, your VA liaison, and your military liaison for the benefits that are going to be available to your family. But you’ll find more information and resources about benefits in your Guide for Caregivers.

Look I know that I have given you a ton of information, and it’s a lot to process. But you can review the material in your Guide. And next week we’ll continue talking about that transition home, planning for the future. And in the meantime, hang in there.

You’re doing a fantastic job. Thanks for coming. And I look forward to seeing you next time! Okay have a great week.

Time Off/Respite Care

The demands of being a caregiver may cause many challenges. Respite, or time off, care helps both the caregiver and service member/veteran in living with brain injury. Respite care is a valuable resource to you and your family member. Respite care offers a break and allows you time for yourself. A companion or sitter may provide respite at home. Respite may be provided outside of the home in an adult day care or assisted living or nursing facility. It can range from a few hours per day, a week, or short-term placements. Day Rehabilitation Programs may help your family member remain in the home. These programs may also provide meaningful, engaging, structured activities during the day while you go to work outside the home.

Respite services for persons with TBI are generally supported by government grants and contracts, nonprofit agencies, Medicare, Medicaid, and through self-pay (most often sliding scale fees). Many VA Medical Centers offer respite care and day programs.

TRICARE provides respite care for homebound service members on active duty who meet the following criteria:

  • their conditions or injuries make them unable to leave home without taxing effort
  • they need more than two interventions during the eight-hour period per day when the primary caregiver would normally be sleeping

For these individuals, TRICARE provides a maximum of eight hours of respite per day, five days per week. This benefit is retroactive to January 1, 2008, and has no cost shares or co-pays. For more information, consult www.tricare.mil.

The National Resource Directory www.nationalresourcedirectory.org can direct you to respite programs. Your religious community, local social service agency, local chapters of Easter Seals, the local mental health agency, military service organizations, veterans service organizations, and Military OneSource’s Wounded Warrior Project are all organizations that can help you find the right respite care for you.

Ask your Point of Contact/case manager about the Exceptional Family Member (EFM) Respite Care Program, and how to qualify. More information can be found at www.MyArmyLifeToo.com and www.militaryhomefront.dod.mil.

There are many organizations that have respite care.  This list may be useful:

Exceptional Family Member (EFM) Respite Care Program

  • 40 hours of respite care per month per EFM 
  • Parents select respite care worker 
  • Monthly Respite Care Newsletter: www.MyArmyLifeToo.com


  • Goal to assist sailors by addressing the special needs of their family members during the assignment process
  • Navy EFMP Coordinators are located at Navy medical treatment facilities. Their role is to refer to the Fleet and Family Support Center for community assistance
    • Special medical, dental, mental health, developmental or educational requirements, wheelchair accessibility, adaptive equipment, or assistive technology devices and services www.militaryhomefront.dod.mil
  • 40 hours/month 
  • Care can be provided by
    • Installation CDC 
    • FCC Home 
    • Visiting Nurse Service 
    • Family member 
    • Neighbor
National Association of Child Care Resource & Referral Agencies (NACCRRA)
  • Partnership Program with Marine Corps EMFP Respite Care 
  • 40 hours/month of free respite childcare
  • 10 participating bases
Air Force Aid Society Respite Care Program
  • Respite Certificate issued with number of hours of respite over three-month period 
  • Services are re-evaluated quarterly 
  • 4-6 hours/week – average 
  • Family identifies care provider 
  • Will not reimburse for a relative to provide care
"I so wish that at the beginning I had had someone like the people I’ve met here at Fisher House, who are already two years post-injury. I wish I would have had some- body like that come up to me and just put their arms around me and say, You know what? Any question you need to ask, just ask it." -  Meredith H.



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