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RAND Report on Military Caregivers

The RAND Corporation recently published a groundbreaking report, Hidden Heroes America's Military Caregivers, which depicts the immense scope of military caregiver work in the United States as well as detailing the shortfalls of current veteran’s care policies and programs. The study distinguishes between healthcare providers and military caregivers, with the latter group assisting with activities related to daily living, rather than diagnosing or prescribing treatment. RAND estimates that 5.5 million military care givers support at least 3.8 million disabled veterans nationwide with roughly 20% of military caregivers assisting post-9/11 veterans. This article will provide a summary of the report’s key findings with respect to military caregivers and the efficacy military caregiver related of Government programs. 

Through their comprehensive survey, RAND identified several differences between pre-9/11 military caregivers and post-9/11 military caregivers. Individuals caring for service members who joined the military after 9/11 are more likely to be non-white, a friend or spouse of the service member (rather than the service member’s child), employed, are less likely to have a support network, and provide care for an individual who is more likely to have mental health or substance use conditions, when compared to pre 9/11 caregivers. The comparatively higher prevalence of mental health conditions and physical disabilities among post 9/11 veterans has substantially affected the work of post 9/11 military caregivers:  

“Two times as many (58 percent) of post-9/11 care recipients have a disability rating compared with pre-9/11 care recipients (30 percent); similarly, two times as many (32 percent) of post-9/11 care recipients have a rating of 70 percent or higher compared with pre-9/11 care recipients (15 percent)… 64 percent of post-9/11 military care recipients have a mental health or substance use disorder; nearly 50 percent of all post- 9/11 military care recipients have depression, twice as many as their civilian and pre-9/11 military counterparts” 
        
The increased burden on post-9/11 caregivers is evident through a host of reported medical ailments including high blood pressure, increased vulnerability to sickness, depression, back pain, and sleep deprivation. The burden of caregiving is especially pronounced in post-9/11 caregivers, largely as a result of limited health care access when compared to pre-9/11 caregivers; roughly 33% of post-9/11 military caregivers do not have adequate healthcare coverage, compared to 20% of pre-9/11 military caregivers. 

Despite the stark findings of the report, RAND identified several government programs that have had a demonstrable positive impact on post-9/11 caregivers, including: 

  1. The Special Compensation for Assistance with Activities of Daily Living program provides post-9/11 disabled service members a stipend usable by their primary caregiver, which helps offset the income lost by the military caregiver as a result of higher than average missed work days per month; and
  2. The Department of Veterans Affair’s Program of Comprehensive Assistance for Family Caregivers provides eligible post 9/11 caregivers with access to healthcare coverage, mental healthcare, a monthly stipend, and caregiver training.   

RAND makes a series of recommendations to further improve the quality of care provided by post-9/11 military caregivers and to reduce their burden, including supporting caregiver’s efforts to obtain healthcare coverage, providing training programs that cover an entire spectrum of required skills, and increase public awareness of the vital role of military caregivers.

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