Caregiving for Veterans

Whether recovering from a recent deployment or requiring increased help as they age, the veteran you care for may need a surprising breadth and depth of assistance.

In this module, we will provide you with knowledge and tools to help you better care for your friend or family member, including:

  • Advice addressing the particular needs of veterans
  • Information to help better navigate the Veterans Affairs organization and services available
  • Critical help available through the VA Caregiver Support program
  • Resources related to specific conditions, injuries, and mental illnesses

We’ll discuss the critical importance of ensuring that you, as a caregiver, are cared for. While the health and well-being of every caregiver are essential, caregivers of veterans often experience an exceptionally high level of burden or distress. Finally, we’ll point you to organizations and resources to support the vital work you’re doing.

Topic Quick Links – Click on a topic below to go to that area of the page.

A Meaningful Calling

Most people agree that giving back to the individuals who protect our nation is an honor. However, providing care for a veteran can be especially challenging. On the one hand, you’re caring for a human being – someone with personal care needs and living with the same physical ailments affecting all of us, such as:

  • Chronic or progressive conditions, including Huntington’s disease or multiple sclerosis
  • Cardiac, circulatory, or pulmonary conditions, such as coronary artery disease, peripheral vascular disease, or chronic obstructive pulmonary disease
  • Any medical condition, ranging from stroke recovery to asthma management

As a veteran, though, your friend or family member likely deals with symptoms directly related to their time in the armed forces. Even if they were lucky enough to come back from a deployment with no physical injuries, they might live with less apparent challenges and disabilities.

Unique Concerns for Caregivers of Veterans

Post-traumatic stress disorder (aka PTSD) – PTSD is frequently experienced by veterans who spent time in combat zones. More than just memories of what happened, PTSD can make a person relive the traumatic event each time they remember it, leading to a near-constant state of feeling on edge and unsafe. PTSD can make it hard to engage fully with day-to-day life and make it impossible to look forward to the future.

If your friend or family member has PTSD, there are signs and behaviors you’ll notice:

  • When triggered by sounds, smells, or sights that remind them of the traumatic event, they may experience physical signs of distress, including a racing or pounding heartbeat, breaking out in a sweat, or hyperventilating.
  • They may avoid places, people, or activities that remind them of what happened.
  • Memories or intrusive thoughts about their traumatic experience may come to them at any time. Their sleep may be disturbed by recurring dreams of what they went through. These flashbacks can feel frighteningly real. Insomnia is common.
  • They also may show signs of frustration or distress at the inability to recall specific parts of what happened, or “lost time” A key symptom of PTSD is hypervigilance, which is a sense of constantly feeling guarded or on high alert that something could go wrong. They may startle easily. This can make it hard to concentrate, affecting work, socialization, and everyday activities
  • Veterans with PTSD can feel disconnected socially from friends and loved ones or find it difficult to show affection. They may seem withdrawn

These reactions combined can make your friend or family member lose hope or enthusiasm about life. They may feel discouraged about perceived limitations around their future opportunities for romance, family, and career.

PTSD: What you can do

The best advice for a caregiver of a veteran with PTSD is to learn about the condition. The more you know, the more confident you’ll be in your interactions. Some basic tips:

  • Encourage mental health support.
    PTSD is considered a temporary condition, but how long it lasts can vary. Seeing a professional for therapy is a good start. Options abound for treating PTSD, including eye motion desensitization and reprocessing psychotherapy (EMDR). Group therapy or a support group may also prove helpful.
  • Try not to take their behavior personally.
    When a person has PTSD, even everyday interactions can be trying and exhausting. Emotional withdrawal is a coping mechanism. They will have good and bad days.
  • Do what you can to reduce the stigma.
    Much work is being done around the world to reduce the stigma around mental health issues. Try to normalize conversation around mental health. Find common ground so your friend or family member knows you have empathy for what they are going through – even if you can’t fathom the events that led to their PTSD.

Many resources are available online to help families and caregivers support their veterans struggling with PTSD. One example is the printable guide “I’m Caring for a Veteran with Post-Traumatic Stress Disorder (PTSD): What Do I Need to Know?” from VA Caregiver Support, part of the U.S. Department of Veterans Affairs.

I’m Caring for a Veteran with PTSD- What Do I Need to Know?

Traumatic Brain Injury

A person sustains a traumatic brain injury when the head is struck hard. It can also happen when the head moves too quickly. Combat, car accidents, physical assaults, or falls are common causes of TBI. The injury’s severity determines the effects TBI can have on a person’s health and life.

  • Impacts to mental health include difficulties with concentration, learning and memory, and a slowed-down speed of processing and thinking. TBI can also affect a person’s ability to judge situations and consequences, which could make decision making difficult.
  • Impacts to physical health often include fatigue, general weakness, and trouble with coordination; dizziness, and pain (including headaches); sleep issues; and changes to vision.
  • Emotional changes are also seen with TBIs. Your friend or family member may find themselves frustrated or irritated easily. They may have angry outbursts for unknown reasons. They may develop depression and anxiety. These emotional issues may inhibit their social interactions with friends and family.

TBI: What you can do

As a caregiver for someone with TBI, one of the best things you can do for them is to be patient and understanding. Some tips:

  • Watch out for fatigue. Fatigue is a symptom of TBI, but when your friend or family member is fatigued, it will make everything else more challenging. You may be surprised just how much of a difference it can make in successfully maneuvering therapies or even everyday activities.
  • Establish and follow a routine. We’re not talking boot camp. Just a gentle routine they can anticipate – something to structure their day. Being mindful of the effects of fatigue, experts recommend scheduling more taxing activities for the morning.
  • Communicate simply and clearly. TBIs often affect a person’s ability to multi-task, do several tasks in succession, or switch quickly from one task to another. When guiding your friend or family member in a task, give them one short, clear instruction at a time.
  • Use visual tools and cues. You may find using calendars, white boards, and notebooks helpful in working with someone with TBI

You can learn much more about TBI, diagnosis, and treatment via VA’s Polytrauma website or VA’s Public Health website.

Mental health: What you can do

If your friend or family member is suffering from any mental health issue, it is vital they see a professional. Therapy is helpful, as is psychiatric medication, including antidepressants and antianxiety meds.

If possible, attend the appointment with them, or if privacy is an issue, ask to speak with the doctor before or after the appointment. Be clear on the medical practitioner’s recommendations and how you can best support them.

  • If your friend or family member starts meds, keep an eye out for any changes or reactions.
  • Even if they have successfully taken mental health meds for an extended period, always watch for worrying behavior. Relapses happen, as do life events; sometimes people stop taking meds cold turkey (with bad effects), and sometimes, medications just don’t work as well as they once did.

Watch for mood and behavior changes; if you observe something concerning, get your friend or family member the help they need.

If the veteran you care for is hesitant about seeking mental health support directly through the VA, another option would be Vet Centers. There are 300 community-based Vet Centers located throughout the United States and surrounding territories that offer a wide variety of services to veterans, service members, and their families. Eligibility information is available on their comprehensive website. You can also find one near you.

Other mental health issues

Serving in a war zone often causes psychological trauma. Many veterans come home from deployments needing mental health support; and often, their mechanism of choice for coping becomes its own challenge. They may live with:

  • Depression
  • Anxiety
  • PTSD
  • Substance use or addiction (alcohol, opioids, other drugs)
  • Paranoia or violent behavior
  • Suicidal thoughts
  • Self-harm 

Suicide

And finally: Suicide among veterans is a serious concern, and it happens more frequently than with civilian populations.

  • If the veteran you care for has access to firearms, safety is paramount.
    Removing the gun from the premises is ideal, but if that is impossible, there are other steps you can take. Gunlocks can provide time and space for a change of heart or for someone else to intervene. Request a gunlock from your local VA Suicide Prevention Coordinator. The VA Resource Locator can help you find them.
  • It can be difficult for a veteran to admit they aren’t doing OK.
    Historically, hallmarks of military training and service have included strength – physical, mental, and emotional – and a high tolerance for discomfort. All of those attributes can make talking about depression or thoughts of self-harm uncomfortable and something they may avoid.
  • This suicide prevention toolkit for caregivers was produced by the VA, and it should help.
  • Keep this phone number for the Veterans Crisis Line next to your landline phones, and add the number to your mobile phone: Dial 988 then Press 1. You may call 24/7. Qualified VA responders are also available through online chat or text (text your message to 838255).

One of your greatest resources will be the VA Caregiver website. They have developed many helpful materials, including tip sheets for specific diagnoses.

Also important is the National Caregiver Support Line 1-855-260-3274 (toll-free) M-F 8 am -10 pm ET and Saturday, 8 am-5 pm ET. This is a toll-free number for caregivers, family members, friends, Veterans, and community partners to contact for information related to caregiving and available supports and services.

Caring for the Caregiver

The work you do as a caregiver is difficult, important, and often overlooked. Even the Veterans Administration secretary is aware of this reality. The best way for you to be there to help your veteran is to take care of yourself.

Risks to Caregivers

In addition to the concerns faced by most caregivers, those who care for veterans have specific issues:

  • Undiagnosed conditions in the veteran they care for.
    TBI or PTSD can go undiagnosed – or the veteran may not want to acknowledge they have the condition. Both of these cases can make it difficult for caregivers to get the support they need.
  • Burnout.
    Symptoms include fatigue, depression, anxiety, health issues, and changes to sleeping and eating habits.
  • Increased risk of suicidal thoughts and self-harm.
    There can be stigma (or perceived stigma) around these thoughts, which can make it tough for people to talk about. That can make getting help difficult.

Risks to Caregivers: What you can do

Start with the basics.

  • Practice good sleep hygiene.
  • Ensure you know how to do your job safely (e.g., transferring someone from a bed to a wheelchair) and have the equipment to protect both of you (e.g., transfer board, pivot disc), as well as recommended wearable safety gear (e.g., back support).
  • Even if your veteran has no formal diagnosis or is resistant to admitting challenges like PTSD and TBI, ask for help anyway. You need the support.
  • Move your body. Look into safe approaches to strength training, especially if your work requires lifting or transferring someone from one seat to another.
  • Eat a nutritious, balanced diet.
  • Maintain a social life.
  • Schedule time for hobbies or favorite pastimes.
  • Pamper yourself from time to time.
  • ee your doctor as needed, including for preventive screenings and vaccines.

Three more things you need to do as a caregiver of a veteran:

  1. Make time away a priority. Longer getaways as well as shorter breaks are important to your physical health and well-being. This is called respite care. The VA has respite care available for veterans, and availability of additional coverage for home care or adult day programs vary by VA region. You have options:
    • Paid in-home help, which you can find through home-health agencies, community resources, or word of mouth. VA may pay for a VA-contracted care provider to care for the veteran at home for up to 16 hours a week depending on the veteran’s ADL needs. Veterans must be enrolled with VA healthcare; however, their injury or illness does not need to be service-connected.
    • Adult day programs, which offer your friend or family member safe opportunities for socializing and activities, usually for 4 to 8 hours a day. Activities often include music, games, art, exercise, discussions, and meals. Some people engage in this service regularly (similar to daycare for kids, on a daily basis); others use it as needed. Adult day programs are frequently offered by community centers, churches, and medical centers.
    • Paid out-of-home respite care usually is available for a few days up to three weeks. You’ll find board and care homes, nursing homes, and Alzheimer’s facilities offer this service, which includes assistance with all daily activities, 24 hours a day, 7 days a week – allowing you a longer time away.
      Veterans enrolled in a VA healthcare system may receive up to 30 days per calendar year of Nursing home respite care in a VA Community Living center or a VA-contracted community nursing home if scheduled in advance. This program is for Veterans who need help with ADLs, veterans who are isolated, or if a veteran’s caregiver is experiencing a burden.
      For information on home health care, adult day programs, respite care, and much more, talk to your VA care team or check out this page of the VA’s website.
      You may find your veteran is reluctant to accept in-home help. They may feel they don’t need it. They may also hesitate when it comes to adult day programs – especially if the friend or family member you care for is a younger veteran. Caregiver.org has a helpful fact sheet on introducing home care when the person you care for says no.
  2. Find a support group of fellow caregivers.
    This can’t be overstated. Something happens when you meet someone who has had the same experience you’ve had. There is an understanding, a reassurance that you’re not flying solo, a validation when you need to let off steam, and an encouragement in connecting with someone – and sharing solutions to similar problems. You need at least one other person who understands the physical work you do, as well as the toll it can take on your emotional and mental health.
    To find out if there is a veterans’ caregivers support group near you, check this page of the VA Caregiver Support Program website to look up the caregiver support coordinator in your area.
  3. Ask for help.
    There is no shame or guilt in asking for help. Ask for it as often as necessary. Support may seem elusive, but it exists. If you’re at a loss, a good place to start is the VA’s national caregiver support line. It’s a toll-free number for caregivers, family members, and others looking for information about caregiving and available support and services. VA’s National Caregiver Support Line 1-855-260-3274 Monday – Friday, 8:00 a.m. to 10:00 p.m. Eastern Saturday, 8:00 a.m. to 5:00 p.m. Eastern

The VA: What to know

Structure: Benefits Administration vs. Health Administration

The VA can be a complex organization to navigate. Short of a roadmap, what we want to do for you is to reduce confusion – and break it down to its most basic and relevant departments and services.

Veterans Benefits Administration

Simply put, the Veterans Benefits Administration (VBA) provides a variety of benefits and services to veterans and their families. Just a few of the major programs they administer include compensation and disability, pensions, education, and home loans, among others.

Veterans Health Administration

In short, the Veterans Health Administration provides health care. It’s America’s largest integrated health care system – providing care at nearly 1300 facilities, including 171 medical centers and 1,112 outpatient sites (also known as VHA outpatient clinics). The VHA serves 9 million enrolled veterans each year, seeing patients for spinal cord injuries to rehabilitation from colds and flu to wellness programs – and nearly everything in between.

Veterans health benefits: Who’s eligible?

If you served in the military, you might be eligible for veterans health benefits. The VA runs the program. Each veteran’s benefits package is unique. Health care benefits are not only available to veterans who have a disability as a result of their military service and many veterans don’t sign up when they first leave the service because they have health insurance through their employer.

This web page of the VA Health Administration links to all the information you might need on the subject of VA health benefits, including eligibility and coverage. We recommend scrolling down toward the bottom third of the page, where a list of frequently asked questions can be found.

Veterans Service Officers

For help in determining eligibility and guidance in navigating the system and applying for specific programs or benefits, consider reaching out to Veterans Service Officers. VSOs are not under the administration of the VA, so they can serve as advocates. The VSOs are county employees and have satellite offices both in the county offices as well as VA sites. Their services are free. They will help you write, submit, and track benefits claims. And if your claim is denied, they will help you file an appeal. VSOs can help you avoid delays caused by improperly filled-out claims and missing paperwork.

Many different organizations offer the assistance of VSOs, and the VA has an online directory.

Long-term care: What help is available?

The VA’s long-term care services include 24/7 nursing and medical care, physical therapy, help with daily tasks, pain management, and caregiver support (respite care). Eligibility for long-term care services varies based on the region and the veteran’s status in the VA.

Long-term care: What are care settings options?

This care is available in many different settings, some run by the VA, and some run by other organizations that the VA inspects and approves.

These can include nursing homes, assisted-living centers, private homes where a caregiver helps a small number of people (also known as board and care facilities), adult day program/health centers, and veterans’ own homes.

For more about long-term care services and support, explore the VA’s guide to long-term or Geriatrics & Extended Care.

What is the VA Caregiver Support program?

The VA Caregiver Support program promotes the health and well-being of family caregivers who care for our nation’s veterans, through education, resources, support, and services. And to keep things interesting, they do so through two separate programs.

Many of the services are available to both programs, so we checked with the VA Caregiver Support Line and have outlined the most significant differences in the table below. For more detail, including how to determine eligibility and how to apply, please use the links below.

The VA Caregiver Support Program –At a Glance

  • Program of General Caregiver Support Services
    • Main offering
      • An entire suite of resources, tools and programs to help support caregivers of veterans, including skills training, one-on-one coaching, group support, referrals, and more
    • Requirements / Eligibility
      • The veteran must be enrolled in VA health care and be receiving help from a caregiver in order for the caregiver to enroll in this program and participate
  • Program of Comprehensive Assistance for Family Caregivers
    • Main offering
      • A monthly stipend
      • Health insurance through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)
      • The suite of resources offered by the general caregiver support services program
    • Requirements / Eligibility
      • You and the Veteran will need to apply together and participate in an application process to determine if you’re eligible for the Program of Comprehensive Assistance for Family Caregivers.

Key VA Caregiver Support resources to keep at your fingertips

You’ll definitely want to bookmark these pages in your internet browsers – they are chock full or information, advice, and tools to help caregivers like you:

Source: Trish Doherty for Family Caregiver Alliance @ https://www.caregiver.org/resource/caring-for-veterans/


Resources for Caregivers

  • Call 2-1-1 throughout Texas for information and access to health and human service information for all ages.
  • Call 800-252-9240 to find local Texas Area Agency on Aging.
  • Call 800-677-1116 – Elder Care Locator service to find help throughout the U.S.

Use resources such as Area Agency on Aging (AAA). Types of assistance provided by AAAs:

  • Information and referral
  • Caregiver education and training
  • Caregiver respite
  • Caregiver support coordination
  • Case management
  • Transportation assistance

Assistance available through AAAs for persons age 60 and older may include:

  • Benefits counseling
  • Ombudsman – advocacy for those who live in nursing homes and assisted living facilities
  • Home-delivered meals
  • Congregate meals
  • Light housekeeping

Be sure to check out our Resource DirectoryFAQ, and Educational Events Calendar for more great information! Permission is granted to duplicate any and all parts of this page to use in education programs supporting family members caring for elders. 

Revised February 2024
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We hope this information is helpful to you in the important work you do as a family caregiver.
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