Military Families Flashcards
Epidemiological Statistics
- > 3 million individuals serving
- 20.6 million veterans
- 2.2 million US military personnel have been deployed
- In more than 150 countries around the world
- 3 million tours of duty undertaken
Military Life - Advantages
- early retirement
- a vast resource system
- job security w/a guaranteed paycheck
- healthcare benefits
- opportunities to see the world; educational opportunities
Military Life - Disadvantages
! being separated from your family; regular household relocations
! living under the idea that the mission must always come first (it can be rigid and regimented)
! feelings of detachment from the non-military community
! the social affect of the rank
! lack of control over pay, promotion, & other benefits
! Children & adolescents show problematic behavior in response to separation from a deployed parent
> they feel isolated and alienated; also, sensations & feelings when they’re relocated to a different area
Deployment Cycle
- Pre-deployment
- Deployment
- Sustainment
- Redeployment
- Postdeployment
?
Military spouse feels disoriented & overwhelmed; experience a range of emotions including numbness, sadness, loneliness, and abandonment
Is a time of disorganization as a spouse struggles to take charge of the details of living without his or her partner
Deployment
?
When the individual receives their orders until departure
Family members experience feelings of denial, anticipation of loss; getting affairs in order
Feelings of stress & irritability
Pre-deployment
?
Is the month before the service member is scheduled to return home
Excitement and apprehension present
Will he or she agree with the changes I’ve made? Will I have to give up my independence? Will we get along?
Redeployment
?
Begins about a month into deployment until about a month before the service member is expected to return
The spouse & children establish a new support system & institute new family routine
Technology makes it possible for the family and service member to stay in touch
Most military families successfully negotiate this stage & anxiously anticipate their loved ones’ return
Sustainment
?
Typically lasts 3-6 months & begins w/the return home
Is a period of adjustment. Somewhat of a honeymoon period w/the spouses reconnected physically, but not necessarily emotionally
Returning service member may pick up where he or she left off only to encounter resistance from the spouse who expresses a reluctance to relinquish the degree of independence & autonomy they have experienced
Post-deployment
This stage can be the most difficult stage and the most important stage for the soldier & spouse. Communication, going slow, lowering expectations, & taking time to get to know each other are all critical tasks to renegotiate here.
> Counseling may be needed if the service member was injured or experiences a traumatic reaction.
Special Concerns of Women in the Military
! Sexual harassment, sexual assault
> Survivors of sexual assault in the military report long-lasting effects which include PTSD, depression, suicidal ideation & attempts, eating disorder, anxiety disorders, relationship difficulties, & substance abuse
! Differential treatment & conditions
! Parenting issues
> Women seem to struggle more w/feelings of guilt of abandoning their children
Veterans
- behavioral health problems
- inadequate healthcare
- Young veterans have screened positive for behavioral health problems & a 1/3 or less of those have adequate healthcare
Traumatic Brain Injury
- classified as mild, moderate, severe
- thinking, memory, reasoning
- depression, anxiety, personality changes, aggression, acting out, social inappropriateness
- seizures, chronic epilepsy
- language & communication problems
- neurocognitive disorders
- adverse effects on social functioning, productivity
TBI’s & degenerative brain disease
Increased risk for:
- Alzheimer’s disease
- Parkinson’s disease
- Dementia pugilistica (assoc w/repetitive blows)
TBI’s & degenerative brain disease
Increased risk for:
- Alzheimer’s disease
- Parkinson’s disease
- Dementia pugilistica (assoc w/repetitive blows)
Is a syndrome characterized by emotional lability, dysregulated mood, ataxia, & impulsivity
Seen in those who have had strikes to the head, incl boxers
Dementia pugilistica
Posttraumatic Stress Disorder
- Is the most common mental disorder among veterans returning from military combat; DSM-5 criteria
Is a disorder that can occur when an individual is exposed to an accident or violence in which the death, serious injury to others, or oneself occurs or is threatened
→ Reliving the trauma
→ Efforts to avoid triggers
→ Negative emotional state
→ Aggressive, reckless, self-destructive behavior
→ Hypervigilance; exaggerated startle response
→ Angry outbursts, problems w/concentration, & sleep disturbances
Mental Health Issues
- Depression
> Older adult veterans [home management, interpersonal relationships, occupational & social function are often impaired in this population] - Suicide
> is closely assoc w/dx of substance abuse disorder, major depressive disorder, PTSD, & TBI
> marital relationship distress
- Substance abuse
> Substance abuse disorder is a common co-occurring condition of PTSD - 65% identified alcohol as their substance of use & heroin & cocaine are also abused
Nursing Diagnoses
→ Self-care deficit
→ Interrupted family processes
→ Risk for delayed development
→ Ineffective coping
→ Risk for complicated grieving
→ Caregiver role strain
→ Risk for suicide
→ Risk for other-directed violence
→ Posttrauma syndrome
→ Ineffective coping; ineffective denial
→ Interrupted family processes
→ Risk for injury
Nursing Interventions
➼ stay w/the client during periods of flashbacks & nightmares
➼ offer reassurance of personal safety
➼ encourage the client to talk about the traumatic experience @ own pace
➼ discuss use of maladaptive coping mechanisms (incl substance use) & assist in use of more adaptive strategies incl stress management techniques
➼ identify support systems, make referrals for additional assistance incl substance abuse help
➼ administer rx’s as prescribed, provide rx education
Nursing Interventions - Risk for suicide
➼ assess ° of risk according to seriousness of threat, existence of a plan, & availability & lethality
➼ ask directly if person is thinking of acting on thoughts or feelings
➼ ascertain presence of significant others for support, involve family/significant others in the plan
➼ determine whether substance use is a factor
➼ encourage expression of feelings, incl appropriate expression of anger
➼ ensure that environment is safe
➼ help client identify more appropriate solutions & offer hope for the future
➼ collaborate w/the client to develop a plan for ongoing safety
Treatment Modalities: PTSD
- Psychosocial therapies
- cognitive therapy
- prolonged exposure therapy
- group & family therapy
- eye movement desensitization & processing (EMDR) [focuses on the emotions & sx’s that result from the event)
- rx’s incl SSRI’s (1st line of treatment)
- Psychopharmacology
- Antidepressants like trazodone and tricyclics; MAOI – phenelzine
- Benzodiazepines have also been prescribed but have an addictive nature [have an anti-panic effect]
- Anti-hypertensives, like propranolol & clonidine, can help symptoms like nightmares, intrusive recollections, hypervigilance, insomnia, the startle response, & angry outbursts
- Ketamine infusions have been used in combination w/psychotherapy
- Complementary therapies
- Acupuncture
- Pet therapy
- Relaxation therapy
- Hypnosis
Treatment Modalities: TBI
- Psychosocial therapies
- CBT
- exposure therapy
- Rehabilitation therapies (i.e., OT, psychiatry)
- Psychopharmacology
- antidepressants, benzodiazepines, anti-psychotics, anticonvulsants, & rx’s to improve cognitive deficits (like attention difficulties)
