Military Families Flashcards

1
Q

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
A
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2
Q

Military Life - Advantages

  • early retirement
  • a vast resource system
  • job security w/a guaranteed paycheck
  • healthcare benefits
  • opportunities to see the world; educational opportunities
A

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

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3
Q

Deployment Cycle

  1. Pre-deployment
  2. Deployment
  3. Sustainment
  4. Redeployment
  5. Postdeployment
A
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4
Q

?

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

A

Deployment

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5
Q

?

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

A

Pre-deployment

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6
Q

?

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?

A

Redeployment

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7
Q

?

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

A

Sustainment

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8
Q

?

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

A

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.

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9
Q

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

A

! Parenting issues
> Women seem to struggle more w/feelings of guilt of abandoning their children

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10
Q

Veterans

  • behavioral health problems
  • inadequate healthcare
A
  • Young veterans have screened positive for behavioral health problems & a 1/3 or less of those have adequate healthcare
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11
Q

Traumatic Brain Injury

  • classified as mild, moderate, severe
  • thinking, memory, reasoning
  • depression, anxiety, personality changes, aggression, acting out, social inappropriateness
  • seizures, chronic epilepsy
A
  • language & communication problems
  • neurocognitive disorders
  • adverse effects on social functioning, productivity
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12
Q

TBI’s & degenerative brain disease

Increased risk for:
- Alzheimer’s disease
- Parkinson’s disease
- Dementia pugilistica (assoc w/repetitive blows)

A
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13
Q

TBI’s & degenerative brain disease

Increased risk for:
- Alzheimer’s disease
- Parkinson’s disease
- Dementia pugilistica (assoc w/repetitive blows)

A
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14
Q

Is a syndrome characterized by emotional lability, dysregulated mood, ataxia, & impulsivity

Seen in those who have had strikes to the head, incl boxers

A

Dementia pugilistica

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15
Q

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

A

→ 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

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16
Q

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
A
  • 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
17
Q

Nursing Diagnoses

→ Self-care deficit
→ Interrupted family processes
→ Risk for delayed development
→ Ineffective coping
→ Risk for complicated grieving
→ Caregiver role strain

A

→ Risk for suicide
→ Risk for other-directed violence
→ Posttrauma syndrome
→ Ineffective coping; ineffective denial
→ Interrupted family processes
→ Risk for injury

18
Q

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

A

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

19
Q

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)
A
  • 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
20
Q
  • Complementary therapies
  • Acupuncture
  • Pet therapy
  • Relaxation therapy
  • Hypnosis
A
21
Q

Treatment Modalities: TBI

  • Psychosocial therapies
  • CBT
  • exposure therapy
  • Rehabilitation therapies (i.e., OT, psychiatry)
A
  • Psychopharmacology
  • antidepressants, benzodiazepines, anti-psychotics, anticonvulsants, & rx’s to improve cognitive deficits (like attention difficulties)