Nichols Linda O, Martindale-Adams Jennifer, Seel Ronald T, Zuber Jeffrey K, Perrin Paul B
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Caregiver Center, Lt. Col. Luke Weathers, Jr. Veterans Affairs Medical Center, Memphis, TN 38105, USA.
Geriatrics (Basel). 2024 Oct 8;9(5):130. doi: 10.3390/geriatrics9050130.
This study provides a detailed examination of older Veterans with traumatic brain injury (TBI) and dementia and their caregivers, focusing on Veterans' demographic, clinical, functional, safety risk, and behavioral characteristics and caregivers' demographic, clinical, and care-related characteristics and well-being.
Veterans' caregivers (N = 110) completed a telephone-based survey.
Veterans averaged eight comorbid health conditions, with over 60% having chronic pain, hypertension, post-traumatic stress disorder, or depression. Caregivers reported helping with an average of three activities of daily living, with the highest percentages of Veterans needing assistance with grooming, dressing, and bathing. Almost all Veterans needed assistance with shopping, cooking, medication management, housework, laundry, driving, and finances. Veterans averaged two safety risks, the most common being access to dangerous objects, access to a gun, and not being able to respond to emergency situations. Although Veterans averaged 14 behavioral concerns, caregivers reported that their family needs relating to TBI were generally met or partly met, and they voiced confidence in their ability to respond to behaviors and control their upsetting thoughts. Caregivers' mean burden score was severe, while mean depression and anxiety scores were mild. Caregivers reported an average of 10.5 h per day providing care and 20.1 h per day on duty.
The findings demonstrate the increased presence of impairments, safety risks, and behavioral issues in Veterans with comorbid TBI and dementia, as well as increased impacts on families' burdens and care provision requirements. Clinicians should be alert for and educate TBI patients and caregivers on the warning signs of post-TBI dementia and its associated functional, behavioral, and safety risk profile, as well as challenges related to caregiver well-being. Healthcare policymakers must consider the increased caregiver demands associated with comorbid TBI and dementia, as well as the need for expanded long-term support and services.
本研究对患有创伤性脑损伤（TBI）和痴呆症的老年退伍军人及其护理人员进行了详细调查，重点关注退伍军人的人口统计学、临床、功能、安全风险和行为特征，以及护理人员的人口统计学、临床和护理相关特征及幸福感。
退伍军人的护理人员（N = 110）完成了一项基于电话的调查。
退伍军人平均患有8种合并健康状况，超过60%的人患有慢性疼痛、高血压、创伤后应激障碍或抑郁症。护理人员报告平均帮助退伍军人进行三项日常生活活动，其中需要协助进行修饰、穿衣和洗澡的退伍军人比例最高。几乎所有退伍军人在购物、做饭、药物管理、家务、洗衣、驾驶和财务方面都需要帮助。退伍军人平均存在两种安全风险，最常见的是可接触到危险物品、可接触到枪支以及无法应对紧急情况。尽管退伍军人平均存在14个行为问题，但护理人员报告称，他们与TBI相关的家庭需求总体上得到了满足或部分得到了满足，并且他们表示有信心应对行为问题并控制自己的烦恼情绪。护理人员的平均负担得分严重，而平均抑郁和焦虑得分较轻。护理人员报告平均每天提供护理10.5小时，每天值班20.1小时。
研究结果表明，患有TBI和痴呆症合并症的退伍军人中，损伤、安全风险和行为问题的发生率增加，对家庭负担和护理需求的影响也增加。临床医生应警惕并教育TBI患者及其护理人员有关TBI后痴呆症的警示信号及其相关的功能、行为和安全风险状况，以及与护理人员幸福感相关的挑战。医疗保健政策制定者必须考虑到与TBI和痴呆症合并症相关的护理人员需求增加，以及扩大长期支持和服务的必要性。
