Skip main navigation

Military Health System

Hurricane Milton & Hurricane Helene

Emergency procedures are in place in multiple states due to Hurricane Milton & Hurricane Helene. >>Learn More

Caregiver Guide Supports Service Members and Veterans with TBI

Image of Military family posing for a picture. Caregivers play a vital role for TBI patient recovery (Photo by: Army Lt. Col. John Hall, 173rd Airborne Brigade)

After her husband sustained a traumatic brain injury from a rocket attack in Iraq in 2006, Tiffany Bodge searched for information to help cope with her new role as a caregiver.

Retired Air Force Lt. Col. Ryan Bodge struggled with short-term memory loss, sometimes taking his evening medication in the morning. The pain from his TBI-induced chronic migraines made it hard to concentrate.

However, when Tiffany Bodge discovered the Traumatic Brain Injury Center of Excellence's Caregiver Guide in 2021, she found tools to help the couple manage his recovery. Now, when he goes for treatment, they work on lists of questions to ask the doctor. If he forgets a conversation, he asks for the details to be repeated.

"I look at caregiving as collaborative, we have to do it together," Tiffany Bodge said. "I'm here to make his life easier, to help him in a way that gives him the freedom to continue to live his life that isn't really defined by parameters. The TBI is going to limit him in the things that he's capable of doing, but you know, we can figure out a way that he can still enjoy life and do the things that he wants to do. He just has to do them in a different way."

Research shows family support leads to better recovery, and addressing caregiver needs has long been a focus of TBICoE. In a recent report to Congress, TBICoE states, "Family education and support are critical components of acute inpatient rehabilitation; however, needs are common in chronic stages of TBI, highlighting the importance of ongoing services through chronic stages of TBI."

To provide those services to family and friends like the Bodges, TBICoE released an updated Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans earlier this month.

"[The guide] gives you a really good understanding of the different types of TBI and the severity, what you're going to be dealing with in the short term, [and] what may possibly be in the long term," explained Tiffany Bodge, who was asked to review and provide feedback on the new guide. "But I also like the fact that it talks about the recovery process, and that the caregiver is an integral part of recovery."

The guide includes the following:

  • Resources to address mild TBI, also known as a concussion, which accounts for over 80% of TBIs in the military reported by TBICoE. The earlier version addressed only moderate, severe, and penetrating TBI.
  • New content on post-traumatic stress disorder, substance misuse, and intimacy (from both the patient and caregiver perspective), and information on suicide and caregiver burnout.
  • Interactive features allowing users to easily navigate the guide and find relevant information that meets their needs.
Military personnel participating in a training exercise
Some service members with TBI can experience vision problems. Navy Cmdr. Matthew Lawrence, a physician deployed in support of Combined Joint Task Force – Operation Inherent Resolve, checks Army Sgt. Jeremy Woodrow’s responsiveness during a mass casualty training exercise at Erbil Air Base in the Kurdistan Region of Iraq, Jan. 16, 2020. (Photo by: Army Spc. Angel Ruszkiewicz)

"The best thing about the caregiver guide is that it is written for caregivers. It has practical tips. You might be experiencing this, [so] try this. These practical tips from people that you know have already gone through it really, really helps," said Melissa Comeau, whose husband Stephen, a staff sergeant in the U.S. Marine Corps, sustained the first of his multiple TBIs around 2004, and who has PTSD, as well.

Comeau also reviewed the guide and liked the content provided on the relationship between TBI and PTSD. "It helped me reach out to the correct type of providers and ask for the correct type of treatment and also ask the right kind of questions to get my husband on a path to the best recovery he could have," she said.

In addition to being interactive and available on desktop and mobile devices, the guide is shorter - only 154 pages.

Both the original and current guides relied on expertise from across the Department of Defense. Congressionally mandated by the National Defense Authorization Act of 2007, the first guide involved collaboration among TBI experts, survivors, and experienced caregivers of service members and veterans with TBIs. Similarly, the new version drew on input from TBICoE, the National Intrepid Center of Excellence, the Psychological Health Center of Excellence, and the Department of Veterans Affairs.

Comeau remains hopeful about how she and her husband will continue to manage his TBI.

"Resources like the Caregiver Guide are an important tool for providers to offer to the caregivers of their patients who are recovering from a TBI," said Navy Capt. Scott Pyne, a physician and the TBICoE division chief. "Each caregiver can use the guide to meet their own unique needs, which can be wide ranging. This is the beauty of the guide. Whether it's using the resource section to lookup local caregiver groups or someone that they can physically connect with, or using the glossary to remind them of the jargon that was used during a medical appointment. The guide can empower the caregiver in their role supporting someone close to them who has been diagnosed with a TBI. It also can help improve the providers' relationship with their patients by arming them and their caregivers with the information needed to support their recovery."

The Traumatic Brain Injury Center of Excellence is a congressionally mandated collaboration of the Departments of Defense and Veterans Affairs to promote state-of-the-science care from point-of-injury to reintegration for service members, veterans, and their families to prevent and mitigate the consequences of mild to severe traumatic brain injury. The center is a division of the Defense Health Agency Research and Development Directorate.

For more information on the Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans and other TBICoE programs, visit: health.mil/TBICoE.

You also may be interested in...

Video
Jul 22, 2021

PRA Training Video 3: Understanding Relative Rest

Thumbnail image for PRA Training video 3, understanding relative rest

In this lesson we explain the differences between complete rest and relative rest in a staged concussion recovery process, and provide examples of activities that promote relative rest. The revised Progressive Return to Activity (PRA) Clinical Recommendation uses the term 'relative rest' to emphasize the importance of early introduction of physical ...

Video
Jul 22, 2021

PRA Training Video 7: Symptom-Guided Management and Specialty Referral Guidance Tables

Thumbnail image of PRA training video 7, the symptom-guided management and specialty referral guidance tables.

This lesson covers how to use the Progressive Return to Activity, or PRA's Symptom-Guided Management and Specialty Referral Guidance tables. This lesson also details primary care management strategies for service members who are not progressing as expected in the PRA. Each video in the Progressive Return to Activity training series is designed to ...

Video
Jul 22, 2021

PRA Training Video 1: PRA Overview

Thumbnail image of PRA training video 1, PRA overview.

In the first of TBICoE's Progressive Return to Activity (PRA) video training series, you will learn about the reasons for using a progressive return to activity process and receive an overview of the 2021 PRA algorithm and its associated tools. By the end of lesson one, providers will better understand the PRA process, and explain that process to ...

Video
Jul 22, 2021

PRA Training Video 2: Six Major Changes

Thumbnail image of PRA Training Video 2, Six Major Changes

In this lesson we review the six major changes in the TBICoE's revised 2021 Progressive Return to Activity (PRA) Clinical Recommendation that differ from the original recommendation. The changes reflect the latest TBI research, and will make it easier for providers to manage the recovery process and return service members with concussion to full ...

Video
Jul 22, 2021

PRA Training Video 5: The Six Stages of the PRA

Thumbnail image for PRA training video 5, the six stages of the PRA

In this lesson, we cover the key activity objectives for each of the six stages of the Progressive Return to Activity (PRA) Clinical Recommendation and provide activity examples for each stage. Each stage is designed to gradually increase the intensity and duration of a service member's physical and cognitive activity as they advance in the PRA ...

Video
Jul 22, 2021

PRA Training Video 4: PRA Progression Criteria

Thumbnail image for PRA Training video 4, PRA progression criteria

In this lesson, we review the criteria for advancing through the stages of the Progressive Return to Activity (PRA) Clinical Recommendation. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Skip subpage navigation
Refine your search
Last Updated: December 05, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery