Monday, April 19, 2010

Caregivers of disabled vets fight their own battles

From The Houston Chronicle:

Paula Engelbrecht's hand flew to her mouth as her stepson steered his walker into the crosswalk in front of the Michael E. DeBakey VA Medical Center.

“Rob!” she shouted, and jerked forward as if she wanted to grab the 26-year-old Iraq war veteran by the collar and pull him back to the safety of the sidewalk.

“I was going to tell him to look both ways,” she murmured.

“I did,” Rob Engelbrecht (pictured) insisted.

If his stepmother seemed a little overprotective, chalk it up to habit. The past four years of Paula Engelbrecht's life have been devoted to helping care for Rob, who was severely injured when a bomb exploded under his Humvee south of Baghdad in July 2006. He lost his left leg, one eye and 60 percent of the vision in the other eye. He also suffered a traumatic brain injury and badly damaged his spine and wrist.

Paula Engelbrecht, a pharmacy technician, and her husband, Robert Wayne Engelbrecht, a machinist, both quit their jobs to stay by Rob's side for extensive therapy at Brooke Army Medical Center San Antonio, a 3½-hour drive from their Magnolia home. For almost two years, the Engelbrechts got by without health insurance and lived off their savings.

“You get tough,” the stepmother said. “You get used to it.”

More than 37,200 service members have been wounded in action in Iraq or Afghanistan since 2001, Department of Defense statistics show. Improved battlefield medicine means that those who might have died in past conflicts have a better chance of surviving multiple serious injuries, such as amputations, traumatic brain injury and burns.

Legislation awaiting final approval from Congress would provide health care, mental health services, training, and stipends to relatives who have become full-time caretakers to veterans like Rob.

Little research has been done to quantify the impact of combat injuries on military families. In a random sample of 1,730 Iraq and Afghanistan veterans, 21 percent of active-duty personnel reported that a family member or friend had been forced to leave a job to provide full-time care, according to the 2007 findings of the President's Commission on Care for America's Returning Wounded Warriors.

The commission also found that 33 percent had a family member or friend who relocated temporarily to spend time with a wounded service member in the hospital.

“What we're really looking for is a comprehensive support system for caregivers of severely disabled veterans,” said David Autry, spokesman for Disabled American Veterans in Washington D.C. “Disability compensation helps, but it's still not a whole lot of money. You can't pay your mortgage on your disability compensation and buy food and clothing and all that stuff, so this is a real struggle for a lot of folks.”

Debbie Schulz's son, Steven Schulz, 25, suffered a severe traumatic brain injury in Iraq in April 2005. A bomb blast during a patrol in Fallujah sent shrapnel through his eye and the frontal lobe of his brain, and damaged the main cerebral artery. Doctors had to remove a saucer-sized piece of his skull. The Marine from Friendswood underwent four brain surgeries and lost the use of his left arm and leg.

Debbie Shultz, her husband and the couple's two younger children flew to the National Naval Medical Center in Bethesda, Md., to be by Steven's bedside. She stayed for six months, using up accrued vacation time and paid leave from her teaching job until she realized she probably would never be able to go back to work.

“I knew he could not live at home independently without round-the-clock nurses,” she said. “In the beginning, he couldn't get in and out of bed by himself. If he needed to get up to go to the bathroom, he could not do that because of that left leg paralysis. He could not successfully move a wheelchair more than 30 to 40 feet.”

Steven has made a lot of progress since then, his mother said. He's taken his first steps since his injury. He can brush his own teeth and shave himself. He recently adopted a service dog and has gotten into the routine of feeding and walking the Golden-Lab mix. But he still needs help to get through the day.

“He needs reminders, verbal reminders, he needs somebody just for supervision and oversight, and he does not like being left alone,” Debbie Schulz said.

The Schulz family kept afloat through the generosity of charitable groups and neighbors.

“Financially it was very, very difficult because as most middle-class families, we depended on two incomes,” she said. “Once I received my last paycheck for the school year, then we were just on my husband's pay, and we had a daughter in college and a son who was a junior in high school and we had the expenses of traveling back and forth, and all the normal bills.”

Debbie Schulz hopes the legislation pending in Congress will enable caretakers and their families to avoid burnout.

“You're so focused on surviving day to day that sometimes advocating for yourself was the last thing you really had time to do,” she said.

Paula Engelbrecht said she wishes the benefits proposed in the legislation had been there for her family, and others she met at military hospitals, struggling paycheck to paycheck.

Right now, though, she's counting her blessings.

In the immediate aftermath of his injury, her stepson Rob couldn't walk, talk or eat. Last week, he moved out of his parents' home in Magnolia to a handicapped-accessible house built by His older sister will move in with him to help out and Paula will only be eight miles away, but the psychological distance is huge.

Rob, who now maneuvers on a prosthetic leg with the aid of a walker, likes to joke that his parents kicked him out because they got sick of him tearing up their carpets.

“We really cherish this because we didn't think we were going to get him back,” Paula Engelbrecht said.