Circa 2009
It’s known as one of the most dangerous areas of Iraq: the Sunni Triangle, an area west of Baghdad, where violence frequently erupts in flare-ups between armed Sunni opposition and the US-led Coalition. In the eye of the storm lies Camp Anaconda.
Known as “Mortaritaville” for the regular onslaught of hostile fire, the attacks rarely hit populated areas of the base. Faint announcements of “all clear, all clear” are mainstays of daily life. Unfortunately, this was not the case on the frigid morning of July 16, 2006, when mortar rocket fire seared into Camp Anaconda.
“Take Cover!” a commanding voice rang out.
As soldiers began diving out of the way, Army Sergeant Major Jesse Acosta again cried out to his soldiers: “Take cover!” That’s when the concussion of the blast hit him and shrapnel ripped through his body, destroying both his eyes, severing his nerves and nicking his brain. Severely wounded, he continued crawling as he yelled orders to his team.
Days later, when he awoke in Germany, a doctor told him: “There’s bad news. You’ll never see again.” Unable to remember the minutes, weeks and months that followed, Acosta continues to piece together the events of that fateful day from stories told to him by fellow soldiers, family and friends.
Once he arrived back in the States, he was treated at Walter Reed Medical Center, in Washington, DC, before being flown out to a rehabilitation center for the blind in Palo Alto, CA. There he found himself frustrated and angered because the new facility not only felt to him like a convalescent home, but also because it seemed unprepared to treat the full extent of his injuries. Throughout the transition, Acosta relied heavily on the emotional support of his wife, Connie.
The Veterans Administration provided her with housing while her husband was treated at Walter Reed, but there were no such accommodations for their family once he was transferred to Palo Alto. “I was lucky that because of my rank we could afford to put my wife up at the local Marriott. What about the younger guys?” Acosta asks. “What about the privates or specialists who are in this same situation, and can’t afford to pay for their wives to be with them?”
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Not that it was easy for the Acostas: they had to cover the additional expenses out of pocket, which added stress to an already trying ordeal. “It was a burden. Yes, it was,” says Acosta, who in losing his sight found his voice as a veteran’s advocate. “But it’s not just about me. What about the rest that came before me and after me? The recovery becomes more difficult when you don’t have someone familiar to you. You’re not getting the assistance that you need coming back from the battlefield.”
Since the start of Operations Enduring Freedom and Iraqi Freedom in 2003, nearly 35,000 US service members serving in the conflicts in Afghanistan and Iraq have made that same, difficult journey home after being been severely wounded in combat.With the advanced care available both in the war zones and in the military’s medical centers, they are surviving at higher rates,yet many require extended outpatient rehabilitation.
Currently, more than 100 VA facilities across the country provide specialized services for returning service men and women who are contending with complex issues, such as traumatic brain injury and amputation, or severe disorders, visual impairment and muscular-skeletal injuries.
There is, of course, overlap between physical and psychological injuries, and the degree to which a family can be present with an injured loved one is believed to be beneficial to healing. Yet a family’s ability to stay throughout the treatment period depends more on the location of the facility where the patient is receiving care, than the severity of the injury sustained.
In Acosta’s situation, when his wife was present at Walter Reed, she provided a great deal of emotional support for her husband, became an integral member of his treatment team, and spoke up as an important advocate for him.
“Particularly in the case of injured individuals who may not yet be totally cognitively aware and alert, the family can provide important information to the rehabilitation team about that service member’s background, interests and special needs,” says Barbara Sigford, MD, the national director for Physical Medicine and Rehabilitation at the US Department of Veterans Affairs.
On a scale of one to 10, how important is a family’s presence?
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“It’s invaluable,” says Sharon Benedict, PhD, acting program manager of Polytrauma, TBI Education, and Caregiver Support for the VA. “By simply being there, the family reduces the stress level considerably, and it allows the patient to engage in the rehab process more fully. It provides validation to the patient that there is a good reason for them to get well.”
From the beginning of the treatment process, medical staff encourage families to become involved as members of the treatment team, helping to set individualized goals that are relevant to the service member. As the individual moves into outpatient care, family continues to provide critical emotional and psycho-social support.
One element that is increasingly key to the recovery process is involving a service member’s children. Experts agree that bonding during this difficult time is therapeutic for both children and the healing parent. “In my experience, a lot of times the parents are nervous about having the kids present,” shares Benedict.
Family & healing: They go together
“There was a case at Walter Reed a while back where the dad was very seriously injured. Although the wife had been present for a few months, the kids were back in Alaska. It was approaching Christmas, and everyone was understandably nervous about the children’s arrival. The kids knew that Dad was hurt and had had a craniectomy with very obvious physical signs of him being injured. When they showed up, the kids wanted to see where Dad had been hurt; they wanted to look at the helmet. They wanted to just spend time with him.
“In a lot of ways, having the kids present grounds the patient and their spouse, because the kids just take it all in. They feel like they’re helping and they’re an important part of the process when they can engage in some of the rehabilitation tasks.”
Caregivers find that children tend to adopt a surprisingly pragmatic approach to what needs to be done and are good about helping to enforce it by saying such things as: “Dad, now it’s time for this or that,” or “the speech therapist said we needed to practice that.” Just being there can ease children’s anxiety when a parent has been 18 ABILITY injured, because a child’s imagination often conjures up a worse scenario than may be the reality.
“Bringing the children in at the appropriate time, giving everybody the appropriate groundwork, responding to the kids’ needs, building the basis to reestablish that bond with their parents, answering their questions and engaging them in the process… that’s what’s really important,” Sigford agrees.
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“There was one extremely difficult case,” Benedict recalls. “The soldier’s wife came with him and she was about eight months pregnant. She had the baby during the time that he was with us, and I believe that having her and the baby here really did help him focus on something beyond the day-to-day medical problems he was experiencing.” As the vet watched his new baby go through the development process, he pulled himself out of his own woes and reengaged with family, and what was going on in the world around him. His family’s presence helped to focus on “the reason why he was struggling as hard as he was to get better.”
At the time of Acosta’s injury, he had four children between the ages of three and 30, and agrees with Sigford and Benedict: “Having your family with you, even the young ones, is absolutely part of your recovery. But you have to ask yourself: What environment do you want your children in? The Marriott didn’t have a playground or anywhere my kid could play and it wasn’t right. I’ll be honest, once I got home and I was able to hear my surroundings—my kids and my grandkids— that was when my healing began.”
Just as families play an integral part in the recovery process, they also play a critical role during a vet’s transition in returning home and into the civilian world. Jeremy Weismiller was a Staff Sergeant in the US Marine Corps when he sustained injuries from a blast in Iraq. Now medically retired, he was able to have his wife present during his recovery. “You’re going from a military environment to a civilian environment, and having your spouse and your children around is helping you to reach the new life ahead.”
To make the transition smoother, it becomes important for families to be educated on the rehabilitation process, to learn the problems the service member is having, and the rehabilitation strategies that have been prescribed. With that knowledge, the family can reinforce those practices at home and within the larger community.
“The hospital setting is very structured, supportive and fairly predictable. When you move into the community setting, it’s less structured, more complex and more demands are made on the individual. No longer do you have a professional staff member there, but it’s the family who’s there 24 hours a day, seven days a week,” says Sigford.
When the medical staff is no longer by their side, family members assume the responsibility of observing the individual in their community setting, and the pace of progress. These same family members are on the front line, watching for any new needs that might arise and helping the rehabilitation team meet those needs.
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Although it’s always the intention of the VA to ensure there is a loved one by the side of every service member, this is not always possible, especially during prolonged recovery periods. Additionally, when housing is ill-suited for children, or when paying for local housing resources imposes financial hardship, the families of wounded warriors often find it infeasible to stay throughout the recovery period.
While paying for a hotel room can come with a hefty price tag, so can the absence of family during recovery: “One of the things I’ve seen for some of our veterans or service members who don’t have family who are close and able to step in and be part of the rehabilitation process, is a higher degree of isolation during treatment. When they do return to the community, I’ve often seen less integration back into the community and typical life activities because they don’t have someone assisting with that process on a day-to-day basis,” says Sigford.
“It’s devastating for those to come home from war to an environment where you can’t have your family with you,” adds Acosta. “Both parties are missing out: not just the warrior who came home injured, but the spouse and also the child who is missing out on being with their mother or father.”
Although there are many organizations across the United States that work to support wounded service members, the need for accessible housing for them and their families significantly outweighs the supply. Accessible accommodations in proximity to second-tier rehabilitative or polytrauma centers are especially needed.
ABILITY Awareness, the nonprofit sister company of this magazine, has responded to this need—and to a request by Brigadier General (Ret.) Combs—by building “The ABILITY House at Los Al.”
The nearly 20,000 square-foot home, which will be erected on the Los Alamitos Joint Forces Training Base in Los Alamitos, CA, will serve combatwounded service members and their families as they undergo extended outpatient rehabilitation.
The house will feature 25 accessible suites, each with a private restroom, along with common shared areas including a family room, kitchen, dining room, gym, library, game room and laundry facilities. This haven, just minutes from the Long Beach VA Medical Center, will serve many as a “home away from home” during their extended outpatient rehabilitation at both the Long Beach and Los Angeles VA Medical Centers.
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In designing this home, ABILITY Awareness focused on the range of accessibility needs of future guests, including people who have had amputations, are blind or low vision, or who have acquired a spinal cord injury, and will provide the highest level of accommodations while ensuring the warmth and comforts of home.
During a focus group, one Marine talked about spending time with his young child on a playground since he sustained a spinal cord injury and now uses a wheelchair: “I didn’t expect the emotion to come out like it did. You don’t want to cry in front of your family, much less other men.” In honor of the sensitive and private road many must travel during their recovery, the ABILITY House at Los Al will feature a private accessible playground that will offer servicemen and women a chance to reconnect with their children out of the public eye.
At the request of the group interviewed, a small gym will be included in the house to provide 24/7 access to basic tools of rehabilitation, and provide a safe venue for a vet, who may be newly blind or using a prosthesis, to experiment with equipment that may have once been familiar, but now feels awkward. There will be falls off the treadmill and weights dropped, and the freedom to have these experiences in a safe environment has been touted as a critical part of the transition.
One of the most unique components of the house will be the way in which combat-wounded veterans and civilians with all degrees of disabilities and health conditions will be engaged as volunteers in the construction of the home. Veterans will have the opportunity to demonstrate their skills and talents, and to realize that they can still achieve the dreams they had prior to incurring their injuries, though the path may will likely be modified.
“While we focus on family involvement in the rehabilitative process, I think community involvement is also just a huge factor in reintegrating our veterans into their home communities and the activities they can participate in,” Sigford says. “Families tell us they often feel isolated after a period of time because of the lack of community support. This project takes it one step further by getting the entire community involved.”
The benefits of bringing the community together on this project continue. In addition to demonstrating the capacity of injured veterans as volunteers, the ABILITY Build will also show the community their employability. At a time when 40 percent of vets are unemployed, this project couldn’t be timelier.
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In the end, what matters most is Acosta’s question: “What about the warriors who come home after me?” To thousands of our injured warriors and their families, the ABILITY House at Los Al will be their answer.
THE ABILITY H LOS AL
This project is in the early stages of development so there are excellent opportunities to get involved from the start.
They gave, now it’s our turn!
The anticipated cost of this project is $5.5 million and the biggest need is for financial support. Every individual donation, regardless of size, will make a difference. All gifts, large and small will be recognized.
Do you own or work for a company who supports our troops? Corporate sponsorship of the ABILITY House at Los Al is a very tangible way of making a direct impact on the lives of thousands of injured servicemen and women along with their families each year. Contact ABILITY Awareness to tailor a corporate sponsorship benefits package to meet your company’s funding priorities!
Donation of Goods and Services:
Help stretch the budget for this project by donating your goods or services! Do you own a construction company that would like to help? Are you a retired contractor who would be interested in overseeing volunteer teams? Do you manufacture an item that we’ll need for the interior, exterior or landscaping of the house? We want to hear from you!
by Taylor Chazz
