Military & VeteransA traumatic brain injury or repeated brain traumas can sometimes lead to chronic traumatic encephalopathy, Parkinson’s, multiple sclerosis, astrogliosis, or other neurogenerative conditions. Since researchers are still learning about the progression of these diseases, which can stem from repeated TBIs, providers are currently trying to plan and address how to change their model of care to best help veterans and their families in the long term.
Dr. Alexander Balbir is the Director of Independent Services at Wounded Warrior Project.
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When you sustain a traumatic brain injury or repeated brain injuries, symptoms can resolve and symptoms can get worse. Symptoms can remain dormant for a long period of time. When we talk about a brain injury we also talk about chronic traumatic encephalopathy, a very progressive, debilitating condition and it’s a result of repeated head injuries. We also talk about the development of other neurodegenerative conditions: Parkinson’s, multiple sclerosis, something called astrogliosis as well, which is a different type of trauma. And we’re still learning about the progression of these disorders after a brain injury or multiple brain injuries. And what keeps me up at night is our ability to address the current needs in their home. But when their conditions start to worsen, the cognitive decline, increase in emotional instability, that’s consistent with chronic traumatic encephalopathy or some of these other neurological conditions like Parkinson’s. What we start to see is that we have to change our model to address that. And that model could involve putting that veteran in a residential facility or an assisted living facility. That’s something that we may not be prepared to do right now. So, without a clear understanding of the progression of these disorders, and an understanding of the natural history of a traumatic brain injury, we can’t prepare as well for the future. We can put in a lot of rehabilitation and treatment right now, which is absolutely effective, it’s the right thing to do, it’s the most appropriate standard of care. But what still remains unknown, is what’s going to happen now to them in the next ten years. When you start to see a 40-year-old individual present with symptoms that you normally would find in a 70 year old Alzheimer’s patient, our standard of care has to change in order to meet that need and we need to be prepared for something like that. We need to prepare these families for long-term care. We need to understand how they are looking at their contingency care planning. If the caregivers no longer provide for someone with that progressive of a condition. The better we prepare now, the better we are prepared to address those needs in the future. If we can get these families onboard with us to help with their long-term care planning, work with our benefits team, work with our staff to make sure everything is in order, we then can look and identify the most appropriate type of care for someone whose condition has declined rapidly. And these are not 70, 80-year-old individuals. We’re talking 40, 50-year-old service members who deserve the best quality care available. BrainLine is powered in part by Wounded Warrior Project to honor and empower post-9/11 injured service members, veterans, and their families.
About the author: Alexander Balbir, PhD, MBA
Dr. Alexander Balbir served as the Director for Independence Services at Wounded Warrior Project (WWP). He currently serves in the United States Navy Reserve as a Medical Service Corps Officer hospital/healthcare administrator.
