When an accident left Morten in a wheelchair with severe traumatic injuries, family members stepped up and offered to help. His sister Claire arranged his accommodations and looked after his finances. His 80-year-old mother did his cooking, fussed over his meal times and otherwise kept a constant watch over him.
Morten, a man living in the Australian state of Victoria, often felt lucky that his family was so willing to provide the intensive, day-to-day care he needed. But other times, he felt uneasy being so reliant on them. He could see these relationships breaking down over time. That was why he was relieved to learn that he qualified for the services of professional caregivers as part of his compensation. Getting those services was a big break for the family, said his sister.
Morten was one of the people recovering from an injury who took part in a qualitative study on the impact of the recovery and compensation process on family members. The study was part of a larger project examining interactions between key stakeholders in three compensation systems in the state of Victoria—including two workers’ compensation systems and one no-fault insurance system for traffic-related injuries—to understand the pros and cons of each system’s approach.
The qualitative part of the project focused on family members was led by Dr. Agnieszka Kosny while she was at Australia’s Monash University during a sabbatical leave from the Institute for Work & Health. It included interviews with nearly 20 injured persons and nine family members. A journal article on this study was published in Disability and Rehabilitation in February 2017 (doi:10.1080/09638288.2017.1283450).
The study found that family members play an important role in the aftermath of an injury—one that’s seldom formally acknowledged by compensation systems in policy or procedure. It also found that the recovery and injury compensation process can have a major impact on family members, particularly in the case of prolonged and complex injuries and illnesses. As a result, compensation systems should formally consider the role of family members and develop support programs for them as a means of improving health and function among injured people, the study authors stated.
Stress and strain among key themes
Through interviews with injured participants and their family members, the study identified several themes:
Different types of support: The support provided by family members spanned the gamut—from personal bodily care such as giving baths or dressing wounds to household chores such as doing laundry and yard work. Family members not only shouldered the expanded burdens of child care, elder care and paid employment, they often had to take on new responsibilities related to the compensation process. These included filling out forms, following up on claims requests and getting the injured individuals to medical appointments. Family members also provided emotional support by talking with and listening to the injured person—which was especially important when they ran into difficulty with the compensation process.
Family as a source of strain and stress: Even when family members provided welcome help, tensions sometimes arose when the injured persons felt their privacy and independence were compromised. Sometimes the injured individuals felt this strain when they considered how much time and energy family members were spending to care for them. Other times, the feeling that family members didn’t fully appreciate their symptoms and functional limitations also led to conflict.
Financial impact on family: Beyond changes to family roles and dynamics, the financial impact of an injury on the family could be considerable. Even when compensated, the injury often resulted in many out-of-pocket expenses. Some family members had to cut back on paid work due to the additional burden of child care, housework and medical appointments. In addition, the worry that the injured person could lose his or her employment often weighed heavily on the family.
Family context: Families didn’t always fit the assumed model. Sometimes, family members also had pre-existing medical conditions that hampered their ability to provide support. Other existing obligations could pose a challenge as well, such as when family members had elderly parents or children with developmental disabilities to care for. Some families were already experiencing strained relationships prior to the injury, and the aftermath only amplified these difficulties.
The compensation context
The interactions with compensation bodies could also shape the experience for the family. One issue brought up frequently by study participants was the lack of support offered as part of the compensation process. (When available, the information about such support may not have been shared.) This lack or perceived lack of support services added to the strain experienced by the injured individuals and their family caregivers.
The compensation bodies seemed to take it as a given that the injured individuals all had family members to help with the day-to-day activities, pick up the additional child care, or be there for financial and emotional support, says Kosny. “The study participants by and large said it was clear that this help was needed, but case managers seldom acknowledged it, and offers of formal support were rare.”
While not all injuries or illnesses will have a major impact on the family, several participants in this study were affected profoundly. And yet, while the injured individuals had access to health care and mental health services, this was not always the case for the family members. Formal services offered as part of the compensation process—such as the professional caregivers provided to Morten—could go a long way to improve the health and well-being of injured individuals and their family members, notes Kosny.
“If family members are to play an active role in assisting injured people during recovery, then support services must be available for family members who need them,” she adds.