Caregivers: Celebrating the Invisible War Heroes

They are invisible war heroes: wives who look after our gravely wounded soldiers when they return home. They never take a break, their tour of duty never ends. Join REDBOOK and show these women how much they mean to you.

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On a chore chart in Debbie Sanford's kitchen, magnets are moved from a "to do" column to a "done" column throughout the day. They track simple tasks like "wash," "brush teeth," "get dressed," "feed dogs," and "make bed." It's the kind of chart found in homes with young children, except in this case the reminders are for Debbie's husband, Brandon. At 31 years old, Brandon's short-term memory is so impaired that he often can't remember what he's doing just moments after he's started. He's been known to fold wet laundry or put milk in a kitchen cabinet. Every shelf and drawer in the house is labeled so he can remember where to put the cereal bowls or hang his clothes. And though he can understand the labels, Brandon's comprehension is too limited to read books or even surf the Internet beyond looking at sites related to his main interests: gardening, remodeling, and dogs.

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"I'd say that cognitively, he's about like a 10-year-old," Debbie says, sitting at the dining table in her immaculately kept home in Hemet, CA, a dusty, scorching town in the San Jacinto Valley. "We don't have real conversations. He can't do anything that requires a sequence of more than two steps. If he wants to make a sandwich, he'll take the bread out but then he'll just sit there because he doesn't know what to do next."

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Just a few years ago, Brandon was an Army staff sergeant who worked with K9 dog units in Iraq to sniff out explosives. He adored his wife, his time at the piano and drums, and the creative meals he'd cook. He and Debbie were theme-park junkies, and spent weekends at concerts and playing mini golf. They were perpetually, Debbie says, like newlyweds. Until, while serving overseas, Brandon was injured in three separate bombing incidents. His external wounds were minor, but eventually he began to have problems with balance and memory, and his personality seemed different. After what felt like endless rounds of tests, Brandon was diagnosed with traumatic brain injury, or TBI, as well as post-traumatic stress disorder (PTSD). Debbie left her job to be by Brandon's side, becoming one of tens of thousands of women who dedicate their lives to caring full-time for their wounded partners. Though PTSD has long been associated with veterans, the wide use of suicide bombs and rocket-propelled grenades has made TBI the signature injury of the recent wars in Iraq and Afghanistan. It is estimated that 20 to 30 percent of all deployed soldiers come home with some form of brain injury. The Department of Defense has counted 240,000 cases since 2000, but numbers are likely higher, because diagnosis is difficult and often, as in Brandon's case, delayed. Unlike soldiers coping with amputations or spinal-cord injuries, TBI sufferers often appear on the surface to have survived the war unscathed. And if her husband's struggle is hard to see, the plight of the caregiver is nearly invisible.

Once the severity of Brandon's injury was understood, he was dispatched to a neuro-rehabilitation facility in Texas, where he spent a year trying to regain as much cognitive function as possible. When it was time for him to come home, Debbie recalls, the neurologist sat her down and told her that Brandon probably wouldn't make much more progress and that she needed to be absolutely sure she was ready for what lay ahead. She said she was. She was wrong.

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"Suddenly I was doing a job that 15 different people had been doing before," Debbie says. "I thought he'd get better, but he actually got worse. He had terrible panic attacks and nightmares. He wouldn't leave the house."

Debbie now spends most of each day with Brandon at a Veterans Affairs rehabilitation facility an hour away from their home. She sits in during his therapies, keeping a notebook that she can show him later so he can remember what he learned. Because of potential seizures, Brandon cannot be left by himself, let alone do things like drive or swim. Debbie is on call around the clock. Her old life, she says, has vanished.

In that life, Debbie had a job she loved and time for passions like photography and dance. She and Brandon were a social couple, and Debbie had a treasured circle of girlfriends. Today, most of those comforts have disappeared. "The women I used to get pedicures with, I don't really see them anymore," she says. "Brandon comes everywhere with me. It's like, 'Come on, Brandon, I need to go pull the weeds. Come on, Brandon, we're gonna garden now.' If I go to the nail salon, he comes with me. And I guess they got tired of that." Many caregivers echo her sense of isolation; it can be particularly painful because the person they'd otherwise go to for emotional support--their partner--is no longer able to offer it.

For Roxana Delgado of El Paso, TX, every day brings reminders of the little things she and her husband have lost. In 1996 she fell in love with Victor Medina, and she remains devoted to him. But while he looks about the same as he did on their wedding day, functionally there's little comparison. "Victor was the smartest man I'd ever met," Roxana says of the onetime accountant and Army sergeant first class who was hit by an explosive projectile in Iraq in 2009. "I fell in love with one brain, but the one he brought back from overseas operated at around a seventh-grade level," she says. "He couldn't drive; he couldn't remember things."

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Though it's difficult for her to say out loud, Roxana concedes that Victor's condition initially made it more like having a child at home than having a partner. And though traces of old Victor crop up, she's always jolted back to reality. "In the early days, I'd look at him and think, Oh, hey, it's Victor! Then I'd have to remind myself that it wasn't the same guy, and that this guy really needs my help."

He will likely never become totally self-sufficient. One hobgoblin of TBI is that a patient's needs often grow, not lessen, once the soldier returns home. And while improvements can be made with occupational therapy, full recovery is rare. "With Victor we were blessed," says Roxana. "He's developed a lot of independence, which means I haven't had to transform my whole life like a lot of wives had to. But there are parts of my husband's personality that will never come back. That's been hard on me, sure. But imagine what it's been like for him? As much as I miss the old Victor, well, he misses the old Victor too."

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The "Is this it?" factor represents a particularly difficult struggle for caregivers, says Judy Myers, caregiver support coordinator at the VA Loma Linda Healthcare System in California. She says that caregivers of all ages (there are also a large percentage of mothers who take care of sons coming back from war) start out enthusiastic because their loved one may look totally normal, and then after years of slow progress they'll think, Is this really as good as it's going to get?

Of course, for some military families, other catastrophic physical injuries mean that TBI is just one part of their troubles. Ivonne Thompson was 29 years old and 20 weeks pregnant when she got a call telling her that her husband, Anthony, a 25-year-old corpsman with the 2nd Battalion, 7th Marines, had been blown off a highway overpass near Fallujah when a suicide bomber passed underneath it in a dump truck. Told at first that Anthony's spinal cord was severed, Ivonne remembers thinking, I couldn't care less if he walks. I just want his mind to be okay. She was devastated when doctors told her he'd suffered brain and spinal injuries that prohibited him from talking, walking, or moving at all.

Anthony was transferred to a polytrauma unit in Tampa, FL. To bathe him, Ivonne used a lift system that allowed her to roll him into the shower. "The nurses would have done it," she says, "but it was our time, our way of being intimate." Eight weeks after arriving in Tampa, Ivonne gave birth to their son, Anthony Jr. "It was bittersweet," she says. "Anthony was so looking forward to having a child. To have him not able to be there--it sucked, really."

After four years in the hospital, Ivonne brought Anthony home to Houston, where it seemed like a lifetime ago that she'd had a job she loved teaching high school Spanish. Today, Anthony still doesn't move or talk. Though she has nursing help, Ivonne shoulders most of the burden. Like many caregivers, she is faced with a situation in which her partner now needs far more help than her young child. She gets Anthony in and out of bed and works alongside his physical therapists. She makes sure he participates in birthday parties and holidays. They used to be avid moviegoers, she says, so she still wheels him to the theater and sits in the dark holding his hand.

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Partners like Ivonne provide tenderness a nurse or social worker never could. If there's anything they neglect, it's themselves. "The VA offers respite services for those in the role of care for veterans," says Myers. "Someone will sit with the soldier so the caregiver can go out--see a friend, get a haircut, anything." But most don't allow themselves to take that break. "In the last year, only three of the 88 families in my district have asked for the services," Myers says.

Compared to women like Debbie and Ivonne, some would say Cheryl Gansner has it pretty good. Though he can't remember much of their wedding, her husband, Bryan, a former Army staff sergeant, can hold down a job. (One that, ironically enough, involves building and repairing bomb-detecting robots.) Six years ago, Bryan was sitting in an Army vehicle when an IED exploded beneath his seat. "Initially we were told he had 'mild' TBI,'' says Cheryl, who had trained as a social worker before putting her career on hold to take care of Bryan. "But when we went home to Tennessee, he started breaking down. He would sleep all day and not go to appointments. He got a job but he was laid off after 30 days. He had another surgery, and then he just stopped communicating with me."

Like Brandon, Bryan has damaged short-term memory that requires an ironclad daily routine. Any diversion in the schedule can leave him nearly paralyzed with anxiety. "We have strategies," says Cheryl. "We go food shopping at times when the least amount of people will be there. If there's a party or family event coming up, I remind him every day the week before so that he isn't surprised by it."

Before the injury, Bryan was gregarious, involved."We had parties almost every weekend," Cheryl recalls. "We'd invite the single soldiers over for dinner." Today, their social calendar is minimal at best: "All he really wants to do is sit in his man cave in the basement," Cheryl says. She recalls going to a party earlier this year and realizing halfway through that Bryan simply couldn't cope. "He just spaced out," she says. "He can't make small talk--or long talk."

It's understandably common for the marriages of injured soldiers and their spouse-caregivers to founder. Both Debbie and Cheryl admit to having been on the razor's edge of splitting up. What allows them to overcome these moments, the women say, is hope--hope for medical advances, hope for more support, hope for a change in the day-to-day grind that won't totally rock the boat.

Cheryl has pinned her ambitions on having children. "I've already given up so much," she says. "I don't want to have to give up kids, too. I've accepted that I will be doing the majority of the work, but I want a family more than anything, so it's worth it to me."

For Ivonne, it's Anthony Jr. that keeps her going, and A.J., who is 5, has his own dreams. Though he's never heard his father's voice or seen him move, he talks about a day when he will, in A.J.'s words, "be alive again."

"He'll say, 'When Daddy is alive again he'll play baseball with me,'" Ivonne says. "'When Daddy is alive he'll do this or do that.' And I have to say, 'Chances are Daddy will never be able to do that with you. But that doesn't mean he doesn't love you or want to be with you.' We go over that story time and time again."

Debbie has become a tireless researcher, frequently staying up all night reading about clinical trials or medical treatments. She also avoids thinking too much about the past. Old family photos cover the walls of her living room, but she brushes past them, trying not to look. "Brandon is still Brandon, inside," Debbie says. "He's a good man. His heart is the one I married. But sometimes I look at him and wonder where he is. It's like, 'By chance if you ever see my husband again, will you tell him to please come home?'"

Care packages for caregivers: Help bring a smile to the wife of a wounded veteran.

The partners of wounded warriors pour everything they've got into caregiving, but who takes care of them? To show our love and respect, REDBOOK is teaming with the nonprofit Operation Gratitude to send very special holiday packages to 1,000 military caregivers who are nursing their combat-injured loved ones. Will you help us make this season a little sweeter for them? These packages will be filled with goodies (thanks to generous donations from Old Navy, Stumptown Coffee Roasters, The Pampered Chef, Bath & Body Works, and many others!) and will contain a beautiful card by with a personal message of support... written by you! Go to our Care Packages for Caregivers page to write a letter, or to make a donation toward the cost of shipping the packages — every dollar helps.

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