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       The study, commissioned by the Elizabeth Dole Foundation, was the first national, comprehensive study of military caregivers in the United States. It aimed to understand the magnitude of military caregiving; define existing policies, programs, and initiatives for caregivers; and make recommendations to better address their needs.

       To answer these questions, the research team completed

       the largest and most comprehensive survey of military caregiving ever conducted an environmental scan to assess caregiver services and identify gaps.

       Research Questions What is the magnitude of military caregiving in the United States? How does caregiving affect individuals, their families, and society? How do these effects differ across cohorts of veterans and their caregivers? What are the current policies, programs, and other initiatives designed to support military caregivers? Do these efforts align with the needs of military caregivers? How can gaps be filled and the well-being of military caregivers ensured?

       Key Findings There are 5.5 million military caregivers in the United States, 1.1 million of whom are caring for military veterans who served after the terrorist attacks of September 11, 2001. Military caregivers perform a wide variety of tasks—from dressing and bathing their loved ones to helping them cope with emotional difficulties. Military caregivers helping veterans from earlier eras tend to resemble civilian caregivers in many ways. All caregivers are adversely affected by their duties. These effects include an increased likelihood of depression and other negative health outcomes; low productivity and problems at work; relationship distress; and increased financial difficulty. Post-9/11 caregivers differ from both civilian caregivers and earlier-era military caregivers. And they face even more acute challenges: Post-9/11 caregivers tend to be younger and juggle work with caregiving duties. Most have no support network. They are four times more likely than non-caregivers to be depressed. One-third of post-9/11 caregivers are without health insurance. They typically help their loved ones cope with stressful situations or other emotional and behavioral challenges. Existing programs offer training and support for military caregivers, but do not target their specific needs. There is an overall lack of respite care programs, which provide caregivers temporary relief from their duties. Recommendations

       RAND made four major recommendations:

       Empower caregivers with education, health coverage, and greater public awareness of their contributions. Create caregiver-friendly environments, particularly among health care providers and employers. Fill gaps in existing programs and services by extending eligibility and increasing availability of respite care, which directly reduces time spent caregiving. Plan for the future to account for the evolving nature of current caregivers' needs, as well as for those of future caregivers.

       This study raised the profile of military caregivers, their sacrifices and contributions, and their need for support. Informed by the results, First Lady Michelle Obama and former Senator Elizabeth Dole announced a new public-private coalition to address military caregiver needs. Initiatives have also been developed by the U.S. Chamber of Commerce, Easter Seals, and the Tragedy Assistance Program for Survivors (TAPS).

       Legislative action is also underway: Shortly after the release of the report in April 2014, Senator Patty Murray (D-WA) and Congressman Jim Langevin (D-RI) introduced the Military and Veteran Caregiver Services Improvement Act, which expands eligibility for benefits, particularly for those caring for veterans and service members with mental health conditions. In July 2014, a bicameral, bipartisan "Hidden Heroes" caucus was introduced. The caucus is dedicated to developing policy solutions that support military caregivers.

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