Table Of Content

Warrior Transition Leader Medical Rehabilitation handbook Editorial Staff Martha K. Lenhart, MD, PhD, FAAOS, Colonel, MC, US Army Director and Editor in Chief, Borden Institute Marcia A. Metzgar Volume Editor, Borden Institute Christine Gamboa-Onrubia, MBA Creative Director and Production Manager, Fineline Graphics, LLC Joan Redding Technical Editor, Borden Institute The opinions or assertions contained herein are the personal views of the authors and are not to be construed as doctrine of the Department of the Army or the Department of Defense. CERTAIN PARTS OF THIS PUBLICATION PERTAIN TO COPYRIGHT RESTRICTIONS. ALL RIGHTS RESERVED. NO COPYRIGHTED PARTS OF THIS PUBLICATION MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM OR BY ANY MEANS, ELECTRONIC OR MECHANICAL (INCLUDING PHOTOCOPY, RECORDING, OR ANY INFORMATION STORAGE AND RETRIEVAL SYSTEM), WITHOUT PERMISSION IN WRITING FROM THE PUBLISHER OR COPYRIGHT OWNER. Published by Borden Institute | Fort Detrick, Maryland US Army Medical Department Center and School | Fort Sam Houston, Texas Office of The Surgeon General | Falls Church, Virginia Library of Congress Cataloging-in-Publication Data Warrior transition leader medical rehabilitation handbook / edited by Rory A. Cooper, Paul F. Pasquina, and Ron Drach. p. ; cm.: Includes index. I. Cooper, Rory A. II. Pasquina, Paul F. III. Drach, Ron. IV. Borden Institute (U.S.) [DNLM: 1. Disabled Persons—rehabilitation—United States. 2. Veterans—United States. 3. Adaptation, Psychological—United States. 4. Military Medicine—United States. WB 320] LC classification not assigned 616.9’8023—dc23 2011032153 For sale by the Superintendent of the Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800; DC area (202) 512-1800 Fax: (202) 512-2104 Mail: Stop IDCC, Washington, DC 20402-0001 Warrior Transition Leader Medical Rehabilitation handbook EditEd by h h h RoRy a. coopeR, phd, col paul F. pasquina, Md, and Ron dRach bordEn inStitutE Fort Detrick, Maryland uS army mEdical dEpartmEnt cEntEr and School Fort Sam Houston, Texas officE of thE SurgEon gEnEral Falls Church, Virginia thiS book iS dEdicatEd to thE mEn and womEn of thE uS army who havE bEEn woundEd, injurEd, or bEcomE ill aS a rESult of thEir SErvicE to thE unitEd StatES of amErica, to thE familiES, and to thE many pEoplE who havE rESpondEd to hElp thEm to providE thE promiSE of a brightEr tomorrow. h h h Contents Foreword ix Preface xi Prologue xiii chaptEr onE Introduction h 3 Rory A. Cooper chaptEr two The History of the Army Medical Department h 17 Rory A. Cooper chaptEr thrEE The History of Disability Rights and Military Conflict h 27 Katherine D. Seelman, Diane M. Collins, and Lauren Atkins chaptEr four Models of Disability and Impairment: How to Promote Positive Interactions h 51 Rory A. Cooper, Ashli Molinero, Diane M. Collins, and Elaine F. Houston chaptEr fivE The Roles of Medical Rehabilitation Professionals h 67 Rosemarie Cooper, Brad E. Dicianno, and Paul F. Pasquina chaptEr Six Definitions, Descriptions, and Complications of War-Related Injuries and Illnesses h 83 Paul F. Pasquina and Daniel F. Fisher viii h contEntS chaptEr SEvEn Soldiers at Risk for Suicide or Medication Misuse h 105 Marian N. Hyatt, Thane D. McCann, Carlo J. Alphonso, and Brandon J. Goff chaptEr Eight Assistive Technology, Accessibility, and Universal Design h 119 Justin Z. LaFerrier, Ian Rice, Nahom Beyene, Nathan Sprunger, Rich Simpson, Andrea Fairman, and Diane M. Collins chaptEr ninE Resilience to Adapt and Overcome h 159 Douglas A. Etter, Michelle L. Sporner, and Rory A. Cooper chaptEr tEn Army Programs Related to Warriors in Transition h 175 Ilana R. Yurkiewicz, Paul F. Pasquina, Mary R. Goldberg, Ron Drach, and James E. Cox, Jr. chaptEr ElEvEn Selected Veteran and Military Service Organizations Related to Warriors in Transition h 193 Rory A. Cooper and Michelle L. Sporner chaptEr twElvE Overview of State and Federal Programs and Agencies for Wounded, Injured, and Ill Soldiers h 213 Mary R. Goldberg, Ron Drach, and Michelle L. Sporner chaptEr thirtEEn Summary h 231 Rory A. Cooper and Paul F. Pasquina Acknowledgments 241 Acronyms and Abbreviations 243 Suggested Reading List 247 Index 249 Foreword our SErvicE mEmbErS and thEir familiES are incredibly strong, resilient, and dedicated. As I travel and reflect upon a career spent with Sol- diers and with Army and Military medics around the world, I am humbled and amazed at the strength and heart of the Military Family and the men and women in Army Medicine who protect and care for them. From the clin- ics and operating rooms of Walter Reed Army Medical Center to Forward Operating Bases in Afghanistan, our laboratories in Africa and Asia, and our installation service facilities, I am continuously awe-inspired by the over- whelming commitment to excellence and service. The US Army Medical Com- mand (MEDCOM) employs every available resource to protect the Force and improve the health of Army Families—leading the way in innovative care and ensuring world-class treatment and rehabilitation for illness or injury. The ability of Army Medicine to fully help wounded, ill, and injured Sol- diers and all Warriors optimally recover is critical for the effective defense of our nation. George Washington, our first Commander in Chief, stated, “The willingness with which our young people are likely to serve in any way, no matter how justified, shall be directly proportional to how they perceive the Veterans of earlier wars were treated by the nation.” Army leadership has worked tirelessly to establish a comprehensive support system for the wounded, ill, and injured in each phase of rehabilitation to reduce health issues, enable maximum recovery, and promote suc- cessful reintegration into the force or separation from the military. This book contributes to the Army’s extensive efforts to train those Soldiers requiring the closest attention and most extensive care—our Warriors in Transition (WTs). Maintaining a professional, multidisciplinary workforce to support WTs is critical; Warrior Transition Command leaders, nurse case managers, and primary care providers must collaborate to meet individual WT needs. I encourage the entire MEDCOM and all leaders to understand their role in the Comprehensive Transition Plan (CTP), an inclusive program that permits individually tailored and aspirational plans for WTs. The CTP documents, synchronizes, and integrates the efforts of WTs, Families, MED- x h Foreword COM staff, and external partners. Additionally, the CTP rapidly incorporates lessons, formalizes policy, and supports Warriors’ current and future needs. Cadre must actively and regularly support the WT in routine activities such as physical fitness, therapy, and daily garrison activities. The Army determined the foundation for the treatment of WTs decades ago as wounded, injured, and ill Soldiers returned from World War II. As an illustration, two Soldiers wounded in World War II sent to the same Army hospital for treatment would later become role models for contemporary Soldiers. The two Soldiers set the same goal—to eventually serve in Congress; each personally challenged the other to accomplish their goals. When Daniel Inouye of Hawaii got to the House of Representatives, he called his friend Bob Dole and asked how much longer it would take him to get elected. Both wounded Veterans served in the House and went on to distinguished careers in the US Senate. Overcoming numerous physical obstacles, they focused on their abilities, committed to optimal recovery, and ultimately dedicated their lives to federal service. Both men have spoken about the “tough love” they received from Army nurses, doctors, and medics who encouraged them to think about their abilities and goals. This book provides examples of wounded Soldiers from prior conflicts who have made important contributions as role models. This handbook will serve as a resource for leaders within the MED- COM, as well as for leaders across the Army and the Department of Defense. Many wounded, ill, and injured Soldiers, Sailors, Airmen, and Marines who participated in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn have made tremendous rehabilitative progress, with significant numbers returning to active duty; their recoveries are amazing. The handbook is a collaborative effort with the Department of Veterans Affairs and private sector colleagues to aid WTs in overcoming physical and psychological hurdles and returning to productive lives. This important work would not have been possible without the leadership of Rory A. Cooper, PhD; Colonel Paul F. Pasquina, MD; and Mr. Ron Drach—all Soldiers. I would like to thank these authors and the dedicated staff of the Borden Institute; their sense of urgency and focused efforts to create this book are commendable. The contributors have helped thou- sands of wounded, injured, and ill Soldiers to regain their self-reliance and pursue life goals. eric B. Schoomaker, md, Phd Lieutenant GeneraL, uS army the SurGeon GeneraL/commandinG GeneraL uS army medicaL command