Warrior in Transition Leader Medical Rehabilitation Handbook

2011·1.7 MB·English

by  U.S. Army. Office of the Surgeon General. Borden Institute

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 [phone]; DC area [phone]
Fax: [phone] 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 rehabilita-
tion 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 physi-
cal obstacles, they focused on their abilities, committed to optimal recov-
ery, 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 psycho-
logical hurdles and returning to productive lives.
This important work would not have been possible without the leader-
ship 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