Kevin Kammerdiener's mother, Leslie, takes care of his every need, which would be fine if he were in preschool. The thing is, "Kamm" is 21. He suffered a traumatic brain injury, shattered bones and burns on 25 percent of his body in Afghanistan in May 2008, which left him in a wheelchair, unable to speak and in chronic pain.
Leslie moved from Pennsylvania to her son's home in Riverview, Fla., to care for him after he spent months at a military hospital in San Antonio.
Now Leslie Kammerdiener, 44, spends her days making sure Kevin eats well, is clean and comfortable, and is not in pain. More recently, she has been helping him rebuild his vocabulary (he can say about 100 words), which he lost after a suicide bomber drove a vehicle full of explosives into his Humvee. By night, she soothes him when he is wakeful, which she says is pretty much all the time.
"I'm lucky if I get two to four hours of sleep at one time," Kammerdiener says.
Mostly, Leslie just wants her once-strapping son to be safe and happy -- to teach him enough words so he can let people know what he needs, maybe even have a relationship one day, she says hopefully, mentioning the prom photo he sometimes cradles and sobs over.
Kammerdiener is among thousands of unpaid caregivers -- parents, spouses, siblings and war buddies -- helping veterans injured in the Iraq and Afghanistan wars get through each day, says Barbara Cohoon, deputy director of government relations for the non-profit National Military Family Association. She says the caregivers are a vulnerable group, often under-recognized, and in need of help to navigate the military's medical system. Cohoon says not all caregivers receive military benefits, even though many have quit jobs, moved out of their homes and drained their savings to care for their loved ones.
"Nobody's got a handle on numbers, but 7,500 is the number bandied about," says Cohoon, whose organization provides counseling and helps families negotiate the health system.
The range of injuries caregivers attend to spans from gashes and fractures that will heal, to comas, amputations, burns, paralysis, nerve damage and brain injuries so severe that cognitive function lingers at the toddler level or below.
The Defense Department's most recent tally of Afghan and Iraq war-related traumatic brain injuries is 161,025. A 2008 report from the non-profit research company RAND, however, put the figure at 320,000 out of the 1.64 million deployed by that time. Cohoon says it's estimated that about 350 to 400 such patients are so severely hurt they will need full-time care for the rest of their lives.
"Invisible" mental health wounds, including post-traumatic stress disorder, are also a major concern for returning veterans, even those who show no outward wounds, says Rene Bardorf, director of the Bob Woodruff Foundation, a non-profit organization that helps the families of injured veterans. It was launched by Bob and Lee Woodruff after the ABC News anchor almost died from a brain injury in Iraq in 2006. Bardorf says it's estimated that more than 300,000 service members have psychological wounds.
"We're seeing complex injuries -- individuals who simply would not have survived previous conflicts, and this has placed an enormous load on families," says U.S. Army Brigadier Gen. Loree Sutton, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury in Arlington, Va.