When Sgt. Ophelia Preston invited the person in who was knocking on her door, she was shocked to see who it was: a uniformed soldier representing the Fort Hood Warrior Transition Brigade.
"I didn't know anyone even knew I was here," said the Soldier who was previously assigned to the 1st Infantry Division out of Fort Riley, Kan. "I was just glad to see the uniform."
'Here' was a Dallas rehabilitation hospital where the 41-year-old Soldier had spent most of 2011 as an inpatient recovering from a stroke that had robbed her of her movement and speech."
"Sergeant Preston," the sergeant first class said, "you're now assigned to the Warrior Transition Brigade. I'm your platoon sergeant. You only job now is to heal and transition."
The 20-year career Soldier's wish had finally come true. She was going home. Her place of duty would now be her parent's house 90 miles south of Dallas. Her emotional and physical struggles in regaining her cognitive skills as the brain rewired itself would now be a family affair.
Although Preston's care would be military based, managed remotely under the security blanket of WTB F Company's military and medical team, her providers would be community resources such as the local Veterans Affairs hospital and physical therapy centers. In doing so, Preston also would be learning how to maneuver through the complexities of the VA system as she transitions out of the military.
Soon to retire, Preston was a perfect candidate for the Army's community-based, remote care treatment option, according to her commanding officer, Maj. Jason Good: She's near a Veterans Affairs treatment facility, her mother is her designated caregiver and she is low risk.
And for Preston, who has regained much of her speech and mobility since her June 2010 stroke, F Company was the miracle assignment she needed.
"I'm so glad the Army has remote care," said the homebound Waco soldier who lives with her three teenage sons, her mother and father and three of her adopted, special-needs brothers. "Being here with my family has really assisted me in my healing process. Plus, I'm able to have influence in the raising of my children, as well as watching them grow up."
Although Preston is active duty, the remote care program is primarily for homebound ill or injured low-risk National Guard and Reservists who would have to remain on active duty and be medically managed at an Army installation, often miles away from their support system and their community.
Not an ideal situation, according to Janique Parnell, WTB's social worker supervisor.
"Your family can be an incredible support system, especially in providing encouragement and emotional support," said Parnell. "Their empathy validates how that Soldier feels and provides the strength needed when that Soldier feels he or she has lost their own strength."
Additionally, caregivers and family members provide a second set of eyes that are critical when managing medical care remotely.
"Family members watch that Soldier every day so they're used to seeing certain habits," said Good, who emphasized partnering with the Soldier's family in managing his or her care is essential. "Our families become one of our greatest resources in taking care of wounded or ill Soldiers. We need them to trust us so that they feel comfortable telling us when they notice a change in that son, daughter, husband or wife."
Good and his team build trust by daily phone calls and frequent home visits to talk and meet with the Soldier and the family.
One of those tasked with building that trust is Sgt. 1st Class Roger West, who isn't the normal "in-your-face"' Army platoon sergeant. Instead of addressing discrepancies, the 45-year-old "old-school" Soldier and artilleryman motivates and observes, looking and listening for any triggers that might interfere with Soldier care like self doubt or a troubling home environment.
And home visits, said West, are the bonding opportunities that are essential to the healing process.
"It's hard to access the Soldier if you don't interact with the family or the care team supporting them," he said. "It's critical to the success or failure of that partnership."
To Sgt. 1st Class Jacqueline Schultz, visiting a Soldier in his or her home puts her more at ease when missing the visual "boots on the ground."
"Seeing that Soldier in his or her environment is comforting," the 38-year-old former drill sergeant said. "We see how they live, and we make sure things are OK with both the Soldier and the family members," adding that it's not unusual to talk to her Soldiers three or four times during the day.
Schultz said it's important for the Soldiers to know that the WTB cares and is there to help.
"The biggest thing is their comfort," she said. "I try to put myself in their footsteps to relate to what they're going through. We're here to take care of the hard things so they can heal and transition."
For National Guardsman, 41-year-old Sgt. Heather Rodriguez, her platoon sergeant's daily 5:30 a.m. phone calls provide her the "uplift" she needs in the morning.
"Sergeant West is the first person I talk to in the morning," said Rodriguez, who has chosen the culinary field as her future career, which, ironically, was the career path her platoon sergeant gave up when he enlisted some 24 years ago. "He's someone I've turned to for moral support. He'll ask me what I'm doing at school today and give me advice like 'stay close to the bone' when I was butchering a chicken."
Rodriguez, who crushed her hand during her 2010 deployment to Iraq, was previously recovering at Fort Bliss miles away from her new husband and credits West and remote care for saving her marriage.
"To have that extra pressure of trying to heal and keep my relationship together was just too much," the Austin-based Soldier said. "I'm thankful for the privilege of remote care--that I'm not just a number-- because it has given me an opportunity to focus on my healing and spend time with my husband. And I couldn't have done it without my platoon sergeant. He's a great guy and my mentor."
West considers all of his Soldiers an extension of his family and follows up with them even after they have transitioned out of the military.
"It's very rewarding when eight months down the road you get a phone call or an e-mail from a former Soldier who is thanking you for helping in his or her transition," he added.
That feeling is mutual, said Preston, who intends on maintaining contact with West after she retires.
"He's not going to leave me," she said, adding that his care and compassion has been a boost to her during her healing process. "I was recently telling my mom how grateful I am that Sergeant West is my platoon sergeant because you don't mind telling him things. He's the kind of non-commissioned officer you don't forget."
Prescott's mom and caregiver, Chaney Hall, agrees.
"He's the man," Hall said of West. "He's been such an encouragement to Ophelia," adding that she's glad her daughter is healing at home. "This way, we get to push her, and I can give her that 'motherly' bit of encouragement."
Caring for an injured or ill Soldier 24 hours a day is physically and emotionally demanding and requires extreme sacrifice on the part of the primary caregiver. Often, a caregiver is forced to give up full-time employment because of the greater need to care for that loved one. To compensate for those lost wages, the Department of Defense authorizes a monthly compensation to designated caregivers.
For Dana Self, who was working full time before she quit so she could care for her 23-year-old son, Pfc. Christopher Sexton, the Special Compensation for Assistance with Activities of Daily Living (SCAADL) was a blessing.
"It was financial tough at first," she said, who cares for her son at her and her husband's home in Royse City, a small town outside of the Dallas - Fort Worth Metroplex with a population of around 10,000. "SCAADL definitely helps to fill the void for that lost income."
She said she believes taking care of her son, a National Guard Soldier recovering from a brain injury, has been the key to his recovery.
"Being around his family and friends in his own environment has been great for his healing process," she said. "Interacting with people he recognizes has really helped him and has enabled him to get into somewhat of a routine."
It's also helped his attitude and sense of humor.
"There're times I just get down and cry," she said when coping with her once athletic son who can't write the word 'Mother' on paper, yet can masterfully replicate writing it in script in the air. "He just does the military thing and tells me to 'Suck it up, Nancy.'"
Helping Soldier's heal and transition is a massive undertaking, as West and his fellow platoon sergeants have discovered, but for West, it's been the most rewarding of his 24-years as a Reservist, Guardsman and active-duty Soldier.
"For me, the job is easy because I want to do it," said West, dismissing the challenges of the job, treating them instead, as opportunities to help Soldiers like Preston, Rodriguez and Sexton. "To witness their healing and to be a part of it is special. They may not like it, but my phone calls aren't going to stop when they ultimately transition back into their community. I'm going to continue to bug them as long as they'll let me."
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