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International perspectives on caregiving.

Every year, millions of people around the world suffer spinal cord injuries, traumatic brain injuries, and strokes. Spinal cord injury (SCI) often strikes young and healthy individuals and is estimated to affect between 11.5 and 57.8 individuals per million around the world, causing death, paralysis, and serious secondary medical complications [1]. Costs associated with SCI have been estimated at over $1 m per patient, including those associated with home modifications, supplies, nursing, and home care [12]. Like SCI, traumatic brain injury (TBI) is a leading global cause of death and disability in the young, estimated to affect roughly 10 million people around the world each year [6,7]. The costs of TBI are many, including those related to direct hospitalization and rehabilitation, lost earnings, and reduced quality of life [5]. Strokes are the third most common cause of death in developed countries around the world; an estimated 15 million people suffer strokes each year, and roughly 5.5 million of these die [10]. The economic burden of strokes is great: the American Heart Association estimates that $73.7b will be spent on treatment of stroke victims in 2010 alone, and strokes are a major cause of long-term serious disability [2]. Overall, persons with debilitating conditions like TBI, SCI, and strokes often require the services of shortand long-term care [3,8,14]. In general, family members often take on the role of caregiving which requires significant amounts of time and dedication,