Spring 2015
Serving Our Older Veterans: Current Issues and Best Practices

Introduction to the Research Articles in the Special Issue on Older Veterans

About the Author

Lenard W. Kaye, DSW, PhD, is Professor, University of Maine School of Social Work and Director, University of Maine Center on Aging, Orono, ME

Lenard W. Kaye, DSW, PhD

Service in the military continues to be counted among those life experiences that run the risk of not being broached in exchanges between clients and helping professionals even though we know all too well it can influence in significant ways, and over a life time, an individual’s physical and emotional well-being.

More than nine million strong, older veterans, for a multitude of reasons, may not take the initiative to tell elder care professionals about their past military service. Reasons for not raising the subject include an older adult’s failure to tie an experience which occurred many years ago with their present day needs and concerns. Still others will avoid confronting their military past because of the emotional (and physical) pain that such memories can engender including the full gamut of unpredictable feelings, flashbacks, headaches, and even nausea. In addition, in part due to the complexity and changing nature of the system of veterans’ entitlements, both older veterans and the professionals that serve them are likely not going to be aware of the vast array of resources and services that are available at the federal, regional, state, and local levels for those having served in the military. The result, in all too many cases, is that the older veteran and his or her spouse fail to benefit from a well-established and supportive infrastructure that has the capacity to dramatically improve their health and quality of life.

In this special issue of the New Journal of Geriatric Care Management, we devote ourselves to advancing a better understanding and appreciation for the enormous impact that military service to our nation can have on physical and emotional health and well-being in later life. At the same time, we want to emphasize how important it is that geriatric care managers make a concerted effort to address any and all issues surrounding the consequences of military service if that experience is perceived to be a potentially meaningful factor impacting on the aging experience of clients.

Kenneth Shay begins by setting the historical context of the U.S. Department of Veterans Affairs (VA). To be sure, Ken has an impressive understanding of this extremely complex and constantly evolving enterprise. The story he tells underscores how the VA has increasingly taking a lead in developing innovative strategies and caring approaches to serving veterans who now find themselves surviving into extreme old age.

Cliff Singer provides us with both an authoritative and succinct review of what we currently know about dementia risk factors in military veterans as compared to civilian populations. He addresses a range of topics including traumatic brain injury, post-traumatic stress disorder, depression, health-related risk factors, and preferred treatment strategies. He has assembled a comprehensive set of professional clinical sources to turn to for those who want to explore these topics further.

Janis Petzel, a geriatric psychiatrist with extensive experience treating patients in VA facilities, provides us with a thought provoking article aimed at both encouraging discussion and informing your clinician-patient relationships. She draws liberally from literary works that depict the harsh realities of war as she shares with the reader what have been some of the most impactful experiences over the years for her personally.

While care management practice can be taxing regardless of the individuals and families you work with, Jennifer Middleton reminds us that working with older veterans can present practitioners with particularly stressful and traumatic situations. To be of maximum benefit to our clients we need to be mindful of and skillful at addressing secondary trauma and compassion fatigue in ourselves through self-care and promoting resilience.

Finally, Jennifer Crittenden provides an extremely helpful and timely summary of the latest resources and benefits available to older veterans and their spouses and where geriatric care managers can turn for help. Her efforts will, no doubt, be a great benefit to those on the front lines working with individuals who served their county in the military. You will also find practical tips on how to effectively serve this population.

I hope you find this collection of articles helpful in your professional practices.

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