The Transition Mapping Study -Understanding the Transition Process for Service Personnel Returning to Civilian Life
Abstract: Since the Armed Forces Covenant was published in 2000, there has been increased interest in the process of helping Service people transition from the Armed Forces into civilian life. In 2006 this process was formalised when the Ministry of Defence published its Strategy for Veterans. The Forces in Mind Trust (FiMT), which has been set up to improve the transition process, commissioned The Futures Company to review existing research, to understand how the transition process currently works, how it is viewed by stakeholders and by recent Service leavers, to develop a model that quantified the costs of poor transition to the UK as a whole, and to make recommendations on how to reduce the number of poor transitions. The research focussed on fulltime personnel, not reservists. Transitioning from military service into civilian life is inevitable for almost all Armed Forces personnel; only a tiny proportion proceeds through to a full career. Most transitions are successful. One of the reasons for this is because of the resources invested in them by the Armed Forces. At the same time, a “good transition” is undefined. For the purposes of this project we developed with help from stakeholders the following definition: “A good transition is one that enables ex-Service personnel to be sufficiently resilient to adapt successfully to civilian life, both now and in the future. This resilience includes financial, psychological, and emotional resilience, and encompasses the ex-Service person and their immediate families.”
Abstract: Objectives: Increasing numbers of older adults are reentering community following incarceration (i.e., reentry), yet risk of incident neurodegenerative disorders associated with reentry is unknown. Our objective was to determine association between reentry status (reentry vs never-incarcerated) and mild cognitive impairment (MCI) and/or dementia. Methods: This nationwide, longitudinal cohort study used linked Centers for Medicare & Medicaid Services and Veterans Health Administration data. Participants were aged 65 years or older who experienced reentry between October 1, 2012, and December 31, 2018, with no preincarceration MCI/dementia, compared with age-matched/sex-matched never-incarcerated veterans. MCI/dementia was defined by diagnostic codes. Fine-Gray proportional hazards models were used to examine association. Results: This study included 35,520 veterans, mean age of 70 years, and approximately 1% women. The reentry group (N = 5,920) had higher incidence of MCI/dementia compared with the never-incarcerated group (N = 29,600; 10.2% vs 7.2%; fully adjusted hazard ratio [aHR] 1.12; 95% CI 1.00-1.25). On further investigation, reentry was associated with increased risk of dementia with or without prior MCI diagnosis (aHR 1.21; 95% CI 1.06-1.39) but not MCI only. Discussion: Transition from incarceration to community increased risk of neurocognitive diagnosis. Findings indicate health/social services to identify and address significant cognitive deficits on late-life reentry. Limitations include generalizability to nonveterans.