Evaluation of the West Midlands Housing Scheme for Armed Forces Veterans – Wolverhampton
Abstract: A large number of military personnel leave the British Armed Forces each year and, while the vast majority resettle into civilian life successfully, a number of veterans experience serious ongoing difficulties that can leave them at risk of homelessness. The Wolverhampton Veterans Housing Service aimed to provide vulnerable veterans with temporary housing and support in their transition to sustainable employment and accommodation. A 3-year pilot scheme was conducted and evaluated to establish its effectiveness in meeting these aims as well as to identify facilitators and barriers to its impact on veterans’ outcomes. As well as key statistics of residents and outcomes, face to face interviews with residents and other key stakeholders as well as findings from quality of life and satisfaction questionnaires were used to explore perceptions of the scheme and surrounding issues. Beneficiaries of the scheme were as expected but had a wide range of complex support needs. Modest rates of success in gaining employment and accommodation were seen by the end of residents’ tenancies and quality of life was low to moderate. Residents were generally satisfied with their experience at the housing service and appreciated the opportunities on offer. However a number of barriers to successful outcomes were identified, including veterans’ attitudes to their military role, dependency on the service, mental health issues, and difficulty finding employment and managing finances. Overall, the Veterans Housing Scheme addresses an important community need and with some refinements the model has the potential to have great impact on veterans’ lives. While overall satisfaction was seen for the accommodation and support offered, some veterans presented with higher support needs than were anticipated and more intense preparatory work may be required in order for these veterans to successfully move forward towards integration with the community and independent living. Recommendations have been made for future provision of specialised housing for veterans at risk of homelessness.
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.