Making dialogue with an existential voice in transition from military to civilian life
Dialogical Self Theory has contributed to the endeavors to map and grid self-identity work in transition from military to civilian life throughout an empirical and longitudinal research project which focuses on existential dimensions. This article is based on a case study from this project and centers upon Sergeant Jonas, who, upon his return from deployment in Afghanistan, struggled with his transition as a new existential position was vocalized throughout the following annual interviews. This voice narrated feelings of meaninglessness, emptiness, and of having been deceived. In turn, this existential voice required an answer to a question which apparently had no answer. The meaning-making eventually evolved into an acceptance which enabled Jonas to proceed with his life. Dialogical processes between positions are important in order to go on with life amid existential concerns in the aftermath of military service since dialogicality of the self opens up a complex of dynamics of meaning-making processes, negotiations, and transformations. Based on the findings, it is suggested that the Personal Position Repertoire could potentially be strengthened by the addition of an internal existential position to its standard repertoire, at least when working with military personnel and/or veterans.
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.