Revisiting Living in Limbo to Illustrate a Pastoral Psychological Understanding of Transition from Military to Civilian Life
The transition from military to civilian life includes a multitude of challenges for service members and their significant others. This transfer from one context to another can include, but is not limited to, a need for an identity shift, cultivation of an alternate mind-set, social reorientation, a search for employment, grief and sadness due to the loss of camaraderie, and/or experiences of alienation and estrangement from civilian society. Although the social sciences dominate this research field and dub it ‘transition,’ the ambiguity of the process can be further advanced through pastoral psychology. This article rethinks and reinterprets qualitative data to develop a pastoral psychological understanding of veterans through Capps and Carlin’s lens of living in limbo. This pastoral psychological construct embraces the ambiguity of the transition to civilian life and addresses it as a potentially complex and acute limbo situation. This construct can resonate with both veterans and significant others while also assisting pastors in providing care and counseling.
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.