The Together Programme: Supporting Caregiving Partners of veterans
Abstract: In a recent analysis conducted by Combat Stress of UK, partners living alongside veterans with mental health difficulties, rates for depression and PTSD were higher compared to the external population (depression 39% Vs 20%, PTSD 17% Vs 3%. (Murphy, Palmer & Busuttil, 2016). As such this suggests the high burden of need within this group. The support currently available here in the UK mainly comprises of peer based support. Whilst research indicates the positive impact peer led groups can have, the clinical severity of partners symptoms implies a need for more structured, bespoke and evidence based intervention. To this end, a bid for funding to support the development of an evidence based intervention ‘The Together Programme’ for UK veterans partners was made and kindly awarded by The Royal British Legion in 2016. Based on review findings, two US psychoeducational programmes, SAFE and Homefront Strong (see glossary) which have been found to be effective and well accepted within the US military population were selected as the most appropriate base to devloop a UK specific injtervention to support military partners.
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.