The experiences of place: Veterans with dementia making meaning of their environments
Little research has examined how older veterans view the long-term care facility as place and how they make meaning of their experiences within specific places. This study examined seven older veterans’ meanings of place within the cognitive support unit of a veteran's hospital and in a summer camp setting. In the facility, the environment was interpreted as restrictive. At camp, the environment was interpreted as freeing. Each of the environments was experienced within the horizons of meaning of residents’ lives [Gubrium, J.F., 1993. Speaking of Life: Horizons of Meaning for Nursing Home Residents. Aldine de Gruyter, Hawthorne, NY.]. What was evident here was that the experiences in both places, both in the moment and through horizons of meaning, contributed to how residents created a sense of place in these two distinct environments.
Abstract: Background: Exposure to potentially morally injurious events (PMIEs) during military service can lead to moral injury (MI) outcomes and posttraumatic stress symptoms (PTSS). This longitudinal study examined the relationships between PMIE exposure, MI outcomes, and PTSS among Israeli combat veterans, and the potential protective role of dispositional forgiveness in these associations. Method: Participants were 169 Israeli combat veterans who participated in a six-year longitudinal study with four measurement points (T1: 12 months before enlistment, T2: Six months following enlistment- pre-deployment, T3: 18 months following enlistment- post-deployment, and T4: 28 months following discharge). Participants’ characteristics were assessed via semi-structured interviews (T1) and validated self-report measures (T2-T4) between 2019-2024. Results: Approximately 36% of participants reported exposure to PMIEs during service, with 13% exceeding the clinical threshold for probable PTSD at T4. PMIE-Betrayal at T3 was positively associated with MI outcomes of shame and trust violation at T4. The indirect effect of PMIEs on PTSS through MI outcome-Shame depended on forgiveness levels. Among veterans with low forgiveness, higher exposure to PMIE-Betrayal was associated with increased MI shame, which was linked to more severe PTSS. Conversely, for those with high forgiveness, exposure to PMIE-Self and Other was associated with decreased MI shame and subsequently reduced PTSS. Conclusion: Dispositional forgiveness moderates the relationship between PMIE exposure and MI outcomes, particularly shame, which mediates the development of PTSS. These findings highlight forgiveness as a potential target for intervention in treating moral injury and preventing PTSS among combat veterans.