PTSD Symptoms and Dementia in Older Veterans Who are Living in Long-Term Care
Co-occurring posttraumatic stress disorder symptoms and dementia can result in increased symptoms, such as suspicion, aggression, and nightmares in Veterans that can be difficult to manage in long-term care environments. The objective of the study was to explore how the co-occurrence of posttraumatic stress disorder symptoms and dementia are understood in Canadian Veterans who are living in long-term care. A descriptive multiple case study was conducted in two Veteran long-term care facilities in Canada. Data collection consisted of semi-structured interviews with Veterans, their family caregivers, and health care providers, non-participant observation, and a chart audit. Three major themes emerged relating to symptom expression and care approach: a) symptoms are the same but different; b) differences in the complexity of care; and c) added dimensions involved in care. The results of this study contribute foundational information about co-occurring posttraumatic and dementia symptoms that can inform policy, care approaches, and potential interventions.
Abstract: One of the key achievements of Forces in Mind Trust’s (FiMT) Our Community - Our Covenant series of reports, beginning in 2016, has been to establish a toolkit for local authorities to help them develop support for their local Armed Forces Community (AFC). The 2016 report launched the idea of a “core infrastructure”, supported by self-assessment questions and some wider tips. Formal research and informal engagement show that the toolkit still provides an important contribution to successful local delivery of Covenant pledges and wider AFC support. It’s a baseline in the face of ever-present funding stresses and a point of reference when there are changes in member and officer responsibilities. This means it is important that the toolkit remains up to date. It was last reviewed in 2022 and presented as an Annex to FiMT’s research report A Decade of the Covenant. Since then, there has been further research into local support for the Armed Forces Community for the next iteration of the Our Community - Our Covenant series. This updated toolkit reflects these recent findings about local practice as well as developments following the introduction in the Armed Forces Act 2021 of the duty of due regard to the principles of the Covenant in the focus areas of housing, education and healthcare. As with the original document, the toolkit remains targeted at local authorities. It covers their own direct role in supporting the local AFC, but also the crucial activity of convening local partnerships and so enabling effective local collaborative action. The key changes to the core infrastructure and self-assessment cover: (1) More emphasis on embedding AFC support into the mainstream of local authority work. (2) An extended top tips section with more advice based on recent research. (3) We have dropped the descriptive scenarios of challenges that members of the AFC face. These have now been overtaken by analytical scenarios included in the freely available national training material and in the Ministry of Defence’s (MoD) Covenant Legal Duty toolkit, which helps to explain the legal duty aspect of the Covenant. (4) Some additional material about the individual roles, collaboration, communication and vision and commitment elements of the core infrastructure. This toolkit update is being made in spring 2025 at a time when further change in the Covenant environment is likely, with potential extension of the Covenant duty and expected re-organisation in English local government and creation of new combined or strategic authorities. Additional modules could be added to the toolkit to reflect these ongoing policy developments.