Geriatric Mental Health Disaster and Emergency Preparedness

Chapter 16 The Experience of Vulnerability in Geriatric Combat Veterans 337
endorse this belief, do not rest any easier at night or in their quiet solitary
moments. Perhaps they reach backward to the archetype of the warrior in
search of the self lost in the depth of this conflict: the self that had to survive
and react rather than respond, or the self that found choices limited—
each one uglier and more distasteful than the last—but that chose within
the limits and lives now in fear of those limits.
As was indicated in the first section, psychosocial rehabilitation offers
a context in which to develop strategies to reduce feelings of helplessness,
powerlessness, and frustration. Veterans’ expressed need to be of service to
and involved with military personnel serving in Iraq and Afghanistan has
resulted in some providers in mental health clinics encouraging, supporting,
or starting such initiatives. These therapeutic activities include packing
boxes of needed items for shipment to units or individuals, visiting
the wounded in the hospital, and participating in social activities with the
wounded through the Wounded Warrior Program .
Another area in which some older veterans participate is mentoring
younger veterans as they attempt to confront their trauma, encouraging
them to make use of the opportunity for therapy. Other older veterans also
help young veterans find their way around the hospital. It doesn’t matter
whether or not the geriatric veteran has received a warm welcome, a cold
reception, or no acknowledgment at all. By and large, they are moving out
of their once-insular world and treating this newly returning cohort with
sensitivity, dignity, and respect. Ironically, the activities focused on the
newest cohort have served to bridge a gap among the differing cohorts of
geriatric combat veterans. They have created some unity, which has overcome
the competitive and bitter feelings of the past about who were the
victors and who were the vanquished.
A number of the existential and spiritual questions raised by these veterans
emerge out of the growth and reflections normal to this and the previous
stage of the life cycle. For some, these questions are not new but were
ever present on the horizon of their consciousness. Often one or more of
these questions is related to the early presentation for treatment. These
questions, for some, may become submerged in the initial phase of treatment
as the worst trauma is confronted and its impact is understood. Over
time, as the traumatic material is processed and integrated, these existential
or spiritual questions resurface and become the focus of therapy:
n Am I capable of doing good?
n What legacy do I leave?
n What is left for me to do?