Veterans’ Identities and Well-being in Transition to Civilian Life – A Resource for Policy Analysts, Program Designers, Service Providers and Researchers
Abstract: This Technical Report highlights important implications for policy and program development, service delivery, communications, commemoration and societal recognition. Transitioning Veterans can have a more difficult time adjusting if they do not form identities with groups outside the military and integrate them into their military identity. During participation in the Invictus Games, Veterans with chronic health problems identified as athletes rather than ill or injured. Identity research explains why Veterans helping Veterans (peer support) is important in helping Veterans deal with identity challenges as they adapt to civilian life. The research shows how civilians can become sensitive to Veterans’ identities. It is important, for example, to ask Veterans what works for them in recognition, rather than making assumptions about how best to recognize and commemorate them. Finally, the report suggests priorities for research needed to answer remaining important questions about Veterans’ identities and well-being.
Abstract: Context: In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Objective: Examine temporal trends in opioid prescribing, pain, and opioid overdoses among Veterans near the end of life. Methods: Retrospective, time series analysis of VA decedents between October 2009 and September 2018 whose next-of-kin participated in VA's Bereaved Family Survey (BFS). Using multivariate regression to adjust for sociodemographic and clinical covariates, we examined temporal trends in outpatient opioid prescribing, uncontrolled pain based on BFS report, and opioid overdose-related hospitalizations, in the last month of life, overall and by clinical diagnosis (cancer versus non-cancer). Results: Among 79,409 decedents, mean daily outpatient opioid dose in morphine milligram equivalents in the last month of life decreased from 4.6 mg in 2010 to 2.1 mg in 2018 (adjusted change -0.20 mg/year; P