{"id":69962,"date":"2023-06-02T10:00:00","date_gmt":"2023-06-02T10:00:00","guid":{"rendered":"https:\/\/one.sightlinemg.com\/marinecorpstimes\/uncategorized\/2023\/06\/02\/america-faces-a-tidal-wave-of-aging-military-veterans\/"},"modified":"2026-08-08T15:26:01","modified_gmt":"2026-08-08T15:26:01","slug":"america-faces-a-tidal-wave-of-aging-military-veterans","status":"publish","type":"post","link":"https:\/\/one.sightlinemg.com\/marinecorpstimes\/veterans\/2023\/06\/02\/america-faces-a-tidal-wave-of-aging-military-veterans\/","title":{"rendered":"America faces a tidal wave of aging military veterans"},"content":{"rendered":"\n

Editor\u2019s Note: This <\/i>article<\/i><\/a> first appeared on <\/i>The War Horse<\/i><\/a>, an award-winning nonprofit news organization educating the public on military service. Subscribe to their <\/i>newsletter<\/i><\/a>.<\/i><\/p>\n\n\n\n

For decades, dawn brought the clarion bugle call of reveille across the lush campus of the Veterans Home of California in Yountville, 60 miles north of San Francisco. The residents, the earliest among them veterans of the Mexican-American war, rose early and dressed in strict accordance with a uniform-like code.<\/p>\n\n\n\n

In the late 1800s and early 1900s, the veterans home was a working farm<\/a>, with chickens, pigs, and a whole herd of cattle, along with apple, peach, and plum orchards. The men spent long days tending to the animals and working the land. The labor was believed to be restorative, giving order and purpose to generations of veterans suffering from what would soon become known as \u201cshell shock<\/a>.\u201d<\/p>\n\n\n\n

\"Members
Members of the Navy Band Northwest perform at the Veterans Home of California in Yountville, California, in 2018. (MCS2 Jacob G. Sisco\/Navy)<\/figcaption><\/figure>\n\n\n\n

Nearly 150 years later, the facility is still in operation. After years of funding and other challenges \u2014 one inspection in 2016 found 14 separate fire safety deficiencies \u2014 investments<\/a> in the home have ensured its future continuing to care for California\u2019s veterans. No longer a working farm, the campus is home to more than 1,000 veterans, most of them elderly, with levels of support ranging from independent living to skilled nursing. Today, the campus hums with activity, as construction equipment reshapes the nation\u2019s largest veteran home into one that can effectively and compassionately meet the changing needs of the state\u2019s aging veteran population.<\/p>\n\n\n\n

As Vietnam and eventually Gulf War-era veterans grow older, they bring with them new needs, different expectations for care, and greater diversity than the Korean War and World War II veterans who came before them. The Department of Veterans Affairs and veterans organizations across the country are working to care for a new generation of older veterans who tend to have greater expectations for longevity and independence than earlier generations, yet also may struggle with more complex medical conditions.<\/p>\n\n\n\n

\u201cWe\u2019re kind of compounding multiple variables, in the sense that not only are people living longer, but \u2026 many of them survived something that wasn\u2019t survivable,\u201d says Scotte Hartronft, the director of geriatrics and extended care at VA. \u201cA lot of veterans have survived significant injuries over the last couple of conflicts that [they] wouldn\u2019t have survived in previous wars.\u201d<\/p>\n\n\n\n

In California, the most populous state in the nation and home to the highest number of veterans, the California Department of Veterans Affairs, known as CalVet, the state\u2019s veterans department, is working to create a modern facility that centers the needs and dignity of older veterans. While the Yountville Veterans Home is unique \u2014 as the largest and one of the oldest veterans homes in the nation \u2014 across the country, people charged with caring for veterans grapple with the same question that drives the redesign of the facility: How do we best care for those who have served on our behalf as they grow old?<\/p>\n\n\n\n

\u2018The bulge of the snake is veterans over 55\u2032<\/h2>\n\n\n\n

Yountville Veterans Home is one of eight facilities across California that provide long-term care for older and disabled veterans, and sometimes their spouses \u2014 part of a legacy that dates back to the decades after the Civil War, when states opened soldiers\u2019 homes to care for the sudden influx of struggling veterans.<\/p>\n\n\n\n

With a veteran population of more than 1.6 million in 2020, California is home to a sizable percentage of the nation\u2019s veterans \u2014 a population that is steadily growing older.<\/p>\n\n\n\n

\u201cA lot of the focus \u2026 is on OEF\/OIF veterans for obvious reasons, but really, the bulge in the snake, so to speak, of the veteran population in California is certainly over 55,\u201d says Keith Boylan<\/a>, the deputy secretary for veterans services at CalVet.<\/p>\n\n\n\n

\"The
The Michigan Veteran Homes, a branch of the Michigan Department of Military and Veterans Affairs provides, provides long-term care and services to enhance the well-being of the residents who live there. (Lt. Col. Kathryn Prater\/ Michigan National Guard)<\/figcaption><\/figure>\n\n\n\n

Other states see this trend mirrored: Between 2021 and 2041, the number of veterans older than 85 is expected to increase by 31%, according to VA data. In part, that\u2019s because the overall number of veterans nationwide is actually decreasing. During World War II, military service was common; in subsequent wars, the proportion of the population who served has steadily fallen. Between 2000 and 2018, the number of veterans in the country declined by a third<\/a> \u2014 the bulk of Americans who have served in the military served decades ago.<\/p>\n\n\n\n

But Vietnam and Gulf War-era veterans represent a different slice of the population than veterans who fought in World War II and Korea. The number of women veterans over the age of 65 is expected to increase by a staggering 237% between 2021 and 2041, according to data from VA. Racial diversity is also increasing, and the geographic distribution of veterans is shifting.<\/p>\n\n\n\n

This means veterans\u2019 care must change as well. Women, for example, have a greater life expectancy than men do.<\/p>\n\n\n\n

\u201cThey tend to live longer, and by living longer, they tend to [need] more assistance with daily living activity needs,\u201d Hartronft says.<\/p>\n\n\n\n

Women veterans, as a cohort, will require more support to continue to live independently as they age for longer \u2014 a fact compounded by the fact that women, who tend to be informal caregivers to friends and family, often have more difficulty than men in finding their own caregivers when needed.<\/p>\n\n\n\n

Other populations \u2014 such as veterans who live in rural areas, far from health services, or without housing, or who deal with more complex physical and mental ailments \u2014 also require unique approaches to care. And behavioral health support more broadly, especially for veterans who have lived through traumas they might not have survived in earlier conflicts, will be critical in the coming decades.<\/p>\n\n\n\n

\u201cWe\u2019re trying to always think of what programs can help with the specific individual needs and situation \u2014 both the socioeconomic and other situations \u2014 because not one thing fits or works for everybody,\u201d Hartronft says.<\/p>\n\n\n\n

\"Air
Air Force Chief Master Sgt. Ben Bush, the North Dakota National Guard State Command Chief, left, gives a gift and visits with a resident at the North Dakota Veterans Home in 2014, in Lisbon, North Dakota. (Senior Master Sgt. David H. Lipp\/North Dakota National Guard)<\/figcaption><\/figure>\n\n\n\n

In addition to higher rates of post-traumatic stres<\/a>s<\/a> and other conditions affecting mental health, veterans are more likely to be exposed to risk factors, such as traumatic brain injuries or toxic exposure, for Alzheimer<\/a>\u2019s<\/a> and other dementias. Veterans also have a higher chance of being diagnosed with certain types of cancer, like lung<\/a> and skin cancer<\/a>. About 50,000 new cancer cases<\/a> among veterans are reported annually; that number is expected to rise as veterans age.<\/p>\n\n\n\n

\u201cYou\u2019re shrinking the population, but the need is still very high,\u201d says Thomas Martin, the head of future operations and planning for CalVet\u2019s veterans homes. \u201cWe want to try to do our best job to make sure that we\u2019re helping patch any holes in the safety net.\u201d<\/p>\n\n\n\n

\u2018You don\u2019t want to go from home to hospital bed\u2019<\/h2>\n\n\n\n

Veterans homes like Yountville actually aren\u2019t very common. There\u2019s a reason for that: long-term in-patient care can cost thousands of dollars per month, according to AARP<\/a>, and seniors often prefer to live at home, whether for financial, emotional, or other reasons. As baby boomers age, the focus of elder care has increasingly shifted from live-in facilities to aging-in-place services, allowing people to stay in their homes for as long as possible, while increasing support and services as needed. Keeping people at home longer reduces hospital visits, and recovering from some medical procedures at home leads to fewer inpatient complications and<\/a> brings down the cost of car<\/a>e.<\/a><\/p>\n\n\n\n

\u201cWhen it comes to aging in place specifically, we\u2019ve had one of the largest expansions of home care in the VA,\u201d Hartronft says.<\/p>\n\n\n\n

Within the next two years, every VA medical center will offer veteran-directed care<\/a>, a popular program that provides qualified veterans with a stipend to hire local caregivers to assist them with daily living or even companionship. VA is expanding home-based primary care \u2014 which provides health care to veterans at home, many of whom are housebound \u2014 to 75 new sites, as well as expanding its Medical Foster Care program, which allows some veterans to live in a private home with a caregiver, rather than in a nursing home. They\u2019re also piloting a program using predictive analytics to help determine which veterans are at the highest risk of nursing home care in the coming years, to connect them with preventive services.<\/p>\n\n\n\n

\"Marine
Marine Corps Staff Sgt. Amanda J. Eason, a planner at Marine Corps Base Quantico, speaks with a resident at the Heatherwood Retirement Home during a Veterans Day visit in Burke, Virginia, in 2016. (Staff Sgt. Sarah R. Hickory\/Marine Corps)<\/figcaption><\/figure>\n\n\n\n

\u201cOur biggest goal is really advertising the aging-in-place services so that people think of them proactively and don\u2019t only think of them during a crisis,\u201d Hartronft says.<\/p>\n\n\n\n

But for some veterans, continuing to live at home as they grow older isn\u2019t an option \u2014 or they prefer to live with people who understand their history of service.<\/p>\n\n\n\n

\u201cThey wanted to be in an environment of veterans, and surrounded by veterans,\u201d says Martin of residents of California\u2019s veterans homes.<\/p>\n\n\n\n

The Yountville renovation<\/a> \u2014 designed by the architecture firm CannonDesign, and slated to be completed early next year \u2014 aims to set a standard for caring for a diverse population of veterans who want to or need to live in a care facility. The project replaces a 90-year-old hospital building with a state-of-the-art skilled nursing facility and memory care center. The same principles that support the idea of aging in place \u2014 dignity and independence \u2014 guide its design.<\/p>\n\n\n\n

\u201cMost of these people have just come from home,\u201d says David Hunt, who leads CannonDesign\u2019s health practice in Southern California. \u201cYou don\u2019t want to go from home to hospital bed.\u201d<\/p>\n\n\n\n

Instead, the project works to make veterans feel as much at home as possible. Visually distinct \u201cneighborhoods,\u201d each with their own small shared dining and living areas, make up the facility. Designers avoided the glaring fluorescence of a hospital ward, instead using light fixtures that build on research into how the eye changes as it ages, as well as what makes a space feel comforting. The same goes for furniture and decor.<\/p>\n\n\n\n

The more a long-term care facility feels like home, the happier residents are \u2014 and the better their health outcomes are, research shows.<\/p>\n\n\n\n

\"Army
Army Lt. Col. James Key speaks with an Air Force veteran from the Veterans Home in Barstow, California, during a Veterans Home volunteer event in 2019. (Pvt. James Newsome\/Army)<\/figcaption><\/figure>\n\n\n\n

\u201cThey have symptoms of less pain, they eat better,\u201d Hunt says. \u201cSo it\u2019s not just to make it homey. It\u2019s also proven to be medically more efficient.\u201d<\/p>\n\n\n\n

The design considerations promote independence, even among veterans dealing with cognitive impairment or dementia. Visual cues, such as photo murals of \u201camber waves of grain,\u201d help orient residents who can no longer read, and outdoor walking paths enclosed in a garden allow dementia patients to wander without getting lost.<\/p>\n\n\n\n

\u201cYou want to maximize their ability to be independent, to be able to walk around without having to keep a close eye on them,\u201d Martin says. \u201cYou want to make sure that its environment is going to be safe and welcoming.\u201d<\/p>\n\n\n\n

Ultimately, many experts say, what matters is thinking through care in a \u201cveteran-centric\u201d way \u2014 buying into the idea that honoring veterans as they age means taking the time to understand who they are and what they want, and then incorporating that into real-world care considerations.<\/p>\n\n\n\n

Take scooters, for example. When designers from CannonDesign visited the Yountville campus, they realized how many residents got around on motorized scooters.<\/p>\n\n\n\n

\u201cThey\u2019ve got this gorgeous 600-acre-plus community, and those scooters allow them to get around a bit,\u201d says Margi Kaminski, a co-director of health interiors at CannonDesign. \u201cI\u2019m not sure I would call them a status symbol, but they definitely are a big thing.\u201d<\/p>\n\n\n\n

That human experience \u2014 the ease of mobility around the sunshine-soaked campus, the social capital that comes with being one of the scootering set \u2014 translated into real-world design considerations. Architects ensured that rooms were big enough for veterans to about-face their scooters with a three-point turn. There\u2019s even a repair shop on the first floor.<\/p>\n\n\n\n

\u201cIt\u2019s not just about having the bed,\u201d Martin says. \u201cIt\u2019s about having the right environment.\u201d<\/p>\n\n\n\n

This War Horse feature was reported by Sonner Kehrt, edited by Kelly Kennedy, fact-checked by Jess Rohan, and copy-edited by Mitchell Hansen-Dewar. Headlines are by Abbie Bennett.<\/i><\/p>\n\n\n\n

Sonner Kehrt<\/i><\/a> is an investigative reporter at The War Horse, where she covers the military and climate change, misinformation, and gender. Her work has been featured in The New York Times, WIRED magazine, Inside Climate News, The Verge, and other publications. She studied government at the U.S. Coast Guard Academy and served for five years as Coast Guard officer before earning a masters in democracy and governance studies from Georgetown University and a masters of journalism from UC Berkeley.<\/i><\/p>\n","protected":false},"excerpt":{"rendered":"

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