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Vietnam War veterans are a sometimes overlooked subgroup of the aging baby boomer generation. Forty years after the war ended, war veterans still seek out VA or Vet Center counselors to assist with traumatic stress symptoms. However, there currently are no specific age-related protocols for treating older war veterans suffering from posttraumatic stress disorder (PTSD), nor have established PTSD interventions incorporated gerontology content for these older trauma survivors. This pilot study juxtaposed life review within regular PTSD group counseling for 12 Vietnam veterans at a community-based Vet Center using a partial crossover design. The Life Review and Experiencing Form (LREF) structured the delivery of the life review component. T-tests and repeated measures ANOVA were used to examine depression and self-assessed wisdom outcomes using measures previously tested with older adults. Findings suggest that life review prior to PTSD group therapy has clinical benefits for reducing symptoms of depression and increasing self-assessed wisdom. The study illuminates the possible relationship of traumatic stress symptom effects on the natural reminiscing process for older veterans and provides insights into methods for more age-appropriate treatment for trauma survivors participating in Vet Center and VA programs nationwide.

Background: Current thinking in health recognises the influence of early life experiences (health and otherwise) on later life outcomes. The life course approach has been embedded in the work of the World Health Organisation since the Ageing and Health programme was established in 1995. Yet there has been limited debate on the relevancy of a life course lens to understanding health service utilisation. Aim: The aim of the review was twofold. Firstly, identify existing healthcare utilisation frameworks other than the dominant Andersen’s behavioural model currently in use. Secondly, to identify if current frameworks incorporate the advocated life course perspective in understanding health service utilisation.     Methods: A scoping review of PubMed, Cinahl Plus, Emerald, PsycINFO, Web of Knowledge and Scopus was conducted. Data extraction used a framework approach with meta-synthesis guided by the four domains of the life course proposed by Elder (1979): human agency, location, temporality and relationships, and interdependencies. Results: A total of 551 papers were identified, with 70 unique frameworks (other than Andersen’s Behavioural Model) meeting the inclusion criteria and included in the review. Conclusion: To date there has been limited explicit discussion of health service utilisation from a life course perspective. The current review highlights a range of frameworks that draw on aspects of the life course, but have been used with this perspective in mind. The life course approach highlights important gaps in understanding and assessing health service utilisation (HSU), such as utilisation over time. HSU is a complex phenomenon and applying a structured framework from a life course perspective would be of benefit to researchers, practitioners and policy makers.

Vietnam War veterans are aging into their late 60s and early 70s. In spite of an increase in older treatment-seeking veterans, none of the recommended PTSD psychotherapy techniques emerging within the past 3 decades includes integration of a life span perspective. In an effort to bridge the gap between PTSD and life span perspective interventions, this article describes an exploratory random-assignment, partial cross-over feasibility study that compared 2 different sequences of life review and PTSD group therapies with 2 groups of Vietnam War veterans (total N = 9) within a community-based Veterans Affairs Readjustment Counseling Vet Center. Participants were assessed for PTSD symptoms, morale, satisfaction with life, and late-onset stress symptomology. Types of reminiscence factors (as scored on the Reminiscence Function Scale RFS) were also observed for significant changes from pretest to posttest. Findings suggest that the sequence of life review attendance before regular PTSD group therapy may contribute to clinically and statistically significant reduction in PTSD and late-onset stress symptoms, and improved life-satisfaction. Both group conditions also appeared to have some slight benefit for morale. By better elucidating the relationship among reminiscence, life review, and PTSD, these findings may contribute to more effective services for older veterans participating in Vet Center and VA PTSD programs nationwide.