For some vets, the war never ends
Health issues mount with age for Canada’s traumatized soldiers
Hubert Gray doesn’t sleep well at night.
The days are fine but when he closes his eyes under the cover of darkness he’s haunted by a time long past. A time of bullets and blood, of dismay and death.
“I fight the whole bloody war all night. I don’t understand PTSD but you’re constantly worried ‘Is somebody gonna attack or not?’ Quite often (I relive) the actual battle.”
For Lieut. (Retired) Gray, that battle was in 1951 in Korea, a brutal affair that inflicted high casualties on all sides.
“It was quite a slaughter at Kapyong. We had 68 howitzers supporting us, we had the Royal Australian Air Force supporting us ... The Chinese at that point would charge into our barrage and we couldn’t understand why. They just kept coming to be slaughtered.”
Nightmares, flashbacks and intrusive thoughts are the hallmarks of post-traumatic stress disorder and some veterans of long-ago conflicts such as the Second World War and the Korean War have endured it for decades. But now, in their twilight years, some of these old soldiers are back in the trenches as they battle Alzheimer’s disease and other forms of dementia.
“One of our crew is in Victoria. He’s very disabled, he lives in bed constantly. He has no wife as she passed away and he is literally a vegetable,” said Gray, who believes a combination of old age and dementia has taken its toll on his comrade.
And for some former combatants, dementia’s journey can be terrifying.
“What some veterans do is they learn how to cope with the memories or emotional responses from these events and they can actively suppress them, avoid them or distract themselves from both thoughts and emotions. But as the brain ages, especially with dementia, effective suppression just doesn’t happen any longer,” said Dr. Kris Rose, a Calgary psychologist who specializes in PTSD treatment for members of the Armed Forces and first responders.
“You can distract yourself from disturbing things throughout a lifetime and get pretty good at it but as soon as you lose that cognitive capacity, all those things you’ve been keeping at bay can intrude back in again.”
A 2010 study in the Journal of the American Geriatrics Society found that veterans over 65 who suffered PTSD were twice as likely to be diagnosed with dementia as were veterans without a PTSD diagnosis. The researchers said the study didn’t definitively establish that one leads to the other. “We need to learn whether PTSD is the direct cause of dementia or whether those with PTSD share another risk factor.”
In Canada, one in 11 Canadians over 65 is living with dementia and the risk doubles every five years after age 65. For those over 80, the numbers rise alarmingly. One in three Canadians over 80 is living with dementia, according to the Alzheimer’s Society.
The majority of dementias are non-reversible and cannot be corrected. While PTSD can be treated, it’s emotionally and physically exhausting and experts say help is hard to find with few dedicated facilities across the country.
“We try to get them to relive their memories to the greatest extent possible which is a miserable process. To them, to have to open up after all these years is a tough one,” Rose said.
“A lot of people assume with older vets we shouldn’t be doing that. We used to water it down a little bit for the older guys as they had so many stories. There was so much stuff in terms of intrusion. But the same treatments you can use with younger people are still effective with older groups.”
During, and after their service in the Second World War and Korea, soldiers, sailors and airmen experiencing difficulties were considered to have shell shock or combat fatigue. PTSD wasn’t officially recognized until 1980 when the American Psychiatric Association added it to the Diagnostic and Statistical Manual of Mental Disorders. Even after that, most veterans suffered in silence, unable or unwilling to burden their loved ones with the terrible memories of what they experienced in battle.
“When I came back from Korea it was too soon after the Second World War. People were getting married, having families, buying houses,” recalls Gray. “No one wanted to hear about it. We were nothing at that point.”
After all these years, he still can’t push away dark memories of the two-day battle to protect a crucial hill from more than 5,000 attacking Chinese. In exact detail,
he recounts the horrific death of a young Canadian soldier standing right beside him.
“That bothers me sometimes. I think why him instead of me?
“The memories come up when I’m with some of the vets. That’s an open and true discussion. But as you age, they fade away and die. I resent that when it happens.”
As of March 2016, Veterans Affairs Canada estimated there were 61,300 Second World War veterans remaining, with an average age of 92. There are 8,400 vets still alive who served in the Korean War, with an average age of 84. Of the total from both wars, 5,900 live in Alberta.
The bulk of those veterans live at home but as of September 2016, 6,209 veterans were in government-funded, long-term care beds in approximately 1,500 facilities across Canada.
“The care and well-being of veterans and their families is a priority for Veterans Affairs Canada, and the department places the highest priority on making sure our veterans have the support they need when they need it,” said Marc Lescoutre, a spokesman for Veterans Affairs Canada.
In addition to long-term care benefits, eligible veterans can receive a range of services and benefits, including the Veterans Independence Program that helps them stay in their own home as long as possible. The program includes personal care, housekeeping and grounds maintenance.
As of March 31, 2016, that pro- gram was providing support to approximately 56,000 veterans and more than 38,000 primary caregivers and survivors.
There are also several dedicated health facilities across the country for veterans, including Toronto’s Parkwood Institute and Sunnybrook Veterans Centre. In Calgary, Carewest dedicates beds to veterans in the Colonel Belcher longterm care centre and also runs an outpatient Operational Stress Injury (OSI) Clinic, a specialized mental health service for veterans, members of the Canadian Forces and eligible members of the RCMP and their families.
There are also private practitioners like Rose, but with a packed patient list, he said he can’t keep up with the demand.
“The big problem ends up being these treatments for traumatic stress, regardless of age, are hard to find. They’re just not widely available. Without (it), the memories just keep coming, coming, coming,” said Rose who diagnosed one elderly patient at age 90.
“He was held in Hong Kong for four years and subjected to all kinds of torture but he was never diagnosed until he saw me and he was 90. He already had 100 per cent compensation for being a PoW but it was the first time diagnosed with PTSD. He was 60 years suffering.”
For veterans with dementia, specialized treatment is necessary, according to the Alzheimer’s Society of Canada. Along with deteriorating symptoms such as memory loss, confusion and loss of other cognitive functions, the images of war are sometimes hauntingly persistent and can cause patients to respond accordingly.
If they feel fear, grief or helplessness — the same emotional tones felt during their war experiences, it’s likely those experiences will come back up again.
“The brain constructs scripts around emotions and it’s a survival thing,” said Rose. “If I’m afraid … what my brain is going to start doing is chucking up other instances in which I felt that before.
“Lots of vets don’t want to talk about it and they’ll push it away. They don’t want to burden family members with what they experi-
enced. That’s where we get a lot of this PTSD and suicide — it gets avoided.”
Veterans Affairs estimates that up to 10 per cent of war zone veterans — including those on peacekeeping forces — will experience PTSD, or at least some of the symptoms associated with it. In 2014, the federal defence department revealed 160 military members (regular forces and reservists) committed suicide between 2004 and March 31, 2014. That compares to 138 soldiers killed in combat between 2002 and 2014.
A U.S. longitudinal study over 40 years (Korean to Gulf war) of veterans’ suicides indicated rates in that country are twice that of the general population. A study of older male combat veterans and ex-PoWs from the Second World War and Korea, the lifetime prevalence of PTSD was 53 per cent.
In Calgary, veterans in distress can seek help from the Calgary Military Family Resource Centre or through Operational Stress Injury Social Support (OSSIS).
As a peer mentor at OSSIS, John Senior has 23 years of service: four times to Bosnia and two tours in Afghanistan. He understands pain and torment.
“We’re not clinical. We’re a safe place to vent where we can relate to combat experiences. We admire those older guys so much. Because of societal pressures, they’ve lived with it for so long. They’ve had to hunker down and carry on. They’re tough as nails.”