Aging Veterans with Disabilities The number of older war veterans receiving disability benefits is steadily growing and is predicted to rise in the next decade. This book provides comprehensive knowledge about health and psychosocial concerns of veterans aging with disabilities and unmet needs and compares policy in three countries that have been involved in massive warfare in the 20th century – the United Kingdom (UK), the United States (US), and Israel. Using a cross-national comparative study of the policies, legislation, and services provided by these three countries, which have significant numbers of aging disabled military veterans, this book provides evidence-based knowledge on the trajectories and attendant mental health and psychosocial problems this sub-group faces when aging with a disability. It sheds light on the paradox in which most veterans with disabilities in the UK, US, and Israel are older, while the current legislation and budget target younger veterans with disabilities. The book reflects the current debate regarding the desired policy toward older veterans with disabilities in these countries and whether to provide them with proactive health services prior to retirement to prevent “accelerated aging.” It also evaluates the dilemma of whether to serve aging veterans separately as a unique population or to provide them with the same services used by the general population. This book will be of interest to all academics and students working in disability studies, rehabilitation studies, gerontology, psychology, sociology, social work, social policy, and law more broadly. Arie Rimmerman is Richard Crossman Professor of Social Welfare and Social Planning and founder Dean of Social Welfare and Health Sciences and head of School of Social Work at the University of Haifa, Israel. His research focuses on comparative disability policies, particularly in areas of employment, civic society, family support, and aging with disability. Routledge Advances in Health and Social Policy Planning Later Life B ioethics and Public Health in Ageing Societies E dited by Mark Schweda, Larissa Pfaller, Kai Brauer, Frank Adloff and Silke Schicktanz E ffective Interventions for Unemployed Young People in Europe S ocial Innovation or Paradigm Shift? E dited by Tomas Sirovatka and Henk Spies S ocial Research in Health and Illness Case-Based Approaches C onstantinos N. Phellas and Costas S. Constantinou E thnic Identity and US Immigration Policy Reform A merican Citizenship and Belonging amongst Hispanic Immigrants M aria del Mar Farina R esearch and Evaluation in Community, Health and Social Care Settings E xperiences from Practice E dited by Suzanne Guerin, Nóirín Hayes and Sinead McNally C ritical Discourses of Old Age and Telecare Technologies Gizdem Akdur Aging Veterans with Disabilities A Cross-National Study of Policies and Challenges Arie Rimmerman F or more information about this series, please visit: www.routledge.com/ Routledge-Advances-in-Health-and-Social-Policy/book-series/RAHSP Aging Veterans with Disabilities A Cross-National Study of Policies and Challenges Arie Rimmerman First published 2021 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 52 Vanderbilt Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2021 Arie Rimmerman The right of Arie Rimmerman to be identified as author of this work has been asserted by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice : Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Names: Rimmerman, Arie, author. Title: Aging veterans with disabilities : a cross-national study of policies and challenges / Arie Rimmerman. Description: Abingdon, Oxon ; New York, NY : Routledge, [2021] | Series: Routledge advances in health and social policy | Includes bibliographical references and index. Identifiers: LCCN 2020020585 (print) | LCCN 2020020586 (ebook) | ISBN 9780367335908 (hardback) | ISBN 9780429323805 (ebook) Subjects: LCSH: Disabled veterans—Government policy—Case studies. | Older people with disabilities—Government policy—Case studies. | Disabled veterans—Great Britain. | Disabled veterans—United States. | Disabled veterans—Israel. Classification: LCC UB360 .R67 2021 (print) | LCC UB360 (ebook) | DDC 362.4086/97—dc23 LC record available at https://lccn.loc.gov/2020020585 LC ebook record available at https://lccn.loc.gov/2020020586 ISBN: 978-0-367-33590-8 (hbk) ISBN: 978-0-429-32380-5 (ebk) Typeset in Times New Roman by Apex CoVantage, LLC To my mother, Raya Rimerman Contents List of figures and tables viii Preface ix Acknowledgment xi Introduction 1 1 Welfare and warfare and policies toward veterans with disabilities in the United Kingdom, the United States, and Israel 4 2 Aging with disability 33 3 Health and psychosocial concerns of aging veterans with disabilities 55 4 Government policies towards aging veterans with disabilities 76 5 Proposed policy to address unmet needs of older veterans with disabilities in Israel 100 6 Closing remarks: insights regarding cross-national policies towards aging veterans with disabilities 117 Index 123 Figures and tables Figures 1.1 20th-Century Veterans Spending in the United States from 1900 to 2020 14 3.1 Number of Recipients of Disablement Pensioners and War Widow(er)s from 2008–9 to 2018–9 59 4.1 VHA Geriatrics and Extended Care Programs 87 5.1 Monitoring Flow Chart 113 Tables 3 .1 Recipients of War Pensions Scheme (WPS) by Age Band and Percentage of Disablement, March 31, 2019 58 3 .2 All Recipients of Disability Benefits by Disablement Percentage 60 3 .3 The Five Most Prevalent SC Disabilities of All Compensation Recipients (2014 to 2018) 61 3.4 Distribution of IDF Veterans with Disabilities by Age (N = 51,454) 62 3.5 Distribution of Aging Veterans with Disabilities by Medical Disablement Percentages 62 3.6 Veterans Reported Secondary Conditions by Age Group (in %) (2011) 67 4.1 Benefit Programs Available to Ex-servicemen and Women and Veterans with Disabilities 81 4.2 Benefits Provided to Israeli Mid-life and Aging Veterans with Disabilities 94 5.1 The Status of the MoD’s Current Services 108 Preface T he number of veterans with disabilities in Western countries is steadily declin- ing and will probably continue to decrease, assuming there is no war or major warfare. However, the number of older war veterans receiving disability benefits is steadily growing and is predicted to rise in the next decade (F letcher et al., 2016 ). This is evident in three countries that have been involved in massive war- fare in the 20th century – the United Kingdom, the United States, and Israel. More than half of those receiving benefits for their military disabilities are senior citizens, and the number is expected to reach about two-thirds of the total number of recipients in 2030. T hese countries have different approaches to warfare and welfare spending and have therefore been selected for comparison of their policies toward aging veterans with disabilities. The book sheds light on the paradox of the 21st century as most of the veterans with disabilities in these countries are older, while the current budget targets younger veterans with disabilities (S hay & Yoshikawa, 2010) . Furthermore, most of the legislation is still aimed at handling the health needs of young veterans with disabilities and integrating them into the labor market. M y interest in writing this book began in 2006, when I was asked by the Division of Rehabilitation in the Ministry of Defense (MoD) to examine and assist them in revising their rehabilitation model, which – at that time – leaned toward the medical model, and to align it with international standards of the functional-social model of rehabilitation ( Tal-Katz, Araten-Bergman, & Rimmerman, 2011 ). At the same time, my doctoral student, Patricia T al-Katz (2010) , wrote her dissertation on “Attachment, acceptance of disability, hope and social networking as predic- tors of activities among Israel Defense Forces (IDF) veterans with disabilities.” She studied a large sample of IDF veterans with disabilities in northern Israel, revealing that older veterans with psychiatric and cognitive disabilities reported lack of social support in comparison to those with physical disabilities, indicating their vulnerability and unmet needs. M y next research engagement with older veterans with disabilities was while advising Yitschak Shnoor in his dissertation. In his doctoral thesis, completed in 2016, he provided a secondary analysis of his data collected in 2011 as a researcher at the Myers-JDC Brookdale Institute on behalf of the MoD. The study shifted