They risk their lives to defend our country. They leave family and friends, the familiar and comfortable, and bravely put themselves in harm’s way for others.

When they come home, military veterans face many challenges, including a higher risk of developing dementia.

According to the U.S. Department of Veterans Affairs, there are more than 560,000 veterans living in Michigan and more than 19.5 million across the country. Of those — using national prevalence rates of dementia applied to veteran population estimates — the Veterans Health Administration (VHA) estimated nearly 768,000 veterans nationwide living with dementia in 2019. As the population ages, that number is expected to grow.

Evidence indicates that even those who experience mild traumatic brain injury (TBI) are at increased risk for dementia, according to the Alzheimer’s Association. And, the risk of dementia increases with the number of TBI sustained. More than 410,000 veterans have been diagnosed with TBI since 2000.

Post-traumatic stress disorder (PTSD) also has been linked to an increased risk of dementia, possibly a doubling of the risk. PTSD is two to five times more common in veterans compared with the general population. From 2000-2015, more than 167,000 service members were diagnosed with PTSD.

Michigan resident Tim Welbaum, a military officer serving in the U.S. Army Reserve and owner of Visiting Angels South Central Michigan in Adrian, lives with PTSD from his 2014-2015 deployment to Afghanistan where he commanded a Vertical Engineer Company containing more than 200 soldiers.

“PTSD has resulted in memory loss for both myself and my Visiting Angels’ colleague Scott Doney, who also served with me in Afghanistan,” Welbaum said. “We know how scary memory loss can be from our own accord, and as a home care agency operator and owner, we understand how detrimental the disease is to both the loved one who suffers from it and the family who supports them.”

Visiting Angels specializes in providing home care and respite services for all residents throughout their community — including many veterans — in Lenawee, Hillsdale and Jackson counties. Many of those whom Visiting Angels care for are living with Alzheimer’s or another form of dementia.

“As a result of COVID-19, the demand for home care services has drastically spiked. The trend we’re seeing is the adult children removing their parents or loved ones from facilities such as assisted living or nursing homes in an effort to move them away from the higher risks of contracting COVID while living around others,” said Welbaum, who along with Doney and others have raised nearly $140,000 for Alzheimer’s support, care and research through their Vets March to End Alzheimer’s. “The largest issue we now face throughout the home care industry is finding caregivers to keep up with the heavy demand for our services.”

The significant impact of COVID-19 on an already vulnerable population, combined with the large increase in the number of veterans with Alzheimer’s and other dementias, places a heavy burden on the health care system.

According to the Alzheimer’s Association, veterans with dementia are 2.6 times more likely to be hospitalized than other veterans — and hospital stays are, on average, 2.4 times longer. The average number of outpatient psychiatric visits is three times greater among veterans with dementia than veterans without, and more than 60% of the VA’s costs of caring for those with Alzheimer’s are for nursing home care.

Samantha Wright, FNP GNP DNP, a family nurse practitioner at the Aleda E. Lutz VA Medical Center in Saginaw, has worked closely with Michigan veterans for years and sees first-hand the challenges they face.

“Access is an issue. There aren’t enough providers, geriatricians or cognitive rehab programs in Michigan,” said Wright, whose dad was a Vietnam Veteran. “Additionally, primary care providers often don’t feel comfortable diagnosing dementia or doing cognitive scoring. And once they do have a diagnosis, there’s often a sense of not knowing what to do next.”

To combat some of the challenges veterans with dementia and their caregivers face, the VHA launched its Dementia System of Care to provide comprehensive, coordinated, person-centered care for veterans with dementia and their caregivers. It also has recently expanded its caregiver program, which provides resources, education, support, a financial stipend and health insurance (if eligible), beneficiary travel (if eligible), to caregivers of eligible Veterans.

For more information, visit caregiver.va.gov/support/support_benefits.asp or alz.org/gmc.