– This article deals with sensitive topics and themes that may be upsetting or offensive and may also contain triggers for people living with PTSD –
When 85-year-old Keith John McGhee begins to speak, it doesn’t take long to realise that the gravelly vocal tones of this Vietnam war veteran have always commanded enormous respect.
“When I came home from Vietnam on the last trip, I was standing at the door and my wife was working in the kitchen, and I was having a yarn to her,” he says.
“She said ‘You know, you’ve changed this time, what’s wrong?’”
It’s no secret that the emotional impact of combat can have devastating long term effects, but Keith and many other veterans of his vintage are still reluctant to voice these issues.
“I said ‘I’m ok’,” said Keith.
“Because that was at the time when PTSD wasn’t talked about, and you were less than a man if you admitted to it.”
Keith attained the rank of Major in the Australian Armed Forces, and he now finds himself living amongst the other residents at the Bolton Clarke aged care facility in Pinjarra Hills.
There has been no shortage of brave soldiers like Keith who have risked their lives for the good of their country, and many of those who were lucky enough to return home still carry an unwanted piece of the experience with them
Post-traumatic stress disorder (PTSD), or shell-shock as it is commonly referred to, is a psychiatric condition that affects somewhere between 10-20% of war veterans around the globe.
A number of people living with PTSD experience long term mental struggles with anxiety and depression, and sadly there are others who turn to suicide.
“I’ve got two really good carers who give me a tolerance that they don’t give others,” said Keith.
“And that psychiatrist that sees me had a little bit to do with me opening up.”
Although it seems unfathomable that a gentleman as brave as Keith could be fearful of sharing his experiences, hearing them told in graphic detail hammers home the realities of war that Hollywood often glosses over.
And while a number of veterans experience PTSD after an accumulation of events, Keith is very mindful of the specific incident that triggered the condition within him.
“I was lying on the ground in what felt like an indention in the grass and I heard the bush up ahead rustling and I thought it was wild pigs because I had heard that they had been eating bodies.
“An enemy appeared and he had an AK-47 in his hands and I wasn’t sure if he saw me and was going to shoot the shit out of me,” said Keith.
Keith lay in the grass close to his enemy for almost two hours knowing that all it would take was a noise to give away his position while contemplating if he should make the first move.
“There was sweat dripping into my arse and there was an ant crawling up my back and I was praying he wouldn’t bite me.
“I eventually made the decision to fire and I got one round off and hit him in the side of his face.
“I then emptied everything I had into his head and I felt the blood spray on my face,” said Keith.
While a story like this can be difficult to read, it’s virtually impossible to understand the mental consequences for those involved.
“I didn’t look at him, and I didn’t check on him, but when we got to a safer area I really began to sweat, then I started to shake, and then I started dry retching.
“Others that I had killed had been in the middle of an ambush but this was one-on-one, so close. I thought he was gonna do me in. It was him or me. It felt cold-blooded,” said Keith.
Despite this incident occurring close to 60-years ago, the negative influence of Keith’s combat days is still extremely present in 2019.
“I had an incident the other night where a bloke came in my room with an AK47 and he went over under the desk in my room. I pressed the buzzer and called the nurse and they said that there’s no one there,” said Keith.
“They put the lights on and there’s nobody there, so that’s a dream or something and that happens occasionally.”
Suppressed memories of atrocities and the guilt for things that you may have done, or not done, in the heat of battle are an extremely heavy burden that many veterans struggle with on a regular basis.
While bedtime is usually synonymous with relaxation, it can actually be the most confronting part of the day for some war veterans, with many enduring decades worth of horrific dreams and night terrors that result in waking up scared and anxious.
Hallucinations are also a common symptom of PTSD along with hyperarousal and anxiety that reduces veterans to a state of perpetual fear regarding their own safety.
People’s exposure to traumatic experiences can be very different, and many are reluctant to share information which can make it difficult for aged care staff to identify triggers that have a negative effect on veteran residents.
This makes communication between staff a vitally important cog in putting together the right care plan and identifying potential triggers for an individual.
Loud noises are well known to be a common trigger for veterans living in aged care as well as overexposure to media like television and newspapers.
Changes to staff and unfamiliar faces are also a common trigger along with engaging in arguments and being told to do things rather than encouraged.
“It’s about routine and certainty. Like the sun coming up,” said Keith.
In the event that a trigger does occur, aged care staff needs to get involved very quickly if there appears to be a safety concern for the resident or the people around them.
Having prior knowledge and understanding of the resident is the most important skill set required to ease a person out of a bad situation.
Addressing a veteran resident by their rank (e.g. Major, Colonel, etc.) instead of their name can also be an effective way to break through.
It is believed that war veterans living with PTSD are almost two times more likely to develop dementia than veterans who are not diagnosed with PTSD and having both conditions can make social integration increasingly difficult.
It is important to remember that despite some potential environmental triggers, the essence of caring for a person living with PTSD is exactly the same as caring for anybody else.
Personal insight and understanding are the foundations of person-centered care, and we need to do our best to ensure that the aged care in this country is worthy of a salute from our veterans.
For more information and support regarding PTSD in Australia, please visit https://www.openarms.gov.au/ or call 1800 011 046