In the fall of 2017, Amanda Carroll ’09 (’12 MS, ’21 PhD) returned to UNC to pursue a PhD in occupational science with a goal of better understanding the relationships between military service, occupational participation, resilience and successful aging for older U.S. military veterans.
“I’ve always been interested in military culture and the way it intersects with life,” said Carroll.
She comes from a military family, and her job as an occupational therapist introduced her to a veteran population that seemed to be particularly resilient – aging adults.
The Research: Military Experience and Resilience
According to Carroll, most veterans’ research to date has focused on the negative, short-term impacts of military service, but less work has taken place to study the positive impacts of service, particularly in older adults.
“During my work as an occupational therapist I began to notice that the aging veterans I worked with would call on their military training when they were dealing with adversity,” said Carroll. “For example, I worked with a Vietnam War veteran who had gotten a hip replacement, and he told me, ‘Don’t worry, I was in Vietnam. I can get through this.’”
Carroll came into the PhD program knowing she wanted to study how occupation, resilience, military service and healthy aging fit together. She launched her dissertation research, a mixed-methods study, in two phases:
- Phase 1, a quantitative study, included surveys about military service demographics, resilience, occupational participation and successful aging.
- Phase 2, a qualitative study, included life history interviews informed by phase 1.
Though the COVID-19 pandemic paused all in-person interactions, Carroll was successful in surveying 41 U.S. veterans over age 65 in phase 1 and conducting nine virtual and phone-based life history interviews in phase 2.
Of the veterans that participated in Carroll’s research, the majority were Vietnam War veterans – the largest cohort of veterans in the U.S. – who are aging into older adulthood.
The Results: Resilience as a Positive Result of Military Service
Based on her quantitative research, Carroll found that occupation positively correlated with resilience, and that aging veterans had higher occupational participation than civilian older adults.
Carroll had 9 female participants in her study, and learned more about their unique resilience within a masculine military culture.
“Having a military identity was shown to be a strength for both male and female veterans that I interviewed,” said Carroll. “Their roles as military identity was something they called upon as they went through stressful situations throughout their lives.”
Additionally, Carroll found the role of social participation with other veterans and service members to be particularly important for connecting through shared experiences. Many veterans used Facebook and other social media platforms to connect with those they served with, which Carroll tied to an overarching sentiment of seeing the military as an extended family and the enduring impact of military culture.
Takeaways for Occupational Science and Occupational Therapy Research and Practice
“Most research about veterans tends to have a negative tone and focuses on mortality, traumatic brain injuries and other issues veterans may face after their time in the military,” says Carroll. “Though this type of research is important and accurate, it’s just as critical to capture the positive aspects of military service that benefit people throughout their lives. A strengths-based approach when working with this population cannot be understated.”
Carroll’s research indicates that older veterans generally hold positive perceptions about their military service, and the influence of military culture tends to last over time. Therefore, her advice for occupational therapists is to understand the positive aspects of military identity and culture in order to build rapport with veterans and, hopefully, see better outcomes in therapy.
“A health sciences professional might not know a lot about military culture and doesn’t factor that in when they encounter someone who is older,” said Carroll. “That can be a lost opportunity, because their military service is still a salient part of their identity which has an impact on their health and well-being.”
Continuing Research and Work with Veteran Populations
Carroll recently moved to Montana where she now serves as Director of Research and Assistant Professor for the Rocky Mountain College OTD Program.
“Occupational therapy is an applied science – I got my PhD to be engaged and use my skills to do research that makes a difference for a population I’m interested and invested in,” said Carroll.
Montana has the second highest per capita population of veterans in the country – nearly 1 in 10 adults has served in the military. About 72 percent of those veterans live in rural areas and many struggle to access relevant healthcare.
“Veterans often have different healthcare needs due to their service,” said Carroll. “I’m hoping to help meet some of their needs here in Montana – there’s a lot of opportunity for research, healthcare and occupational therapy, and I’m eager to promote the health and wellbeing of veterans in this area.”
The Division of Occupational Science and Occupational Therapy is one of seven health sciences programs in the Department of Allied Health Sciences. The DAHS is housed in the UNC School of Medicine.