TRAUMA IN OLDER ADULTS

WHAT IS TRAUMA?
Individual trauma results from an event, series of events, or set
of circumstances that is experienced by an individual as
physically or emotionally harmful or life threatening and that
has lasting adverse effects on the individual’s functioning and
mental, physical, social, emotional, or spiritual well-being.
 TRAUMA IN OLDER ADULTS
• Trauma is under-recognised

• Trauma is under-treated

• Older adults may fail to report or minimize traumatic

experiences
FOUR RS OF A TRAUMA FOCUSSED APPROACH
• Realisation that trauma can affect older adults
• Recognition of the signs of trauma
• Responding to the trauma so that the person feels safe physically,
psychologically and emotionally
• Resisting re-traumatisation by understanding the triggers for the memories and
preventing them

• Remember the goal is not for the older adult to disclose any or all details but
rather to feel safe, develop trust and ultimately become improve their functioning
 REALISATION THAT TRAUMA CAN
AFFECT OLDER ADULTS
• Up to 90% of older adults have experienced at least one traumatic event in their
lifetime
• Examples include evacuation in the war, the unexpected death of someone close,
serious illness or serious injury to self etc.
• As a result of the previous trauma the person can find that situations that occur in
everyday life may trigger memories of the trauma and affect the person’s
responses
• If you are unable to ascertain that there is a history of trauma the best approach is
to assume there is
 TRIGGERS TO TRAUMATIC MEMORIES
Possible triggers to traumatic memories could be:

•A particular date – anniversary of a traumatic bereavement

•A rigid regime with in a care setting – reminding them of

being in a prison camp

•A particular place/noise – reminding them of past physical

abuse
 RECOGNITION OF PAST TRAUMA
Possible symptoms of past trauma include
•Intrusive distressing recollections/thoughts
•Recurrent distressing dreams
•Irritability and sleep disturbance
•Flashbacks in which it can feel like the event is reoccurring
•Distress when exposed to “triggers” symbolizing or resembling the trauma
•Intense physiological reaction to trauma triggers
•Avoidance of activities/places which provoke thoughts/feelings about the trauma
•Negative beliefs and expectations
 QUESTION
How to ask about trauma in older adults
•“Some people have told me about difficult experiences they had during their
lifetimes, such as being threatened or assaulted. Has anything like that ever
happened to you?”
 RESPONDING IF TRAUMA IS MENTIONED
• It is appropriate to express your care and concern: “I am sorry
that this has happened to you.”
• You will need to allow the person extra time so you can listen
to them
• Validate the response: “That must have been very
frightening”. 
• Normalise the response: “You are not alone”, “I know that
this has happened to others” but don’t minimize the trauma
• You should not respond by questioning the person and asking
“did that really happen? ”
• It is often inappropriate to probe the person for details at this
point
 RESISTING RE-TRAUMATISATION
• Ensure that if this trauma is new information to your care team that it is
reported.

• Assess and then care plan with the aim to reduce or prevent re-traumatisation by
understanding the triggers for the traumatic memories and preventing them.
 GUIDING PRINCIPLES TO PREVENT RE-
TRAUMATISATION
• Create a physically and emotionally safe environment
• Establish trust
• Support autonomy and choice
• Create collaborative relationships and participation opportunities
• Use a strengths and empowerment-focused perspective to promote resilience and
reduce re-traumatisation and promote healing
 OVERVIEW OF TECHNIQUES TO INTERVENE
AND TREAT TRAUMA IN OLDER ADULTS
Techniques include
•Psychological First Aid
•Developing skills for Psychological Recovery
•Trauma-focused Cognitive Behavioural Therapy
•Exposure therapy – EMDR (eye movement desensitisation
and reprocessing), life review and narrative
 PSYCHOLOGICAL FIRST AID
• It is like medical first aid

• It can be used by non-clinicians

• It is an evidence based approach designed to reduce the

initial stress caused by traumatic events and to foster short
and long term adaptive functioning
 SKILLS FOR PSYCHOLOGICAL RECOVERY

• Give information about common physical and psychological

reactions to crisis

• Provide education around stress and coping

• Help to restore the individual’s sense of control

• Encourage increased networking and re-establishment of

contact with informal and formal support
 TRAUMA-FOCUSED COGNITIVE BEHAVIOURAL
THERAPY
This therapy is based on using a range of psychological techniques to help the
person come to terms with the traumatic event.

•Identification of the unhelpful thoughts as a result of the trauma

•Evaluation of the validity of these thoughts and challenging those thoughts that
are incorrect
•Replacement of the dysfunctional thoughts with more helpful ones

•Usually there is an exposure element and cognitive therapy element

 EYE MOVEMENT DESENSITIZATION AND
REPROCESSING (EMDR)
• This involves the person making side-to-side eye movements,
usually by following the movement of the therapist's finger,
while recalling the traumatic incident. 

• Other methods may include the therapist tapping their finger

or playing a tone.

• It's not clear exactly how EMDR works, but it can help

change the negative way the person thinks about a traumatic
experience.
 RESOURCES
• MPC_08_01 - Post Traumatic Stress Disorder And Other Traumas | Effects of
Trauma (mindedforfamilies.org.uk)

• This is an easy to access website for older adults and their families which has
good advice about what trauma is ,the effect of trauma , post traumatic stress
disorder and practical suggestions of things that could help.