Managing Director, Center on Aging and Trauma
Director of research and evaluation, Center on Aging and Trauma
According to a 2013 study in the Journal of Traumatic Stress, 90 percent of adults in the United States have been exposed to at least one traumatic event in their lifetime.
Think of how many in your community might have gone through a natural disaster just in the time they have been residents there—and then consider the years before they moved in. Other traumatizing events include domestic violence (affecting an estimated 10 million Americans annually) or being a victim of a violent crime (an estimated 1.2 million).
Trauma exposure not only is associated with mental health issues such as anxiety and depression, but it is also associated with physical health problems—and, of particular importance to senior living, with cognitive health.
Yet the effects of trauma on older adults and aging is little studied or researched. That’s where the Center on Aging and Trauma, a project of the Holocaust Survivor Initiative of The Jewish Federations of North America and its Person-Centered Trauma-Informed care approach is helping.
Person-Centered Trauma-Informed Care (PCTI) is defined as a “holistic approach to service delivery that promotes trust, dignity, strength, and empowerment of all individuals by incorporating knowledge about trauma into agency programs, policies, and procedures.”
In 2015, the Administration for Community Living/Administration on Aging within the U.S. Department of Health and Human Services awarded The Jewish Federations of North America a grant to develop innovative person-centered trauma-informed care approaches for Holocaust survivors and their family caregivers.
In September 2020, ACL granted the Center $5 million to expand their work; the lessons learned from helping Holocaust survivors could benefit all older adults. The Center has funded more than 200 projects across 21 states, including programs that teach caregivers about PCTI approaches.
Their website, agingandtrauma.org, has factsheets and more information.
Authoring many of the materials are Shelley Rood Wernick, MBA, managing director, and Barbara Bedney, PhD, MSW, director of research and evaluation. They shared some basics for senior living leaders to think about as they increase their awareness of aging and trauma. While most in senior living practice person-centered care, the “trauma-informed” part of the phrase and what it entails means may be new.
- Symptoms of trauma can emerge for the first time during older adulthood—even decades after exposure to traumatic events. And trauma symptoms that re-emerge can be more extreme in older adulthood. Leaders and caregivers likely have insight into why this is; they understand that transitions are stressful. Other life changes, such as loss of the ability to drive, can reflect back to earlier traumas such as loss of a home or a job.
- With increased isolation, caregivers wearing personal protective equipment, and disruption of familiar routines—not to mention grief and loss—COVID-19 could lead to trauma becoming more pronounced or evident in behaviors. Among Holocaust survivors, being told that they must “isolate for their own good” can bring back traumas around hiding; and the presence of people in medical attire and unfamiliar tests and treatments can touch off memories of trauma caused by forced medical experiments.
- Some older adults want to have certain objects and clothing always at the ready. With a PCTI approach, a caregiver might understand that this is because of past trauma around having to quickly run and hide, or move out of the home, to stay safe.
- Caregiver and staff awareness of the sensory nature of triggers and being sensitive to loud noises, bright lights, or strong smells can help. Wernick retells the story of an older veteran who would constantly wake in fear at the same time each night. They discovered that it was the time of a shift change, and lights from cars in the parking lot were flashing into his room—a blackout curtain at night helped alleviate this.
