Traumas Experienced by Elderly

What is Trauma? 

Individual trauma is a result of an event, series of events, or set of circumstances that can be sudden or drawn out, which present physical or emotional harm to an individual, or are life threatening. Traumatic events may have lasting adverse effects on an individual’s functioning and mental, physical, social, emotional, and spiritual wellbeing (SAMSHA, 2014).

Up to 90% of older adults have experienced at least one traumatic event in their lifetime (Pietrzak, et.al, 2012). Approximately 70% to 90% of adults aged 65 and up have been exposed to at least one potentially traumatic event during their lifetime (National Center of PTSD, 2017).

Symptoms of trauma can evolve after long symptom-free periods’ Reemergence of trauma symptoms after symptom-free periods is not uncommon. Symptoms of trauma can emerge for the first time during older adulthood-decades after exposure to traumatic events.  Symptoms of trauma emerging in older adulthood can be more extreme that previously experienced (CAT, 2023). 

Significant life changes which can rekindle experience of trauma from earlier times in the life of elderly are: Change in Family Roles; Beginning of Retirement; Emergence of Health Problems; Loss of Independence; and Loss of Loved Ones (CAT, 2023)

Symptoms of Trauma: 

Older adults who experienced trauma later in life report more avoidance, sleep problems, and hyperarousal than younger adults (Kaiser, et al., 2022)

Other common symptoms of the impact of trauma on aging adults are:

• Noticeable changes in mood, energy level, or appetite
• Feeling flat or having trouble feeling positive emotions
• Difficulty sleeping or sleeping too much
• Difficulty concentrating, feeling restless, or on edge
• Increased worry or feeling stressed
• Anger, irritability, or aggressiveness
• Ongoing headaches, digestive issues, or pain
• Misuse of alcohol or drugs
• Sadness or hopelessness
• Thoughts of death or suicide or suicide attempts
• Engaging in high-risk activities
• Obsessive thinking or compulsive behavior
• Thoughts or behaviors that interfere with work, family, or social life
• Engaging in thinking or behavior that is concerning to others
• Seeing, hearing, and feeling things that other people do not see, hear, or feel (NIMH, 2023).

Some of the common symptoms of psychological trauma include:

• Fear, ranging to overwhelming fear.
• Obsessive and compulsive behaviors.
• Detachment from other people and emotions.
• Emotional numbing.
• Changes in libido/interest in sex.
• Depression.
• Guilt, survivor guilt.
• Shame, self-blame (Rose Hill Center, 2023)

Behavioral Signs of Unhealed Trauma: Trauma can also lead to elderly experiencing behavioral idiosyncrasies. For instance, they may avoid places or activities that make them think about the event. They may withdraw from their friendships and become uninterested in the activities that they enjoyed in the past. In addition, they may begin practicing obsessive behaviors, such as compulsively checking locks on their doors (Rose Hill Center, 2023).

Physical Signs of Unhealed Trauma: Elderly that have experienced a traumatic event may be startled easily, which can cause heart problems and edginess. They may also be extremely alert because they are constantly looking for the next potential danger. Furthermore, they may be unable to sleep through the night, leading to excessive fatigue or feeling exhausted (Rose Hill Center, 2023).

What are other issues that seniors would perceive as trauma?

They are:

• Loss of spouse and peers
• Chronic and life-threatening diagnoses
• Accidents, falls
• Physiological changes, limitations, disability
• Loss of roles and resources
• Increased dependence on caregivers
• Cognitive or memory loss
• Loss of home
• Abuse
• Neglect
• War, or terrorism
• Domestic violence
• Historical trauma
• Death by suicide
• Disaster
• Community violence
• Exploitation
• Attachment disruption or abandonment as a child (NIMH, 2023).

Falls a major type of Trauma Experienced by the Elderly: Falls are the main cause of trauma in the elderly, accounting for 75% of cases, and are often low-level from standing or sitting height (Atinga, et al, 2018). These may be mechanical or due to a variety of medical causes. Injuries due to such low-level falls in the elderly should not be presumed to be insignificant and can carry serious consequences. Falls are the fifth leading cause of death in adults over 65 years old (Atinga, et al., 2018). 

Approximately 30% of individuals over the age of 65 living in the community (and > 50% of those living in residential care settings) fall every year. Furthermore, half of these do so repeatedly. Although these falls are diverse in their risk factors, precipitants, and mechanics, 20% of falls result in injury requiring medical attention (5% result in fractures or other serious injury). Among women over the age of 75, these percentages double. Despite the importance of the foregoing etiologies of trauma, more than 80% of all injury-related admissions for those over the age of 65 years are due to falls. Furthermore, these all too often are sentinel events. Perhaps the most feared consequence of a fall—a hip fracture—in addition to commonly being associated with long-term pain and functional impairment (< 50% fully recover), is associated with a 20% chance of death and a 25% chance of institutionalization as a direct result. Falls (especially with injury) are usually the result and cause of gait and balance difficulty. As one fall increases the risk of future falls, and fear of this leads to decreased mobility, gait and balance further deteriorate in a vicious, isolating cycle.