Assessment, Treatment, and Care of Older Adults Who Have Experienced Traumatic Stress

Exposure to psychologically traumatic events is common and can have long-term debilitating effects. Psychologically traumatic events are those that are experienced or witnessed by an individual as physically or emotionally harmful or life threatening. Up to 90% of the population will experience a psychologically traumatic event in their lifetime, with approximately 9% developing a posttraumatic stress disorder (PTSD) syndrome characterized by intrusive reliving of the event/s, avoidance of reminders of the event/s, alterations in cognition and mood, and hyperarousal and reactivity. Prolonged exposure to traumatic events or circumstances, particularly in childhood, can disrupt neurodevelopment and result in complex psychiatric conditions including personality disorders and complex PTSD.

Even where a trauma survivor does not develop a PTSD syndrome, psychological trauma can have ongoing developmental, cognitive, and psychological impacts that last into later adulthood and affect their experience of aging and care. This review describes the current state of knowledge about traumatic stress exposure among older adults, summarizing approaches to treatment and clinical care including the use of trauma-informed care (TIC) models in elder care settings.