Life Trauma and Nursing Home Residents Early-Life

¶ … Life Trauma and Nursing Home Residents

Early-Life Trauma

When a person loses their ability to live independently and is forced to enter a nursing home, the experience can be a difficult one. But not all of the problems arise because of current influences, past traumas, which occurred in early-life, can sometimes arise in a resident's later years to cause trouble. Keith Anderson, and his colleagues at the College of Social Work at Ohio State University recently published an article which examined the impact of early-life trauma on older nursing home residents. After discussing how early-life traumas can influence how an elderly person reacts to certain aspects of assisted care, the authors then provide a hypothetical case where a patient has a difficult time adjusting to life in the nursing home. In this hypothetical case, social workers did not discover an early-life trauma which resulted in both the resident and the staff enduring a difficult time in providing care. The authors were especially careful to provide the reader with a complete discussion and numerous common examples to illustrate their points. Overall, the article was well written, provided a clear understanding of the issues involved, as well as an excellent hypothetical example which demonstrated what the article was trying to express to the reader.

The authors begin the article by defining exactly what they mean by the term "trauma," and assert that trauma can take various forms "from the severe (e.g. war, torture, disease) to the more sublime (e.g., extreme poverty, divorce, loss)." (Anderson, 2011, p. 756) But the important thing is that the individual suffering the trauma must feel that there is real death or serious injury, to that person or someone else, involved with the event. The authors provide a number of examples of some extreme early-life traumas such as combat, abuse, life-threatening illness, and torture; as well as some more common ones like divorce or poverty. And while traumas can be defined as extreme forms of stress, the authors point out that many people have the ability to cope and adapt to traumatic events. However, when some people become older, their ability to cope with traumas declines which can allow the re-emergence of reactions to early-life traumas such as post-traumatic stress disorder (PTSD), or late-onset stress symptom logy (LOSS). These two conditions may be similar, but "LOSS is differentiated from delayed-onset PTSD in terms of the severity of the symptoms." (Anderson, p. 757) Two groups which have provided examples of individuals suffering from these conditions are combat veterans and holocaust survivors, and the authors then examine how people who have suffered traumas react to care-giving situations.

While briefly discussing the effect of PTSD and LOSS on combat veterans, the authors provide a detailed examination of the effect of an early-life trauma, such as the Holocaust, on elderly survivors. For instance, showering, standing in line, or enduring a simple medical procedure may trigger memories in Holocaust survivors "resulting in anxiety, fear, and refusal;" reactions that can have a negative impact on the caregivers and care-giving. That is the reason it is so important to identify early-life trauma victims as early in the process of transition to nursing home life, ideally during the initial admission. However, the authors disclosed that the current set of question asked upon admission, the government provided Minimum Data Set (MDS), are inadequate and cannot provide an assurance that early-life traumas can be identified. As a result, they suggest that in addition to the MDS, which has some value, "other tools are needed to supplement information regarding the psychosocial needs of residents…" (Anderson, p. 760) The authors then suggest simply asking the patient and/or their family members if the patient has suffered any traumas in their lifetime. They also suggest listing a few so they have an idea of what is meant by "trauma," as well as noting any resistance or discomfort to answering question of this nature as they may be signs of trauma.