Abstract:IntroductionUp to 70% of older adults have experienced a psychologically traumatic event in their life. Traumatic events can have lifelong effects on functioning and emotion regulation and can affect behavior and experiences in care settings. Common healthcare practices and environments can be re-traumatizing for trauma survivors. These features may trigger behavior change (e.g., aggression and agitation) particularly after the onset of dementia. However, very little research exists to understand how the effec… Show more
“…Thus, incorporating education and training for care staff in trauma‐informed care is an integral aspect of delivering better support to individuals with dementia. Published case series provide anecdotal evidence of successfully reducing the impact of NPS by amending care to account for traumatic stress symptoms, even without access to psychological or psychiatric expertise 35 . Future studies assessing the implementation of trauma‐informed care models into dementia care environments will be helpful for assessing the potential benefits of these approaches.…”
ObjectiveTo compare the number and severity of neuropsychiatric symptoms (NPS) and associated caregiver distress between those with and without a noted history of psychological trauma among those referred to a specialised national dementia NPS support service.MethodsThis was a 5‐year retrospective observational study of records from the Dementia Support Australia NPS support service. NPS were reported by formal or informal caregivers at service entry using the Neuropsychiatric Inventory Nursing Home version or Questionnaire version. A history of psychological trauma was recorded in the person's social or medical history and/or endorsed as a contributor to NPS by a trained dementia consultant after a comprehensive clinical review. Regression was used to examine the impact of a recorded history of psychological trauma on NPS severity and associated caregiver distress, controlling for age and sex.ResultsAmong 41,876 eligible referrals with dementia, 6% (n = 2529) had some reference in their records to a history of psychological trauma. Referrals with a recorded history of psychological trauma were rated with a higher rate of both NPS severity (mean = 12.0) and associated caregiver distress (mean = 16.5) at service entry than those without a recorded history of psychological trauma (means = 10.7 and 14.5, respectively). A recorded history of psychological trauma was associated with higher odds of psychotic symptoms, agitation/aggression, irritability, disinhibition, affective symptoms and night‐time behaviours.ConclusionsTraumatic stress symptoms may represent a neglected target for intervention to reduce the impact of NPS in people with dementia.
“…Thus, incorporating education and training for care staff in trauma‐informed care is an integral aspect of delivering better support to individuals with dementia. Published case series provide anecdotal evidence of successfully reducing the impact of NPS by amending care to account for traumatic stress symptoms, even without access to psychological or psychiatric expertise 35 . Future studies assessing the implementation of trauma‐informed care models into dementia care environments will be helpful for assessing the potential benefits of these approaches.…”
ObjectiveTo compare the number and severity of neuropsychiatric symptoms (NPS) and associated caregiver distress between those with and without a noted history of psychological trauma among those referred to a specialised national dementia NPS support service.MethodsThis was a 5‐year retrospective observational study of records from the Dementia Support Australia NPS support service. NPS were reported by formal or informal caregivers at service entry using the Neuropsychiatric Inventory Nursing Home version or Questionnaire version. A history of psychological trauma was recorded in the person's social or medical history and/or endorsed as a contributor to NPS by a trained dementia consultant after a comprehensive clinical review. Regression was used to examine the impact of a recorded history of psychological trauma on NPS severity and associated caregiver distress, controlling for age and sex.ResultsAmong 41,876 eligible referrals with dementia, 6% (n = 2529) had some reference in their records to a history of psychological trauma. Referrals with a recorded history of psychological trauma were rated with a higher rate of both NPS severity (mean = 12.0) and associated caregiver distress (mean = 16.5) at service entry than those without a recorded history of psychological trauma (means = 10.7 and 14.5, respectively). A recorded history of psychological trauma was associated with higher odds of psychotic symptoms, agitation/aggression, irritability, disinhibition, affective symptoms and night‐time behaviours.ConclusionsTraumatic stress symptoms may represent a neglected target for intervention to reduce the impact of NPS in people with dementia.
“…Participants also reported how past trauma, and fears over the possible heightened risk of abuse by being autistic, affected their ability to engage with services. This suggests a need for trauma-informed services for older autistic adults that recognise that service practices and environments can be re-traumatising and put strategies into place to mitigate against this (Couzner et al, 2022). Participants felt that strategies could include offering mental health and peer support, and empowering people through collaboration.…”
BackgroundDespite increasing numbers of people aging with autism, little is known about the ageing experiences and support needs of middle-aged and older autistic adults. This is important, especially as autistic people have higher rates of health conditions, decreased functional independence, and experience greater difficulties in accessing relevant support, in comparison to their non-autistic counterparts. The aim of this study was therefore to understand middle-aged and older autistic adults’ views and experiences of ageing well.MethodSeventeen autistic adults (10 women and seven men), aged from 46 to 72 years (mean age=56 years) were interviewed about their understanding of what it means to age well; their age-related needs; and how services could better support them to age well. The transcribed interviews were analysed using inductive thematic analysis. ResultsThe findings revealed several ways that autism influenced people’s ability to age well. This included concerns about a perceived higher likelihood of age-related conditions such as dementia; age-related changes in the experiences of autistic characteristics; a lack of knowledge and understanding about autism and ageing; increased risks of social isolation and inadequate support system; and a lack of appropriate support services. ConclusionNovel recommendations for supporting autistic adults to age well were identified, including involving autistic people in the design of health and social care services, supporting ageing autistic adults with reablement; promoting their autonomy and individual strengths and introducing specialised advocate/coordinator roles or “one stop-shop hubs” that could help autistic people further their understanding of the interactions between ageing and autism.
“…Some will develop triggers, a stimulus that activates a painful memory or emotion, that can result in secondary traumas. Patients with dementia seem to be especially vulnerable 8. They can find themselves in a loop in which the traumatic event replays in their mind.…”
Section: The Pharmacologic Management Approachmentioning
confidence: 99%
“…Patients with dementia seem to be especially vulnerable. 8 They can find themselves in a loop in which the traumatic event replays in their mind. The use of psychotropic agents in this case example resulted in a fall with injury.…”
The neuropsychiatric symptoms associated with dementia, often referred to as unwanted behaviors, are one of the most difficult aspects of this disorder for caregivers to navigate. This article presents strategies to manage dementia-related neuropsychiatric symptoms.
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