PTSD Symptoms and Dementia in Older Veterans Who are Living in Long-Term Care

Abstract

Co-occurring posttraumatic stress disorder symptoms and dementia can result in increased symptoms, such as suspicion, aggression, and nightmares in Veterans that can be difficult to manage in long-term care environments. The objective of the study was to explore how the co-occurrence of posttraumatic stress disorder symptoms and dementia are understood in Canadian Veterans who are living in long-term care. A descriptive multiple case study was conducted in two Veteran long-term care facilities in Canada. Data collection consisted of semi-structured interviews with Veterans, their family caregivers, and health care providers, non-participant observation, and a chart audit. Three major themes emerged relating to symptom expression and care approach: a) symptoms are the same but different; b) differences in the complexity of care; and c) added dimensions involved in care. The results of this study contribute foundational information about co-occurring posttraumatic and dementia symptoms that can inform policy, care approaches, and potential interventions.

Care aides' perceptions of caring for residents with a history of psychological trauma in Western Canadian care homes

“…Of these, only 6.6% were reported as being in the medical record. Even in veteran‐specific studies, most family members knew little about the veteran's trauma experience because negative memories were rarely shared 42 . A comprehensive admission history, including mental health diagnoses and exposure to past potentially traumatic events, could support high‐quality person‐centered care by providing important context for interpreting resident behaviors.…”

“…Results of the logistic regression showed five factors that were statistically significant with all other factors held constant (Table 5). The odds of reporting caring for one or more residents with trauma were lower for care aides in age groups 30-39 (OR = 0.71), [40][41][42][43][44][45][46][47][48][49] (OR = 0.58), 50-59 (OR = 0.56), and 60+ (OR = 0.51), with under 30 being the reference group.…”

“…A third, Canadian case study explored how the co‐occurrence of PTSD and dementia is understood from the perspectives of the veterans themselves, families, and care home staff. This study reported that veterans with co‐occurring PTSD symptoms and dementia had increased intensity of fear, suspicion, nightmares, aggression, and sadness and were more withdrawn than those with dementia alone 42 . These studies emphasized the care complexity of this population, the emotional impact on staff, and the importance of adequate support 40–42 …”

“…This study reported that veterans with co-occurring PTSD symptoms and dementia had increased intensity of fear, suspicion, nightmares, aggression, and sadness and were more withdrawn than those with dementia alone. 42 These studies emphasized the care complexity of this population, the emotional impact on staff, and the importance of adequate support. [40][41][42] The purpose of this study was to explore care aides' perceptions of caring for residents who aides perceived had a history of psychological trauma.…”

“…42 These studies emphasized the care complexity of this population, the emotional impact on staff, and the importance of adequate support. [40][41][42] The purpose of this study was to explore care aides' perceptions of caring for residents who aides perceived had a history of psychological trauma. Specific objectives were to: (1) explore whether care aides perceived having cared for residents with psychological trauma, (2) identify the types of traumatic events that care aides perceived residents had experienced, and (3) identify the reasons why care aides perceived residents had experienced a traumatic event.…”