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PTSD in late life and terminal illness
Transcript of PTSD in late life and terminal illness
Thoughts and feelings
Talking about event
Reminders and triggers
Exaggerated startle Re-Experiencing
Flashbacks Criterion A (Traumatic) Event-
"the person witnessed, or was confronted with an event that involved actual or threatened death or serious injury...response involved intense fear, helplessness, or horror" (DSM-IV) "...significant distress or impairment Presentations...
Late-onset (early trauma)
PTSD in dementia Prevalence-Incidence
66% of older adults experience trauma (Rauch et al., 2006)
11.8-15.6% develop PTSD symptoms
0.9-1.6% meet PTSD dx criteria
Other studies have reported as high as 24% (Quereshi, Kimbrell, Pyne, et al., 2010)
PTSD dx 2x more likely to develop dementia Impact of PTSD on Older Adults
Increased bed days
Lower life satisfaction
Less satisfaction with providers
(van Zelst et al., 2006)
Increased risk of substance use
Increased suicide risk
Higher comorbid illness Late-Onset PTSD
Working, physically active
Losses, illness, retirement
Cues similar to original trauma
Onset of neurological disorders (i.e., dementia) PTSD and Dementia
Greater risk of TBI in PTSD
PFC involvement leads to reduced emotion regulation
Cognitive decline compromises use of coping strategies
(Andrews et al., 2007) Symptoms Specific to Older Adults (Averill & Beck, 2000)
More intrusive memories
More survivor guilt
Higer somatic complaints PTSD Treatment in Older Adults
(Cook & O'Donnell, 2005)
Problems with processing
Group interventions PTSD Considerations in Long-Term Care (Cook et al., 2001)