My comment submitted to the White House conference about PTSD and Aging

Recently the White House hosted a conference on aging. There are very interesting and important resources that were made available online for the public following the conference. One of the particular documents is The Healthy Aging Policy Brief (http://www.whitehouseconferenceonaging.gov/blog/policy/post/healthy-aging-policy-brief), which includes specific sections that address important topics such as promoting health and preventing disease and injury; optimizing cognitive health; optimizing behavioral health, maximizing independence in homes and communities and promoting community and civic engagement among older adults.

I communicated to the White House Staff the comment appended below, stressing the need for attention to post traumatic reactions in the elderly as a particular problem in behavioral health that tends to be aggravated in the later years in people who suffered traumatic experiences or losses in earlier phases in their life.

Irit Felsen, Ph.D.

In the context of issues addressed by the recent White House Conference on Aging, which examined many topics related to aging well, I would like to call specific attention to post traumatic reactions which are a significant issue for older adults who have been through difficult experiences during prior times in their lives. Sometimes difficulties related to trauma that was suffered in earlier years surface as individuals age, after many years of good functioning. In other cases, the struggle with the residues of prior traumatic experiences has been life long, but is exacerbated by the challenges and losses that accompany aging.

Studies demonstrate that elderly people who suffer from full-blown Post Traumatic Stress Disorder (PTSD) or even from partial symptoms related to earlier exposure to traumatic events, show greater impairment in functioning in daily life, are less satisfied with their life, report greater subjective age, and receive less optimal care. Trauma in elderly individuals is often masked by somatic and medical complaints, and goes often unnoticed in primary care settings. There is insufficient research about post traumatic reactions in elderly but some recent studies offer new and promising treatments directions which must be further examined.

Epidemiological studies show full PTSD is experienced by about 8-9% of the general population in the USA, with some pockets of the population showing much higher rates. In addition, many others experience sub-syndromal levels of post traumatic reactions. Among recently returning war veterans, the numbers of those suffering from psychological and other relevant health problems related to war trauma are high, reaching 30%. Given these tragically high numbers, it is critical to invest in development of treatments for survivors war and other types of trauma to prevent and alleviate severe problems that are aggravated by processes of normative aging. It is also necessary to invest in education and training of healthcare staff in recognizing trauma in the elderly and in applying new approaches to its treatment.

This topic is an important social and public health issue, with serious ramifications not only for the well-being of survivors themselves but for the physical and mental health and occupational functioning of the countless numbers of those who care for them now and in the future.

A presentation addressing Post Traumatic Reactions in Elderly that was shown at a professional conference for directors of nursing homes and directors of social services and nursing can be viewed at http://www.leadingageny.org/home/assets/File/War%20Related%20Traumatic_Irit%20Felsen.pdf.

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