Grief, loss, shifting roles of identity and place, changes to physical, cognitive, and mental health-related factors and capacities, increased dependence on caregivers, greater vulnerability to neglect, abuse, or exploitation, increased feelings of loneliness and isolation, and other challenges can emerge for older adults at this stage of life. ​

​

While many endorse feeling healthy, supported, and fulfilled when reflecting upon their aging experiences and the end-of-life care they have received, others’ experiences can be characterized as traumatic. Further, older adults who already endorse significant trauma histories are more susceptible to being adversely impacted by stressors that evolve and emerge in one’s older years. Research suggests that people with trauma histories are more likely to experience earlier onset and increased severity of age-related conditions such as heart disease, stroke, and dementia. This cumulative effect, often referred to as allostatic load, emphasizes the need for tailored support systems that address the unique healthcare needs of older adults with trauma histories.

 

CTIPP sees within this urgent challenge significant opportunities for systemic and institutional transformation so that older adults may receive the comprehensive, compassionate support they deserve. By getting radically honest about uplifting these challenges as well as presenting solutions grounded in realistic hope for change, we can destigmatize essential conversations surrounding aging and end-of-life experiences. It is through these processes that we all may come together to pave the way for a more robust and responsive network of services and supports for healthy aging and end-of-life care. 

 

There is no time better than now to join in action toward cultivating a culture where the aging process is met with acceptance and grace, and where everyone stands empowered to navigate significant life transitions across the life course with dignity, compassion, and resilience. 

 

​ This dimension of the vision calls for us to:

• Increase funding for community-based programs supporting older adults aging in place

  • Establish and fund programs promoting social engagement and community connection among aging and older adults

  • Partner with community organizations as well as a diverse body of older adults to inform service design and delivery

  • Implement and create reimbursement pathways for programs to combat isolation through in-home visitation services and technology-based interventions, particularly for individuals with limited mobility or social support to increase safety, trust, connectedness, and choice

  • Create networks to help make connections between older adults and community engagement opportunities to volunteer and make meaning

• Allocate resources to have ongoing training for providers to learn about implementing the trauma-informed care principles

  • Ensure all relevant workforce members engage with content specifically covering building resiliency and well-being when working with older adults and in end-of-life care

  • Train all relevant workforce members on trauma-informed interviewing and referral pathways

  • Hold organizations and systems of care accountable to anchoring in trauma-informed approaches to pain management and symptom control that honor self-determination and respect individualized needs

• Promote cross-sector collaboration to provide comprehensive, integrated care and a full suite of wraparound services to support holistic well-being

  • Ensure these go beyond “bare minimum” for survival to meaningfully support thriving, which may include supports for: affordable and accessible housing, specialized health and mental health supports, voice and choice in accessing long-term care options, and supportive in-home services like house cleaning, hygiene management, and food preparation services

• Fund the creation and sustainment of accessible, free groups for older adults to engage peer support

  • Examples may include: grief groups tailored to older adults addressing increased loss and trauma, reminiscence groups fostering purposeful social connections, integration, and positive cognitive functioning, and so forth

• Implement programs to provide trauma-informed physical, spiritual, emotional, and logistical aid related to end-of-life planning, preparation, and decision-making processes

  • Require services and programming for older adults receiving any public funding to be culturally- and linguistically-relevant, honoring the many traditions, perspectives, and approaches to aging and dying

  • Provide funding to expand access to supportive services for such processes, such as the use of death doulas as well as free legal aid to create a will

• Introduce trauma screening tools across care settings to better understand and co-create care plans to address the complex needs of older adults with diverse lived experience

  • Develop culturally and linguistically appropriate assessment tools sensitive to various belief systems and diverse experiences across the life course

• Fund and provide additional federal- and/or state-level oversight to ensure adult protective systems function through a trauma-informed lens

  • Enhance identification and reporting mechanisms to protect older adults who may be vulnerable to abuse, neglect, or exploitation

  • Strengthen whistleblower protections for individuals reporting exploitation within adult protective systems

• Support families as well as professional/formal and non-professional caregivers in attending to their well-being while supporting older adults

  • Develop a framework to enhance collaboration between care facilities and families of older adults, ensuring transparent communication and holistic care

  • Establish support groups to address direct and secondary traumatic stress, burnout, moral distress, and compassion fatigue, among caretakers of older adults

  • Expand accessible, affordable trauma-informed respite care programming and services

  • Increase opportunities for family caregivers to receive support and compensation and/or paid leave to reduce the burden of taking care of others and increase the likelihood of retaining the capacity to deliver compassionate care

  • Educate family members about trauma and a trauma-informed approach to supporting aging loved-ones 

• Fund participatory action research to help identify and address systemic barriers contributing to health disparities for older adults with trauma histories

• Launch public awareness campaigns to educate the general populace on the impact of trauma on aging and end-of-life experiences

  • Partner with media outlets to promote positive narratives about aging, end-of-life care, and dying well