Post-traumatic stress disorder (PTSD) in older adults is often overlooked, despite research showing its significant impact on quality of life. Many seniors experience PTSD from early-life trauma, recent losses, or a lifetime of accumulated stress. This article explores how PTSD shows up differently in older adults, why it often goes unrecognized, and how trauma-informed care (TIC) can improve both mental and physical health outcomes in the aging population. Click here to learn about our work in Long Term Care.
PTSD is commonly associated with younger people, especially veterans and survivors of recent trauma. But older adults are also vulnerable to PTSD, whether due to past events like war or abuse, or recent experiences such as loss of independence or chronic illness. As we age, stressors change, and old trauma can resurface. Unfortunately, PTSD in seniors is often missed because symptoms can look like depression, anxiety, or even dementia.
PTSD in Older Adults: Prevalence and Risk Factors Studies estimate that 1.5% to 4% of adults over 60 have PTSD, with rates as high as 9% in veterans or those with multiple traumas (Hankin et al., 2019; Pietrzak et al., 2012). Common risk factors include:
- Military service or wartime experiences
- Childhood abuse or neglect
- Long-term exposure to domestic violence
- Bereavement or serious medical illness
- Nursing home placement or hospitalization
Older adults may also be more vulnerable to PTSD because of reduced coping resources, chronic health conditions, or social isolation.
How PTSD Looks Different in Older Adults PTSD symptoms in older adults don’t always match the typical checklist. Instead of flashbacks or nightmares, seniors may report:
- Physical symptoms like pain, fatigue, or digestive issues
- Avoiding people or places
- Trouble sleeping or concentrating
- Feeling emotionally numb or withdrawn
These symptoms can be confused with other aging-related conditions, making diagnosis more challenging.
Barriers to Diagnosis and Treatment Several issues prevent PTSD from being diagnosed and treated in older adults:
- Mental health stigma, especially in older generations
- Mislabeling symptoms as “normal aging”
- Limited provider training in trauma among seniors
- Few tools specifically designed to screen older adults for trauma
What Is Trauma-Informed Care (TIC)? Trauma-informed care is an approach that acknowledges the lasting effects of trauma and makes safety, trust, and respect central to treatment. Key principles include:
- Safety – Making patients feel physically and emotionally secure
- Trust and Transparency – Clear communication and reliability
- Peer Support – Involving others who have experienced trauma
- Collaboration – Working together with patients on care plans
- Empowerment – Respecting patients’ choices and independence
- Cultural Awareness – Recognizing how history, culture, and gender affect trauma
How to Use TIC with Older Adults To apply trauma-informed care with seniors, healthcare providers can:
- Ask about trauma gently during intake or assessments
- Avoid triggering language or environments (e.g., loud noises, restraints)
- Offer therapy that fits older adults, like reminiscence therapy, EMDR, or simplified CBT
- Involve caregivers and family in care when appropriate
- Train all staff—from CNAs to physicians—in trauma awareness
Many older adults carry the effects of trauma with them, even decades after the event. By recognizing the signs of PTSD and using trauma-informed care, clinicians can better meet the needs of this population. Adapting our systems to be more compassionate, inclusive, and aware of trauma history can help seniors heal and thrive. Click here to learn more about us.
