Although most psychosocial interventions are similar to those used in PTSD treatment with younger adults (eg, education about symptoms, enhancement of social support, coping tools to more effectively manage symptoms), some specific concerns should be considered when working with older traumatized adults. First, it is crucial to consider older adults’ cognitive abilities to help determine the most effective psychotherapeutic approach. For example, older trauma survivors with cognitive impairment (such as non-reversible dementia) may have lowered thresholds for responses to trauma cues or triggers. Older adults with moderate to severe cognitive impairments may not be able to fully benefit from traditional learning-based therapies.
Since older adults may have sensory problems and slower learning rates, repetition is important in the psychotherapy process. Psychoeducation, trauma-processing therapies, or distress management skills can be presented in both verbal and visual modalities (ie, on chalk boards and hand-outs), in order to help them encode and retain information. Psychotherapy with traumatized older adults may also necessitate a few clearly outlined goals and a more active or task-focused approach, with goals of treatment highlighted and reinforced. Age-related changes can constitute stressors that exacerbate PTSD (eg, ill health, retirement, widowhood).