Episode 208 - Dr. Nancy Kusmaul and Lisa Kendall: Impacts of Trauma in Later Life

Monday, January 30, 2017, 7:45:29 AM

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In this episode, our guests Dr. Nancy Kusmaul and Lisa Kendall discuss the possible impacts of traumatic experiences as people transition into older adulthood. They describe specific applications of a trauma perspective with elders and what helping professionals might observe in their clients to warrant further assessment. Dr. Kusmaul and Ms. Kendall highlight the distinctive opportunities and manifestations for re-traumatization with the older adult population, and the trauma-informed care implications for organizations and caregivers serving older adults.

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Average Rating: 5stars  informative session on dealing with trauma in the elderly, Sunday, February 09, 2020

By Wendy :

As a current social worker in a nursing home setting I realize that several of our residents are veterans and have some type of combat trauma. There are others that find more recent events (losing an eye or leg, etc.) as traumatic. There are some types of trauma that still are not discussed, for an example, a history of physical or emotional abuse, which can be ongoing trauma instead of one event. Dr. Kusmaul and Ms. Kendall (2017) bring to light that trauma that is not dealt with in a younger stage will affect the state of peace in the elderly. I also found it fascinating that Kendall (2017) talked about traumas that have not been dealt with making themselves manifest in the stage of "Elderhood." Dr. Kusmaul (2017) brings out the effects of old traumas on current caregivers. Social workers tend to think that there is a “why” involved, where someone from another health professions may not think that way. At least that is personal experience of how different professions think. If an elder exhibits a behavior, after listening to the podcast, it is clear that there may be a past trauma involved. As a social worker the inclination is to want to delve into the “why” and to help the elder find peace. I like the part of this podcast that mentions peace. I think that is an important stage to focus on as the elderly face the end of their life. The podcast ended with the reminder that it is important to remember the elderly when thinking of those who have had traumatic experiences. With an additional undergrad major in gerontology I found this especially important to remember, as well as when working with nursing home clientele.

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Average Rating: 5stars  the impacts of trauma, Monday, February 03, 2020

By Tamasha H :

Trauma is a very serious issue as we have learned in the school of social work. When I used to think of trauma, I would think that it was only about big natural disasters because if they can have such a huge impact on someone’s life, then it wouldn’t be something like bullying or getting into a small accident. Now my views have changed ever since I started this program and learning more about mental health, trauma, the effects, etc. Each individual is different including their tolerance and it all depends on many different things. What can be life long traumatic for one person may not be so for someone else. Just like Dr. Lisa said, “they can be man-made circumstances. Like shaming or bullying or sexual abuse or physical abuse or neglect”. So, there isn’t really the same level of trauma for everyone. This answers the question asked to Dr. Nancy about whether there are people who seem to be affected more than others, and how that would look like. This depends on many things as to why or how people can be affected more from the same situation. Some people also have less financial resources which can prevent them from seeking mental health resources.

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Average Rating: 4stars  trauma-informed care and the elderly, Saturday, February 09, 2019

By Tracyjab :

One of the things that stood out to me from this interview is how childhood events/experiences can impact a person in their later years of life. As a student social worker, this is important for me especially because of my desire to work with the geriatric population after receiving my MSW. This interview brings to light the prolong effect that childhood trauma can have on the life of individuals if left unaddressed. As Dr. Nancy stated, “when we as professionals see the elderly, the care needs, they present are a very small fraction of their whole life story.” This statement is true, and that is why it becomes even more important that as generalists, we are aware and have an understanding of trauma-informed care, and how to incorporate this practice approach when working with this population. I like too that the presenters talked a lot about theories especially Erickson developmental theory.

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Average Rating: 5stars  elderhood: peace beyond trauma, Saturday, February 02, 2019

By Jennifer :

As someone navigating the challenges of transitioning into older adulthood, I find the prospect of post-traumatic growth in later years personally relevant - and inspiring! It’s interesting to consider Erikson’s “integrity vs. despair” in terms of accepting the task of making peace with the past, as Lisa Kendall mentioned. At this stage, one potentially enjoys the results of skills acquired in spiritual maintenance - the culmination of honing an ability to process and assimilate experiences, forgive, and release destructive beliefs. Metaphorically, this series of choices represents a pruning process, where, if done strategically, deliberately, one may enjoy an abundance of integrity to harvest in “ripe old age”.
However, obstacles along the way make healthy decisions difficult, if not impossible for many carrying invisible emotional trauma. With scant resources, spiritual maintenance is deferred in order to survive. Compromise eventually becomes habit, as untended toxic stress renders traumatized minds spiritually shaggy and unkempt. Into such circumstances, elderhood often arrives as coping abilities wither and weeds of despair take hold, fed by societal stigmas.
The exposure of such obstacles and impairments can offer an excellent opportunity for growth! For in those moments of vulnerability, if the elder is supported in rediscovering their strengths through trauma-informed care, and sets a course toward peace, they can develop an interest in how their experiences, even more importantly their interpretations of those experiences, have brought them to their current understanding of life. With curiosity piqued, and optimism toward recognizing and managing their trauma responses, new insights begin clearing the way for meaning to flourish.

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Average Rating: 4stars  elderhood -- a stage ripe for growth, Thursday, January 31, 2019

By Rebecca :

I am studying toward my MSW, and trauma is a topic we discuss often in class. As Kusmaul and Kendall note, trauma arises from a broad ranges of experiences. An event may be traumatic to one person, but not to another. Kusmaul and Kendall say that the key is resources — coping skills, family supports, community supports. If a person experiences a stressful event that exceeds their resources, it can be traumatic.

As a social work student, it is fascinating to see how different professionals bring a strengths-based approach to their clinical work and research. Kusmaul and Kendall talk about elders as powerful teachers, and about "elderhood" as a developmental stage that's ripe for growth.

As a daughter and advocate for an elder who has spent a fair amount of time in doctors’ offices, I’m keenly aware of the various indignities older adults face as they are funneled through the health care system. Something as simple as calling an older adult by their name — rather than “honey” or “buddy” — makes a difference. As Kusmaul and Kendall note, we social workers need to take the time to think about and be aware of how trauma presents itself in older adults, and also give our elders the time and space and respect to work through it.

A final note: It struck me as a bit funny that Kusmaul and Kendall often refer to other researchers and authors in the field, giving them credit for one idea or another. At first, I thought Kusmaul and Kendall were simply name-dropping, but then I remembered that social work scholars take source citations very seriously. Even in an interview setting, cite your sources!

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Average Rating: 5stars  elderhood , Wednesday, January 30, 2019

By Danielle Hoare :

As a current MSW student, trauma informed care is something that is stressed to us. I particularly liked the fact that Lisa spoke about the elderly and older adult’s mainly because I feel that a lot of people ignore this population. When I think about trauma, the elderly are the last population that would come to mind. After this podcast, I see how truly important trauma informed care is during elder hood. Many older individuals may not have dealt with their trauma but now all of these feelings and reactions are resurfacing. I found it very interesting when it was mentioned that Post Traumatic Stress Disorder can be delayed until elder hood. I found it fascinating when it was mentioned about the veteran who went fifty years without having any signs or symptoms of PTSD until his life slowed down and these feelings started to resurface. I believe this population is very underappreciated and often not thought about during these conversations of trauma. Many people think that because these individuals are closer to the end of life, that these traumas cannot be dealt with, when in reality they can be and it would be very fulfilling to the individual if those were satisfied. I also appreciated how it was mentioned that a lot of family members are often the ones taking care of these individuals and find themselves being mentally and physically abused. As social workers, we stress self-care and I think we need to educate this to families as well as our clients.

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Average Rating: 5stars  refreshing perspective for end-of-life care, Sunday, February 11, 2018

By Badiah :

Dr. Nancy and Lisa Kendall have a progressive stance to Erik Erikson's stages of psychosocial development by changing the way our society views "old people." Instead of focusing on a physical or medical model of care, "elderhood" widens the scope of spirituality in this stage of development. Elders are encouraged to embrace healing and growth and to share their lifelong wisdom/ The expectation is that caregivers implement trauma-informed care that now only recognizes behaviors that surface as a result of past traumas, but also works to help individuals resolve those traumas. Thus, the elder person can "make peace" with the pst and within themselves.

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Average Rating: 5stars  always a time for change and growth , Monday, February 05, 2018

By Shanda :

The subject of this podcast is so important and yet this is the first time I have seen the specific topic of how people in the later stages of life are affected by trauma. The speakers describe ‘elder-hood’ as a stage of development separate from adulthood with its own set of tasks and developmental stages to be worked through. People who have experienced trauma may need help and supports to make peace and work through the tasks of this distinct life stage. The speakers also mention that there can be a time delay from experiencing a traumatic event and experiencing symptoms. People can keep symptoms at bay when they are very busy and involved with many things. As they get older and things start to slow down, they may start to experience symptoms from earlier trauma. Caregivers involved with the day to day care of elders do not typically have a lot of support built into their jobs. The speakers mention that these caregivers can also come to their job after experiencing their own unrelated trauma and this is bound to have an impact on both parties. Working towards a trauma informed system of care for elders would help to increase the level of care elders receive as well as support for those involved with day to day care tasks. Healing and growth can be supported by focusing on an individual’s strengths and skills they’ve used over time to help them survive. Allowing time for elders and workers/staff to build a relationship is also mentioned as important to create a trauma informed system. Asking about early experiences in a non-stigmatizing way so elders will feel safe answering and talking about their experiences. Using the phrase “painful memories” can be a low keep way to ask and allow people to talk about past experiences. Family members and staff need to keep in mind that the person in front of them has lived a full life and likely has had many experiences that they may be unaware of.

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Average Rating: 5stars  the importance of trauma informed practice with older adults, Sunday, January 21, 2018

By Gina :

Thank you for sharing your views on trauma and the elderly. I found the subject matter of this podcast to be so very important. Given the continued rapid growth in the number of older adults in our society, social workers and other care providers should become educated and remain mindful of the issues raised in the podcast. Somehow, it doesn’t seem like discussions on elderhood typically receive nearly as much attention as they should.

I truly appreciate the reference to “elder” as someone with special gifts and the ability to teach us. What was once a group that was revered, often now seems cast aside. I also feel that the discussion regarding a declining ability to cope due to a dwindling of all types of resources is a point well taken and one that I will try to keep in mind. Also, I feel that the point regarding the potential for delayed reaction to trauma is important for those working with older adults to be mindful of. The issue of retraumatizing an older adult who may be in a very vulnerable position should probably be near the top of the list of topics to discuss with caregivers.

I am hopeful that education in trauma informed care for the elder population and routinely creating work environments with a focus on safety for elderly clients and staff will expand and become standard practice. Increasing a focus on self- care for providers appears to be a win- win situation. Providers have an outlet for what can be a very stressful job, and clients benefit from working with providers who are feeling better and able to pass that renewed positive energy on toward work with their clients. Developing trusting and collaborative relationships with older adults and working toward building on their strengths presents a much more positive outlook for day to day living. It also seems to benefit the caregiver as well by shifting the focus from the negative to a more positive approach.

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Average Rating: 5stars  renewed interest, Sunday, February 05, 2017

By Sara :

A variety of points that were made during this discussion were thought evoking. One of the first points being that elder hood should be viewed as the individual having a broad range of knowledge to share. I found this to be a wonderful way to view later life because it is often viewed as the end. Elders have experienced a wide variety of situations, so they can share their methods of coping and knowledge gained. This mindset puts the elder in a position of power when they often feel they are losing control.
This relates to a point that was made later in the discussion regarding elder hood as a time of growth and healing. I found this perspective to be refreshing because I believe healing can occur at every age. Social workers can assist elders in their healing while focusing on the strengths of the individual. I am a firm believer that attitude is everything, meaning if we have a positive outlook on life then the quality of our life will be better.
This podcast gave me further confirmation that I chose the right field to practice in. Social work is a way of life and attending the University at Buffalo has provided me with priceless tools to assist clients to the best of my ability. I believe taking a trauma informed approach to healing is brilliant and should be used universally. This podcast has furthered my interest in the trauma informed approach and ways in which trauma impacts individuals.

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Average Rating: 5stars  self care, Saturday, February 04, 2017

By Catherine :

I really appreciated this podcast. It was very informative and talking about a population that I feel is sometimes forgotten about. As a future social worker and working in a nursing home right now, I see the toll that this work takes on people. Not just the social workers that work there but the CNAs and families as well, who might not be aware of how important self care really is. It is critical that one takes time for themselves, so that they are able to take care of someone else and give their 100%. I also think that the CNAs should be aware of trauma informed care and the different models that are out there to care for people in elderhood. You never know someone's story when you look at them so it is important to know to say "what happened to you?" and not "what's wrong with you?" It is also important to recognize that people can be traumatized at every age and that issues can be equally as important for the eldery as they are with someone who is younger. I would suggest this podcast to anyone who is interested in working with the elderly because it is super informative as well as an easy listen.

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Average Rating: 5stars  elderhood, Wednesday, February 01, 2017

By Brianna :

This is a great podcast to bring awareness to social work professionals and care providers, especially whom may work or want to work with individuals in their elderhood. Understanding a Life Span Approach that Kusmaul and Kendall mentioned would be beneficial for practitioners to integrate with a Trauma Informed Perspective. Knowing that while working with individuals in their elderhood, past trauma may not have been dealt with or talked about until the present moment in their lives, and to be aware of that to avoid retraumatization can save someone from wanting to avoid care from any other provider. It was mentioned that elderhood is a time of growth and a great time for healing so that when their time on earth does come to an end, they have a sense of closure. I really like that approach to dealing with trauma because so many people look at their elders as being so fragile almost so that it translates into a mental fragility concept and that is really far from most cases from what I heard. It is critical that providers and practitioners are mindful when working with the elderly because the challenge of aging may bring up past challenges, also mentioned. Always using a Strengths Based Perspective can give individuals the tools for coping, no matter what age. I appreciate the advice on working with elders and learning about the person directed movement that is going on within nursing homes. I agree it is my job as a future licensed social worker to educate and bring awareness to people on trauma and trauma informed care along with the education and awareness that not all healing comes from medical solutions but can come from more simpler things. Thank you for the knowledge!

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DISCLAIMER: The content shared by the presenter(s) and/or interviewer(s) of each podcast is their own and not necessarily representative of any views, research, or practice from the UB School of Social Work or the inSocialWork® podcast series.