Post-Traumatic Stress Disorder and dementia | Ask Steve

On November 11, we remembered the sacrifices made by those who served our country. Thinking of this, I wanted to share with you the impact that a traumatic experience – such as the violence of war can have when someone develops dementia and Post-Traumatic Stress Disorder (PTSD).  

In my experience, PTSD, a set of reactions triggered by events that remind the person of their original trauma. Some individuals living with dementia may carry a pre-existing PTSD diagnosis, while others might exhibit PTSD symptoms alongside their dementia diagnosis, especially if tied to traumatic events such as war.

For a person with dementia, trauma can be triggered by events that remind the person of their original trauma. I've encountered numerous instances where the aged care environment itself can trigger behaviours by incidents such as sudden noises or unexpected interactions with residents or care staff.

Recognising the symptoms — ranging from reduced tolerance of noise and hyper-alertness, to increased heart rate or flushed face — in individuals with both dementia and PTSD is an important step in supporting the person. Here are some strategies that I've found to be effective:

1. Awareness and acknowledgement of past trauma provides a key to understanding behaviour changes. Involve family and friends in implementing and reinforcing strategies based on this awareness, creating a supportive environment.
2. Encourage the use of relaxation techniques and reminiscence of positive experiences.
3. Modify the surroundings to minimise or eliminate known triggers for PTSD.
4. When contemplating medication, a careful evaluation of individual cases is paramount, ensuring that any prescription aligns with the unique needs of the person living with dementia.

A/Prof Steve Macfarlane is the Head of Clinical Services at DSA. He is a geriatric psychiatrist and spent 11 years working as the Director of two metropolitan public-aged psychiatry services in Melbourne, prior to helping establish the Severe Behaviour Response Team in 2015.