You might be wondering what an announcement about Post Traumatic Stress Disorder (PTSD) awareness is doing on a blog about palliative care. While many think of PTSD as a disorder experienced primarily by younger adults, it can be an issue in late life and palliative care as well. Some symptoms experienced as part of a serious illness (such as dyspnea) may echo experiences associated with a traumatic incident and reactivate PTSD. There is also some evidence that ICU admissions are associated with later development of PTSD.
Signs of PTSD include (from the American Psychological Association DSM-IV-TR):
- Exposure to a traumatic event that included actual or threatened death or serious injury and that was met with a response of “intense fear, helplessness, or horror”
- And symptoms from each of the following categories:
Intrusive recollections of event
Numb affect or avoidance of people/activities/thoughts/places that remind one of the traumatic event
A diagnosis of PTSD may be made if the symptoms last for at least a month and cause significant impairment in a person’s daily life.
What can be done about PTSD?
There are effective non-pharmacologic therapies for PTSD, which is encouraging in a palliative care setting where polypharmacy risks may be a concern. Cognitive behavioral therapy is one of the most promising types of non-pharmacologic therapy for PTSD. Other therapies that may be beneficial for patients with PTSD include eye movement desensitization and reprocessing (EMDR) and relaxation training.
Watch and share this five minute video about the need for prophylactic end-of-life conversations. Laura Heldebrand, an ICU nurse tells her mother's story.
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