The National Institute for Mental Health (NIMH) describes post-traumatic stress disorder (PTSD) as, “a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.” Although fear is natural and provides a protective factor (i.e., fight or flight reaction), it usually dissipates after the threat is no longer there. However, people with PTSD will continue to feel stressed, anxious or even frightened even after the threat has been removed.
PTSD has been linked to an increased risk for developing dementia in the general population. A this risk may even be higher among war veterans and combat soldiers, due to a combination of other risk factors.
The Invisible Wounds of War & Dementia
Traumatic brain injury (TBI) is a known risk factor for dementia. Soldiers, compared to the general population, have a higher risk of acquiring TBI. Furthermore, the nature and conditions by which they may have acquired their TBI can compound the trauma of their experience.
With advances in healthcare and technology, soldiers are able to receive timely treatment and rehabilitation. Ironically, swift [physical] recovery can lead to more deployments increasing further their exposure to trauma. In the 21st century, soldiers are exposed to more emotionally (and mentally) scarring events such as suicide bombings and witness traumatic images such as injured or dead civilians.
These combat-related injuries are known as the “invisible wounds of war.” It’s “invisible” because those who are affected appear to be “normal.” They neither show physical symptoms nor obvious scars. This is not a new phenomenon, as it dates back to the Frist World War. Back then, this combat-related trauma is referred to as being “shell shocked.”
The Link Between PTSD & Dementia
According to the article, “Alzheimer’s Disease: Prevalence, Costs, and Prevention for Military Personnel and Veterans,” published in the Alzheimer’s & Dementia – The Journal of the Alzheimer’s Association, PTSD seems to cause changes in the connections or synapses in the brain that are responsible for learning. This study further demonstrated that veterans with PTSD have a “reduced hippocampal volume” which may explain the impairment in memory.
In addition, veterans with depression are “twice at risk” of developing dementia compared to those who do not have depression.
Hallucinations in Dementia & How to Manage Them
Hallucinations in dementia are common particularly among those with Lewy-Body Dementia. Sadly, people living with dementia can re-live not only good memories, they can also re-live bad and even traumatic ones.
When caring for a client in their 80’s or 90’s or older, keep in mind that this person may have lived through one or two World Wars. They have survived The Great Depression and have witnessed at least one or two pandemics. If they appear genuinely afraid or fearful, believe them. Then, re-assure them that they are safe. Say things like, “We’re safe now. You may even need to say, “The soldiers have left.”
The Alzheimer’s Society (UK) emphasizes, “when a person is hallucinating, how you respond has a big impact on their experience and wellbeing.”
As caregivers, empathy reminds us to try and put ourselves in the shoes of the person we are caring for. In the world of dementia care, this means seeing what they are “seeing,” and hearing what they are “hearing,” even if you do not really see or hear anything. Compassion springs from understanding the person we are caring for. In the case of veterans and soldiers, they literally are heroes who served their country and allowed us to enjoy the lives we now enjoy today. We owe them at least that.
To learn more about dementia and how to better support someone living with symptoms of dementia as a healthcare professional, we invite you to register for our online self-paced course called, “Cracking the Dementia Code™ Fundamentals.” Grow your empathy and compassion skills by deepening your understanding of dementia.
