ACL coined the term “person-centered, trauma-informed,” or PCTI, in 2015 to describe a goal. PCTI was envisioned as a holistic approach to providing services. It would promote dignity, strength, and empowerment of trauma victims by incorporating knowledge about trauma in victims’ lives into agency programs, policies, and procedures.
As the name suggests, PCTI combines the principles of:
- Person-centered supportive service delivery, which considers everyone’s experiences, needs, strengths, preferences, and goals, and
- Trauma-informed approaches to care in which all individuals and levels of an organization or system have a basic realization about trauma and understand its impacts on individuals, families, groups, organizations, and communities.
In 2015, at the direction of Congress, ACL awarded a grant to the Jewish Federation of North America (JFNA) to develop and disseminate innovations in PCTI care for Holocaust survivors. In the years since, JFNA has awarded over 80 sub-grants to nonprofit organizations to support the development of a range of PCTI innovations in the areas of socialization, health and wellness, mental health, cognitive support, and family caregiver support programs. In addition, several sub-grantees have trained professionals (including physicians, nurses, dentists, lawyers, social workers, and home health workers), volunteers, and family caregivers on how to provide PCTI care.
With additional philanthropic funds, and in combination with a national PCTI capacity building initiative, over 400 PCTI programs have been implemented in communities across the country to promote the health and well-being of Holocaust survivors and the family members who care for them. The initial grant from ACL served over 15,000 Holocaust survivors and over 4,000 of their family caregivers and trained 10,000 professionals in the PCTI approach.
Currently, approximately 80,000 Holocaust survivors reside in the United States (Hoffman and Weiner, 2019). Victims of the Holocaust endured torture, starvation, imprisonment, forced migration, and extermination. Because of these experiences, Holocaust survivors are at higher risk for a variety of physical and emotional conditions, including heart disease, osteoporosis, dental problems, cancer, and an overall greater difficulty performing activities of daily living (Van Pelt, 2013). Holocaust survivors are also at high risk for poverty. Those survivors living in the United States are three times more likely to live in poverty than other older adults are. In fact, nearly 35% of survivors live below the poverty level (Hoffman and Weiner, 2019) and often struggle to meet their basic needs, including those for meaningful social interactions (Sherman, 2014).
Approximately 70-90 percent of adults in the U.S. have been exposed to some type of traumatic event during their lifetime (Kaiser et al, 2017; Kilpatrick et al, 2013).
Trauma can occur at any point during the life course, without regard to age, gender, socioeconomic status, race, ethnicity, geography, or sexual orientation (SAMHSA, 2014).
In 2020, ACL awarded JFNA a second grant to build upon the success of the initiative by:
- Further developing, and expanding the delivery of innovative, community based PCTI services to Holocaust survivors in the U.S., other older adult populations with a history of trauma, and family caregivers of these individuals.
- Providing technical assistance to continue growing the capacity of the aging services network to provide PCTI to any older adult with a history of trauma and their family caregivers.
In addition to Holocaust survivors, this grant expands the focus of PCTI approaches to include:
- Older veterans and first responders;
- Older adults who are refugees and victims of war, crime, domestic violence, and natural disasters;
- Older adults who have experienced racial, economic, and gender discrimination;
- Family caregivers of all these groups.
Examples of possible focus areas for such interventions include (but are not limited to):
- Comprehensive care management, including care transitions activities;
- Innovations in other care settings (e.g., nursing homes, assisted living facilities, senior centers, etc.)
- Psychosocial interventions;
- Trauma-informed lawyering and legal assistance;
- Socialization and wellness programs;
- Caregiver support;
- Dementia care;
- Advance planning and end-of-life and palliative care; and
- Homecare, nutrition, and transportation services.
You can learn more about this at www.holocaustsurvivorcare.org.
Additionally, these authors provide additional information you may be interested in reading about:
Kaiser, A.P., Wachen, J.S., Potter, C., Moye, J., Davison, E., with the Stress, Health and Aging Research Program (2017) Posttraumatic stress symptoms among older adults: A review. National Center for PTSD. https://www.ptsda.va.gov/professional/treat/specific/symptoms_older_adu….
Kilpatrick, D.G., Resnick, H.S., Minanak, M.E., Miller, M.W., Keyes, K.M., and Friedman, M.J. (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM 5 criteria. Journal of Traumatic Stress, 26, 537-547.
United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.