Trauma-Informed Dementia Care
Trauma happens to all of us. At its core, trauma stems from painful experiences so overwhelming that we simply do not have the capacity to feel them fully at the time. Think of it like a thorn stuck deep under your skin. It doesn’t just disappear. Instead, it gets ignored, new skin grows over it, and life moves on. But underneath, it never truly heals. The moment that spot is touched, it remains incredibly sore.
If we live long enough to develop dementia, you can bet that we are entering that season of life carrying a heavy backpack full of this unfelt, silent pain.
We all rely on psychological walls to contain our trauma and live a normal life. We build sturdy barriers to keep those old, painful feelings at bay so we can get through our days, raise families, and go to work. But the problem with progressive brain disease is that those walls begin to crumble.
When dementia takes hold, a person loses the neurological capacity to contain their emotions and maintain a polite exterior. Suddenly, someone you have known and loved all your life may begin to act strangely. They might express simmering rage, profound fear, or a deep, haunting grief in ways that feel overwhelming to witness.
As caregivers and loved ones, our instinct is often to panic and try to help them calm down. But if we look at these behaviors through a trauma-informed lens, we realize we aren’t just witnessing symptoms of a disease—we are witnessing the unloading of a heavy packsack of unfelt feelings they may have been carrying for many years.
Moving Beyond "Talk Therapy"
What is fascinating about modern trauma research is that treating trauma does not require a person to cognitively understand or intellectually process their emotions. In fact, traditional "talk therapy," telling a story to try to make sense of it, is often re-traumatizing for people with PTSD, leaving them feeling terrible without actually helping them let go of the feelings.
In his groundbreaking book, The Body Keeps the Score, Dr. Bessel van der Kolk, alongside other leading trauma researchers, established that effective trauma treatment must involve the body. Somatic practices like yoga, theater, and EMDR (Eye Movement Desensitization and Reprocessing) allow a person to physically feel and release their emotions without needing to cognitively analyze them. Interestingly, scientists still don't fully understand the exact mechanism of how EMDR works in the brain—and yet, amazingly, it works.
What Dementia Teaches Us About Healing
My clinical experience serving as a chaplain with older adults—specifically those living with dementia—has shown me a beautiful parallel to this research. When a person is allowed to truly experience an emotion and feel it all the way through to the end, there is a profound, healing release in that physical outlet.
The trouble is, when our loved ones with dementia begin to express this raw pain, our societal reflex is to make them stop. We want them to calm down, be quiet, and "be nice."
But when we try to suppress their storm, we create a wall between us. It leaves both the carer and the individual feeling disconnected, afraid of each other, isolated, and incredibly lonely.
If Grandma is cussing up a storm, instead of trying to shush her or calm her down, try validating her raw reality. Meet her where she is: "Grandma, I hear you, and I see that you are absolutely MAD today!"
The Sacred Role of Witness (Not Fixing)
When these intense storms hit, the pressure on a caregiver can feel crushing. But here is the profound, liberating truth you need to hear today: You cannot fix it. You cannot heal it. You cannot even fully understand it.
And you don’t have to.
Your job is not to cure a lifetime of historical trauma or rewrite the architecture of a failing brain. All you have to do is witness it.
Witnessing these moments requires a skillful dance of presence. On one hand, you must stay connected enough with deep empathy to let your loved one know—and feel in their very bones—that they are not alone. They need to know they are sitting with someone who loves and accepts them, exactly as they are in their messiest moments.
On the other hand, you must maintain enough healthy internal distance to keep from being swallowed whole by their painful emotions. Protecting your own peace isn't selfish; it is how you keep your own soul intact so you can continue to show up tomorrow.
The Lifeline of Connection
Loving, connected relationship is healing. It is the breath of life that allows us to go on day by day. When supporting someone with dementia who is carrying historical trauma, the goal is not to fix their memory, but to anchor their soul.
So, what can you do?
Give them space to feel. As long as they are not hurting themselves or others, let the emotion move through them.
Let them know they are seen. Stay with them and mirror their emotion with simple words and without judgment. Do not abandon them by ignoring their pain or changing the subject.
Validate their feelings. Acknowledging their pain out loud is a powerful tool. Amazingly, when a person feels truly heard and validated, it often helps their nervous system finally de-escalate and calm down naturally.
You Don't Have to Walk This Path Alone
Navigating these intense emotional waves while protecting your own emotional boundaries is incredibly hard work, and it is completely normal to feel overwhelmed. But please know that you don't have to navigate this fog by yourself.
I have spent 15 years sitting with hard, heavy emotions. I have learned how to hold space for the unexpressed pain of a lifetime while helping caregivers protect their own well-being. This is a practice that can be taught.
Every person deserves a peaceful, dignified end-of-life experience, and every caregiver deserves to come through the experience whole. Let’s work together to unpack the backpack safely, lead with connection, and bring peace back into your caregiving journey.
Are you navigating difficult behaviors or emotional storms with a loved one? Reach out today. Let's find a path forward together.
