1. MACSWA Community Partners Program Supporting Culturally and Linguistically Diverse Older People Who Have Experienced Trauma

2. MACSWA Workshop Facilitators Insert facilitators’ names here

3. MACSWA Workshop Outline Overview of ……and ……..services Working with CALD clients Reflections on diversity Definitions of trauma and PTSD Case studies Strategies in the workplace Evaluation

4. MACSWA Agency Information

5. MACSWA Agency Information

6. MACSWA Traumatic Events A traumatic event is one in which The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity to self or others. The person’s response involved intense fear, helplessness or horror. Diagnostic & Statistical Manual of Mental Disorders (DSM – IV - TR), 2000

7. MACSWA Developing Post Traumatic Stress Disorder Subsequent to experiencing or witnessing a traumatic event a person may develop ongoing characteristic symptoms described in the DSM – IV as Post Traumatic Stress Disorder or PTSD. The development of this disorder may depend on variables such as Emotional and/or psychological resilience Pre trauma experiences Severity and extent of the traumatic experiences Level of support before, during and following those experiences

8. MACSWA Impact of Trauma - Mental Changes Concentration problems and memorising difficulties Disorientation Intrusive memories

9. MACSWA Fear, guilt, anger, loss, grief Anxiety, phobias, panic attacks-fear of complete disintegration Depression-paralysed helplessness, diminished power & control, unresolved grief and loss Impact of Trauma – Affective Changes

10. MACSWA Impact of Trauma – Behavioural Changes Sleeping and eating disorders Irritability, impulsiveness, aggression Withdrawal, avoidance Relationship difficulties, cross-generational difficulties Suicidal ideations Domestic violence Psychosomatic complaints Impairment in functioning in practical matters

11. MACSWA TRIGGERS Triggers are different for each person and can be thoughts, images, sounds and smells, tastes, stressful situations and many more. Many stimuli can only be identified as triggers, once details of the person’s personal history are known.

12. MACSWA POTENTIAL TRIGGERS Can be a normal, everyday event that relates to past trauma. Being placed in an aged care facility can be a reminder of loss of home, family and community. Injections, visits to the doctor Knocks on the door

13. MACSWA Similarities - Mental Function A Client may: Be very forgetful of recent events - memory for distant past generally seems better although some details may be confused. Become lost if away from familiar surroundings or be unable to find their way around. Be forgetful about practical tasks, eg: forget saucepan on stove. Dementia & Post Traumatic Stress Disorder

14. MACSWA Similarities - Personality & Behavioural Changes A Client may: Behave inappropriately or oddly. Be aggressive, perhaps without apparent cause. Be neglectful of hygiene or eating. Be disturbed at night. Be restless and anxious Become angry, upset or distressed through frustration. Similarities - Physical Mobility problems. Dementia & Post Traumatic Stress Disorder

15. MACSWA PTSD Be confused about time and place, rarely confuse day and night. Forget names. Rarely forget or confuse names of family members. Experience flashbacks. Differences - Mental Function A client may: Dementia Be confused about time and place and day and night. Forget names of friends, family or confuse family members. See or hear things that are not there. Dementia & Post Traumatic Stress Disorder

16. MACSWA PTSD Not normally associated with PTSD. Not a symptom of PTSD - may be factor of culture. Have occasional difficulties with comprehension. Their speech may make little sense (cultural/language) Differences - Mental Function (cont’d) A client may: Dementia Become very repetitive. Fail to recognise everyday objects. Have difficulties with comprehension. Their speech may make little sense. Dementia & Post Traumatic Stress Disorder

17. MACSWA PTSD Wander around streets, may become lost, rarely at night. Not a symptom of PTSD. Not a symptom of PTSD. Dementia Wander around streets, becoming completely lost, sometimes at night. Need help or supervision with feeding, washing, toileting, dressing. Take clothes off inappropriately. Dementia & Post Traumatic Stress Disorder Differences – personality and behavioural A client may:

18. MACSWA PTSD Not a symptom of PTSD. Differences - Physical A client may: Dementia Be incontinent of urine and/or faeces. Adapted from: Stages of Dementia by Alzheimer’s Australia, WA Dementia & Post Traumatic Stress Disorder