Home Care Aide Tamara works with a Consumer who has never served a day in the military, but her experience with post-traumatic stress disorder (PTSD) is no less intense. Tamara knows all too well. For the last year, she’s worked as a caregiver for a survivor of domestic abuse (name withheld for privacy), who was diagnosed with a condition commonly associated with military veterans.
“She used to be on heavy medication,” Tamara says on a sunny spring Friday. “But she’s growing, and she’s getting healthier.”
The Mayo Clinic defines PTSD as “a mental health condition that’s triggered by either witnessing or experiencing a terrifying event.” The initial trauma can include anything from sexual assault to traffic accidents to experiences related to war. As relayed in countless movies and television shows, symptoms include nightmares, drastic mood swings, and flashbacks. A condition that affects the memory and psyche, long-term effects of PTSD can include personality disorders and identity alteration.
For Tamara’s Consumer, it’s been years of “growing and getting healthier.” But it was only in 1987 that the official causes of PTSD were expanded to include a host of experienced, as well as witnessed traumas, such as domestic violence.
“She acquired PTSD at a young age,” Tamara says. “Where is the help? How do you get out of a situation like that and never get back into it?”
Tamara describes all the ways in which her Consumer’s condition has affected her life. She has difficulty trusting the people around her. Building a support system for Consumers like Tamara’s can be difficult, since every interaction is a potential trigger of their past. “People who talk about their own situations can trigger her in thinking about her own safety,” Tamara says. “She can be very paranoid and her senses are very heightened.”
Possible Causes & Events
PTSD can occur after a traumatic event that you see, hear about or that happens to you, such as:
- Sexual or physical violence
- Serious accidents, such as car wrecks
- Combat exposure
- Natural disasters
- Physical injury
- Emotional Abuse
Common Symptoms
- Reliving the event. You may have bad memories, nightmares, or feel like you’re going through the event again. This is called a flashback.
- Avoiding the situations that remind you of the event. You may try to avoid situations or people that trigger memories of the trauma. You may avoid talking or thinking about the event.
- Negative changes in beliefs and feelings. You may feel fear, guilt or shame. Or you may not be interested in activities you once enjoyed.
- Feeling keyed up (or hyperarousal). You may feel jittery, always alert and on the lookout for danger. Or you may have trouble sleeping or concentrating.
The eldest daughter in a family of nine, Tamara’s father passed away when she was just 10 years old. She credits her childhood—as well as her Oglala Sioux ancestry and her background in livestock management—for her patience as a caregiver.
Tamara says. “Through my life, I’ve always been a nutrition-conscious, healthy person. I worked 10 years as a machinist, another 20 years in construction, and I got my livestock master’s. I’ve just always seen how people have to take care of each other. Even in construction, you have health and safety concerns, and you need teamwork. You have to be sensitive to who can’t deal with heights— with who might get motion sickness.”
In Washington state, caregivers like Tamara are not alone in supporting Consumers with PTSD. The array of treatments for the condition are as diverse as the range of PTSD triggers; some of which are related to war-time experiences, while many aren’t. In Washington, traditional psychiatric treatment—often facilitated by mental health professionals—exists alongside novel methods such as medicinal marijuana.
Home Care Aide Tamara walks her dogs in eastern Washington. Photo by Paul Joseph Brown.
HelpGuide.org provides extensive online resources for caregivers supporting Consumers with PTSD. They recommend patience, self-education on the condition, and not pressuring your Consumer into seeking help or talking about their experiences. According to their guide, they recommend framing professional treatment in a positive light. “Emphasize the benefits. For example, therapy can help them become more independent and in control. Or it can help reduce the anxiety and avoidance that is keeping them from doing the things they want to do.”
Located in Seattle’s Central District, The Samarya Center is pioneering a form of yoga treatment known as Integrated Movement Therapy. Molly Lannon Kenny is the center’s founder and director, and she advocates for a holistic method of healing for patients with conditions stemming from PTSD. “At Samarya Center, we provide a sense of wholeness, and we take judgment out of the equation,” Kenny says. “The most healing thing for people is to acknowledge that they’re valuable, and to let them know that nothing they’ve experienced or seen can take that away from them.”
Kenny reasons that care is a two-way street, and insists that her instructors take an active, receptive attitude to caring for anyone who comes to The Samarya Center for treatment. “Our job as helpers,” she continues, “is to keep our minds open to complexity, and to keep our hearts free of judging others for situations that may’ve led them to acquire PTSD.” Kenny points out that, “The thing about a PTSD diagnosis we often don’t talk about is that it isn’t just about something you’ve experienced, like war or sexual trauma. It can also be the result of something you witnessed.” Kenny believes that as a society and as individuals, our self-worth is constantly in danger.
It is one reason why mental health is as important for Home Care Aides as it is for the Consumers they care for. Tamara recommends that HCAs caring for Consumers with PTSD look into resources for their own self-care. “Many Consumers with PTSD are on medication and not in good physical health,” she says. “When they’re stressed, you get stressed too.”
The U.S. Department of Veteran Affairs has an extensive online PTSD Caregiver Support library at www.Caregiver.VA.gov. The VA also encourages HCAs to create space for themselves and acknowledge how caring for someone with PTSD can affect them. Their guide, “Creating Space for You,” says, “Your feelings are valuable sources of information about what you need, your own boundaries, and about what matters to you.” Taking time to pay attention to those feelings through journaling, meditation, talking to a friend, or therapy can help HCAs process their work as caregivers.
With imaginations weaned on cinematic spectacles that celebrate the veterans’ valor, so much of our nation’s attention when discussing PTSD is focused on wartime experiences. And rightfully so. But trauma can also be tied to verbal abuse, sexual assault, and poverty, which are equally important causes of PTSD. Caregivers like Tamara are doing the work at home to make sure all citizens have a quality of life worth defending.
Tamara says, “This isn’t just about PTSD. We all need taking care of.”
Editor’s Note: The Consumer referenced in this story gave Home Care InSight permission to share information about her PTSD. Specifics about her past and identity are withheld for her privacy.
Find Support
Talk to your Primary Care Provider about options available to you, like therapy and support groups. Below are other resources available to you and your Consumer.
