Research led by UC San Francisco and the University of Michigan underscores the profound consequences that childhood trauma can have on individuals as they face the end of life. The study reveals that experiences such as repeating a school year or suffering abuse can significantly exacerbate feelings of pain, depression, and loneliness in later years.

According to Dr. Ashwin Kotwal from the UCSF Division of Geriatrics, “We found that early-life trauma in particular, especially physical abuse by parents, was strongly related to end-of-life pain, loneliness and depressive symptoms.” This highlights the long-lasting effects of traumatic experiences.

Findings from the Health and Retirement Study

The insights from this study stem from the Health and Retirement Study (HRS), which monitored around 6,500 older Americans who passed away between 2006 and 2020. The analysis, published on October 1 in the Journal of the American Geriatrics Society, illustrates that traumatic events throughout a person’s life can lead to severe end-of-life distress.

Participants reported their experiences with various traumatic events, including childhood trauma, and received follow-ups until death, with average mortality occurring around age 78. A final interview offered insights from family or friends about the participant’s last year, particularly concerning pain and emotional state.

Trauma’s Long-Lasting Effects

Individuals who faced multiple traumatic events in their lives exhibited alarming probabilities of suffering from pain and loneliness. Specifically, those affected by at least five traumatic experiences had a 60% chance of encountering moderate to severe pain and a 22% likelihood of feeling lonely at the end of life.

“Connecting with a psychologist, chaplain or social worker may be what’s most effective in alleviating pain,”

Understanding the Types of Trauma

About 40% of the study participants reported experiencing childhood traumas, with the most common being the repeated school year. In adulthood, prevalent traumas included life-threatening illnesses affecting themselves or loved ones.

Furthermore, over 80% of individuals reported at least one traumatic experience throughout their lives, and one-third encountered three or more. Those who reported no traumas displayed a considerably reduced incidence of pain (46%) and loneliness (12%), contrasting sharply with those who had faced numerous traumatic events.

The Path to Mitigating Suffering

The conclusions drawn from this research stress the importance of viewing patients’ experiences through a lens of trauma. “Near the end of their lives, people may experience ‘total pain’ – pain that may be spiritual and psychological, as well as pain from physical sources,” Dr. Kotwal explains. Providers are encouraged to offer support that addresses both physical conditions and emotional distress stemming from trauma.

Co-author Chelsea K. Brown, a social worker formerly with UCSF’s Division of Palliative Medicine, adds: “For a person who has also experienced trauma, this loss of control may serve as a reminder of previous harmful experiences, and this is painful to relive in so many ways.”