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Traumatic events—whether in childhood or adulthood—can have profound effects on a person’s physical and emotional wellbeing, extending all the way to their final months. These experiences, such as parental abuse, repeating a school year, or involvement in armed combat, are linked to increased pain, loneliness, and depression at the end of life. For palliative care volunteers, understanding these impacts can enhance the support they offer to patients.

The Lasting Impact of Trauma

A long-term study that followed more than 6,500 Americans over 50 years old, until their deaths, found that traumatic experiences often reverberate throughout life. Participants who had experienced five or more traumatic events were significantly more likely to suffer from depression, moderate-to-severe pain, and loneliness during their final months compared to those who experienced no trauma.

For example, participants without trauma had only a 12% chance of feeling lonely near the end of life. In contrast, those with five or more traumas had a 22% chance of loneliness. Similarly, the likelihood of experiencing depression jumped from 24% to 40% for those with extensive trauma histories.

Common Traumatic Events

• Childhood: Repeating a school year was the most frequently reported trauma, followed by exposure to family members’ substance abuse.
• Adulthood: Facing a life-threatening illness or having a spouse or child with such an illness were the most prevalent adult traumas.
• Less Common: Events such as the death of a child, combat experience, or surviving a natural disaster were reported less often, but their impact on end-of-life distress was no less significant.

Over 80% of participants reported experiencing at least one trauma, and about a third endured three or more. These traumatic events were linked to increased emotional and physical suffering, especially in later years.

The Importance of Trauma-Informed Care

The study highlights the importance of addressing “total pain”—the physical, emotional, and spiritual distress that patients may feel near the end of life. Trauma can exacerbate suffering by making it harder for patients to cope with the loss of control over their bodies, triggering memories of earlier harmful experiences.

For palliative care volunteers, this underscores the value of adopting a trauma-sensitive approach. Patients may benefit greatly from empathetic listening and emotional support. Partnering with professionals such as social workers, chaplains, and psychologists can help patients find relief from deep-seated emotional pain.

Supporting Patients Beyond Physical Symptoms

Volunteers are in a unique position to offer meaningful support by recognizing that a patient’s suffering may go beyond disease-related symptoms. Emotional or spiritual pain may require the same attention as physical pain. Simply being present, offering comfort, or encouraging patients to connect with mental health professionals or spiritual caregivers can make a profound difference.

As a volunteer, understanding the role trauma plays in shaping a patient’s experience can help you respond with greater compassion. Together with care teams, your empathy can alleviate not just physical discomfort but also emotional burdens, giving patients the peace and dignity they need in their final journey.

Palliative Care NSW will be running training on Trauma Informed Care for volunteers in November and December.  Please contact us for more information.