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Positive Child-Parent Bonds Lead to More Positive Caregiving for Aging Survivors

Last week we observed Holocaust Remembrance Day. This year marks the 70th Anniversary of the liberation by the Allied Armies of the Auschwitz and Dachau concentration camps. To mark this day we are sharing observations made by the Transcending Trauma Project (TTP) team from the interview statements of survivors explaining how the experience of the Holocaust affects them as they age and the observations from their children’s interviews of how their parents’ aging affects them. TTP has focused on family dynamics in all of its work based on the deepened life history interviews conducted by TTP interviewers with 300 survivors, their children and grandchildren. In the interviews, survivors describe the profound impact on their lives resulting from the loss of their spouses. The devastating suffering and losses and struggles to rebuild their lives creates a strong bond between survivor spouses, even in difficult marriages. Often the survivors’ spouses are the only people who know the extent of each other’s suffering and when one passes there is a profound sense of loneliness. During the rebuilding process survivors were able to put their energies into work and raising a family. With aging and diminished health it becomes more difficult, due to diminished activity, to put the haunting memories aside. In addition adult children become occupied with their own lives and are less available to survivor parents even if there are good intergenerational relationships. Aging is a difficult life stage and loss of a spouse is, of course, a significant loss. For survivors these realities leave them vulnerable to the residual pain of their traumatic experiences during the Holocaust.

Looking at this material from an intergenerational lens, the attempt to learn about the dynamics affecting aging survivors leads us to look at the effects on the children. It was very striking to find that in survivor families where the children reported positive relationships with their parents throughout their childhoods, the adult children had a more positive attitude towards the parents’ aging.  Even when they described the emotional demands of the negative coping behaviors of their parents, they still expressed empathy, understanding and often gratitude towards their parents for the life lessons they received from them.  In families where the relationships between the survivor parents and children were characterized by distance, self-centeredness, criticalness or expressions of negative emotion such as anger, the children did not express empathy towards the parents and viewed the aging of their parents as a burden and negative force in their lives.

It is crucially important that health care providers caring for aging survivors of extreme trauma gather information about how the survivor is coping with the long term effects of their traumatic experiences during the war. These residual effects can greatly affect medical care if the survivor reacts to confinement for a test or in an institution especially if surrounded by strangers.  In addition, with the knowledge that familial caretaking of aging and ill people directly affects their response to care and their recovery, it is important for health care providers to have a sense of family dynamics between the aging  survivors and their children in order to assess how much to rely on the family system for supportive care. With this knowledge, medical practitioners will be able to better assess the potential assistance from family, the impact of the assistance, and what needs are left to address when working with patients who are survivors of the Holocaust.

Having learned these patterns from interviews with Holocaust survivors and their children it is interesting to apply these observations to the elderly in general and to the elderly who have experienced trauma in specific. With the propensity for early trauma to be re-experienced during aging, health care workers need to address the increased vulnerability of these older patients. Knowing the quality of family relationships, in spite of these increased difficulties, can help the medical practitioners understand their patients better and be better able to assess their ongoing needs. It is likely that in all cases of the long term effects of trauma on aging survivors, addressing the needs of the elderly are mediated by the quality of the relationships with their children. How these positive and negative bonds affect the course of illness would be important to investigate. From the work of TTP we have learned that the positive relationships forged in childhood help the children cope with their parents’ needs during the difficulties of aging.