In the past two years, a quiet phenomenon of ongoing civilian trauma has been developing in Israel among elderly people and chronically ill patients living under the daily alertness of war. The trauma manifests in sleep disturbances, increased blood pressure, worsening heart and lung diseases, confusion, social withdrawal, extreme fatigue or accelerated functional decline.
The ongoing burden on the nervous system can be identified and prevented using simple tools.
Here are five practical steps for early prevention of cumulative trauma among the elderly and chronically ill:
1. Breathing for daily regulation
The nervous system of an older person is especially sensitive to prolonged stress. Rhythmic and slow breathing can reduce arousal, lower heart rate and stabilize blood pressure.
A simple exercise is a medical tool for reducing overwhelm – slow inhalation through the nose for four–five seconds, and slow exhalation at the same pace, for several minutes, which can be performed in the morning, before sleep or during a feeling of pressure can reduce stress. During a siren or stressful event, a shortened version can be adapted: Two short inhalations through the nose followed by a long and slow exhalation. Several such cycles may help reduce overwhelm.
2. A mental anchor and a sense of control
Many elderly people experience a loss of control in situations of uncertainty. It is possible to create a simple “anchor” such as a personal word like calm, or a small gesture of pressing between the fingers and practice it during a calm moment. Thus, during alertness, repeating the anchor helps the brain recreate a sense of stability.
3. Sensory grounding in situations of confusion or overwhelm
During extreme stress, the brain may shift into a state of confusion or disconnection. Among elderly people, this condition may manifest as cognitive slowing or momentary disorientation.
A simple grounding exercise to identify three things that are seen, two sounds that are heard, and one clear physical sensation (such as the touch of the chair or the floor under the feet) will help bring attention back to the present through sensory focus and reduce the feeling of overwhelm.
4. An initiated conversation after a stressful event
A siren, staying in a protected space or difficult news accumulate in the body. Therefore a short conversation within 24–72 hours with a family member, caregiver or medical staff member in which they share what happened, and what I felt. Will help reduce alertness. Early processing prevents emotional accumulation that may turn into chronic anxiety.
5. Emotional regulation as part of routine medical care
Chronic medicine cannot focus only on clinical indicators. A routine check of sleep quality, sense of alertness, daily stress level and social involvement should be integrated.
When medical teams integrate tools for emotional regulation as part of a home visit or rehabilitation follow-up – the risk of functional decline decreases significantly. Such prevention reduces the risk that the cumulative burden will turn into ongoing damage.
There is paramount importance in creating a supportive community framework and reducing exposure to stress-inducing content. Family members and neighbors constitute a central axis in preventing functional decline through maintaining continuity of social meetings and a stable routine. At the same time, wise management of news consumption, especially in the evening hours, is essential for preventing over-arousal that harms sleep quality and blood pressure indicators. Limiting threatening information allows the aging brain to process reality in a more balanced way. The combination of sensory regulation, continuous human connection and a protected communication environment constitutes the full infrastructure for long-term medical and mental resilience.
The challenge of the healthcare system today is not only to treat diseases, but to prevent the entrenchment of chronic stress as a disease factor in itself therefore treating trauma while it is still “young” is a necessary step for maintaining public health in the coming years.
The author is the director of the geriatric department at the Integrative Medical Kar rehabilitation hospital.