This application is in response to NIA Pilot Research Grant Program PA- 00-053 Objective 3.2 Racial/Ethnic Differences: Research on clinical and social factors contributing to racial/ethnic differences and changing patterns of difference in late life diseases and disability. The proposed 12 month study is designed to examine the way in which traumas of forced relocation and attempted genocide remain salient in old age to members of a particular ethnic group. There are three goals of the study. First, to complete a secondary analysis of an already collected data set in order to examine how a traumatic event (the Nazi attempt to exterminate the Jew, the Holocaust) continues to intrude on the lives of very old survivors, and how the survivors cope with these intrusions. Second, to develop specific hypotheses concerning trauma and coping in this population. Third, to construct a proposal for a larger (R01) study to formally test the developed hypotheses. The data used for the analyses is drawn from a study of the experience of trauma survivors in long-term care settings. The data contains material collected in both closed and open-ended questions, including material on physical, functional and mental health; attitudes toward care providers, quantity and quality of relations with family and friends, and information on their lives before, during and after the Way. Sixty Holocaust survivors were interviewed, half in community based and half in institutional based long term care. In addition, a care provider for each elder was interviewed and in a third of cases a family member was interviewed as well. A matched sample of older American Jews who did not experience the Holocaust were also interviewed. Our analysis will focus on the qualitative materials, although we will use the quantitative material as well. Our research team, which includes expertise in mental health and aging, trauma, long-term care and coping, will participate in the coding and analysis of the data. This R03 proposal will increase our understanding of the effect of these traumas on the individual and in helping to explain racial and ethnic differences in old age due to differences in historical experience and thus constitute the first stage for a R01 proposal.
