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This study of 73 centenarians found that pain—not age—was the key disruptor of function, mood, and cognition. Surprisingly, the most distressed group had the sharpest minds, suggesting cognitive clarity may heighten the emotional toll of pain and decline. For clinicians, it’s a reminder to treat pain proactively, validate lived experience, and address connection and meaning alongside movement.

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Social Health

Yes, pain matters as we age—but how we cope with pain, and how much it interferes with life, often comes down to something deeper. That’s where resilience, connection, and social health step in. These elements don’t erase pain, but they can buffer its impact—helping people adapt, stay engaged, and protect their quality of life in the face of life’s inevitable challenges.

📌 Li et al. (2024)

Using data from the Chinese Longitudinal Healthy Longevity Survey, they found that socially isolated older adults were significantly less likely to reach age 100. Social connectedness — via family, friends, and community — was a stronger predictor of longevity than many traditional physical health metrics.

📌 Waldinger et al. (2025)

Harvard Study of Adult Development – Following people for over 80 years, this study found that strong, supportive relationships in midlife predicted better physical health, mental health, and longevity later in life. Social connection was more predictive of long-term health than cholesterol levels.

📌 Wang et al. (2024)

In a 10-year follow-up of over 15,000 older adults, those who increased their social participation (e.g., group activities, community involvement) had a 30% reduction in all-cause mortality. Again: connection is medicine.

The Clinician Toolkit

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Heywood and colleagues (2024) took a close look at physiotherapy practice in a large Australian hospital and mapped what they saw against the five trauma-informed care (TIC) principles: safety, trustworthiness, choice, collaboration, empowerment.

When clients feel safe, have choices, and share power, they don’t just move more—they recover with meaning and agency.

As Maya Angelou put it, “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

That’s the essence of TIC. Our clients may not remember every exercise or cue we give them, but they will remember whether they felt safe in our presence, whether they felt heard, and whether they had a say in their own care. Those experiences shape not only outcomes, but the trust that makes recovery possible.
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Here is what stood out from the Heywood paper: 

Safety 🛡️ → Physiotherapists were approachable and attentive, which supported interpersonal safety. But “safety” was mostly viewed as physical (fall risk, mobility). Psychological and emotional safety, things like privacy, pacing, and acknowledging difficult emotions, were rarely addressed. A consistently upbeat, “cheerleader” approach sometimes shut down space for discomfort or distress.

Trustworthiness 🤝 → Touch was a reflexive “go-to.” While often professional and caring, it wasn’t always explained, and explicit consent was often assumed rather than sought. That assumption—doing what’s “best for the patient”—risks eroding trust.

Choice 🎯 → Patients were usually given small, low-stakes choices (“Do you want to walk now or later?”), but meaningful decision-making was rare. Many patients couldn’t identify moments where they had real agency in their care.
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Collaboration 👥 → Some physios used “let’s do this together” language and worked with patients, but collaboration often broke down under time pressure or when clinicians believed they knew the “right” treatment. The power imbalance—clinician as expert, patient as passive—wasn’t always acknowledged.

Empowerment 🌱 → Encouraging independence was common (getting people up, walking, regaining function), but empowerment of non-physical skills—like pacing, grounding, or building confidence—wasn’t emphasized. The focus often defaulted to “getting the physical stuff done.”

The takeaway: physios (SLPs, OTs, etc) are already doing pieces of trauma-informed care well—listening closely, validating symptoms, and being warm and approachable. But the practice is patchy, and often confined to the physical. To truly align with TIC, we need to widen our scope: expand what safety means, ask for consent explicitly, give meaningful choices, share power, and build skills that go beyond mobility.
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🌐 GO DEEPER ON TRAUMA-INFORMED CARE (TIC)


Curious about what it really means to practice trauma-informed care? Check out this short video above.


And explore the Trauma-Informed Care Champions website here 🌱

It’s a powerful resource for anyone who wants to shift from simply treating to truly healing.

At its heart, TIC is about how people experience care. Warmth and expertise matter, but so do voice, transparency, and partnership. When we weave those into practice, we create the conditions where people can truly flourish.

Additional Courses

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Discount Code to AMP Online Masterclasses
  • Strength Under Stress
  • Mastering the Clinical Encounter
  • Changing Behaviour  
  • Navigating Clinical Uncertainty  

  • BA for Depression.       

  • CBT for Physically Symptoms      
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