Beyond the Injury - Exploring the Foundations of Health-Related Quality of Life in Older Adults and Their Caregivers

Background: Older adults (aged ≥65 years) represent 21% of the trauma admissions in the United States, yet little is known about their health-related quality of life at baseline prior to injury. This study aimed to describe the pre-injury daily activities and social engagement of older adult trauma patients and their caregivers. Materials and Methods: We conducted a longitudinal mixed-methods study including critically injured older adult trauma patients (aged ≥60) and their self-identified caregivers (aged ≥55). This manuscript reports qualitative findings from baseline semi-structured interviews with 16 patient-caregiver dyads enrolled at a single academic trauma center. Interviews were transcribed and analyzed using applied thematic analysis. Results: Two themes emerged: (1) older adults maintained active and socially engaged routines before injury and (2) family relationships were a consistent source of connection and support. Prior to injury, most participants reported involvement in physically and cognitively engaging tasks, including exercise, volunteering, spiritual activities, and caregiving responsibilities. Family interactions, irrespective of frequency, provided comfort and meaning for participants. Conclusions: Older adult trauma patients and caregivers engaged in a wide range of meaningful daily activities and social roles prior to injury. These findings underscore the importance of contextualizing health-related quality of life following injury within the lived experiences of older trauma patients.