As we are learning, trauma-informed care shifts the question from what is wrong with you to what has happened to you? This is an important shift in mindset. Yet, additional questions need to be asked if we are to become healing-centered communities. This section offers strategies for going beyond trauma-informed care.
Healing-Centered Engagement
How can we make meaningful use of what we have lived through? While we are still recovering from our experiences during the pandemic, the opportunity before us is to build communities where healing and growth are central. No doubt, our nursing home communities have been through extreme distress and continue to have unmet needs related to COVID-19.
Just as person-centered care evolves toward trauma-informed care, the next turn in care is toward healing-centered engagement. Healing-centered engagement asks: What’s right with you? (Ginwright, 2018).
This podcast episodes explores Shawn Ginwright's healing-centered engagement as a visionary next step in how we care for each other in our families and communities, including in nursing facilities.
Recognizing that nursing facilities are places where people live and work together, sometimes for years and under difficult circumstances, we in the field have a responsibility to understand the impact of ongoing distress and to offer resources and assistance to relieve suffering and promote well-being of staff, residents, and family members. The science around mindfulness-based stress reduction interventions for staff and residents is growing and persuasive. Randomized control trials (RCT) have demonstrated that such approaches help reduce burnout, stress, and compassion fatigue among nursing home staff and have a long shelf life relative to impact (Perez et al., 2022). Likewise, RCTs conducted among nursing home residents indicated these practices may help improve health-related quality of life and reduce symptoms of depression (Ernst et al. 2008). Offering training in these approaches for chaplain services, social services, and activities team members in service to staff and volunteers could prove to be a valuable internal resource for nursing homes.
Capacitar International has developed a kit of simple basic practices for immediate use to help people cope with overload and chronic stress. The Capacitar Emergency Kit of best practices has been translated into more than 40 languages and used around the world to support recovery from war, natural disasters, and conflict.
Non-violent communication
Non-violent communication (NVC) is an approach to communicating that centers harmony, compassion, and love. As such, NVC furthers the aims of person-centered trauma-informed care and healing-centered engagement. This podcast episode from the VCU Department of Gerontology offers an introduction to NVC in long-term care.
Power disparities exist in every healthcare setting. Addressing power disparity between residents and staff is essential to recovery and healing for nursing home residents. Listen to a powerful discussion on the role of power dynamics in care environments and an introduction to the RESPECT model of communicating with patients and residents (Mostow et al., ).
Cultivating Connection and Belonging
Trauma often impairs our relationships through violations of trust, loss of agency, and loss of safety. Social connection plays an important role in healing from trauma. Positive social experiences and healthy social bonds offer therapeutic benefits for all of us, regardless of our role or job in a nursing home community. When employees experience chronic stress and trauma, including on the job, it becomes even more crucial to foster a healthy sense of belonging and support in the workplace. One way to support the entire nursing home community is to create cultures of connection where every employee and resident feel like they belong. When nursing home employees are happy and thriving, they can in turn help create a sense of belonging and community for residents and other staff members.
