Trauma-Informed Care Toolkit

College of Health Professions

Resident Wellness

Two hands gently holding each other - one visibly older

Like person-centered care, trauma-informed care is a strengths-based approach that takes a holistic view of each person in our community. Trauma-informed care considers residents’ experiences and preferences in order to avoid triggers that may cause re-traumatization and in order to identify and pursue pathways to recovery. This section shares ideas for supporting and connecting with residents.

Generally, trauma survivors may have more struggles in finding joy and satisfaction in their day-to-day lives, and they may have difficulty in using healthy coping strategies to manage stress. Showing the right support and care can help people feel safe and increase feelings of satisfaction. For example, care that addresses the unique needs of Holocaust survivors and survivors of war, disasters, and other profound trauma are an important aspect of person-centered, trauma-informed care.

Emphasize cultural values, preferences, and approaches in residents' care plans.

Strong connections to culture and community support overall wellbeing and can anchor residents in their identities and purpose. As a part of a person-centered, trauma-informed response, knowing residents' cultural values, preferences, and needs can also help nursing facility staff to avoid triggers and re-traumatization. Spend time getting to know the cultural experiences and needs of residents and document care plans with respect to food preference and food preparation requirements, clothing, voice tone and volume, cultural etiquette, and residents preferences regarding physical contact with staff.

Use connecting conversations to evaluate quality of care.

Throughout the toolkit, we lift up the importance of stories in getting to know residents and their needs. Connecting conversations use appreciative inquiry as a narrative method to understand resident and family member experiences of care (Sion et al., 2020).

Cultivate care team members who are aware, sensitive, and responsive.

In their 2019 article, Fleishman and colleagues offered three simple questions as a starting point for taking a trauma-informed stance in nursing:

  1. Safety: Does this cultivate a sense of safety?
  2. Respect: Am I, and others, showing respect?
  3. Trust: Does this build trust?

Their work also provides a collection of practical tips for providing health care using a trauma-informed lens. While many nurses and team members already use these practices, it may be helpful to understand the link to the principles of trauma-informed care.

Practical Tips for Trauma-Informed Care to Support Resident Wellbeing
(Adapted from Fleishman et al., 2019) 

Trauma-Informed Approach Examples TIC Principle

Use open and non-threatening body positioning.

 Position your body on the same level as the resident.
Consider where you and the resident are relative to the exit, so that all parties have access and no one feels trapped.		 Safety

Provide guidance, so residents know what to expect.

Explaining the steps and reason for each procedure (e.g. vitals, wound dressing changes, personal care).

 Safety
Trustworthiness and Transparency

Ask before touching.

Even appropriate, non-invasive touch can be unpleasant and triggering for trauma survivors, leading to increased anxiety and stress. Ask every time you perform a physical task. “I need to take your blood pressure. May I place my hand on your arm?”

 Empowerment, Voice and Choice

Protect resident privacy.

Know who the resident would like in the room during care. Sometimes, residents may not feel comfortable asking family members or visitors to leave.

 Safety
Collaboration and Mutuality

Provide clear, consistent messaging about care and roles.

Consistency about limits to care, services, and roles encourages realistic expectations and builds trust.

 Trustworthiness and Transparency

Use plain language and teach back.

Avoid jargon and medical language. Break complex information down into smaller pieces. Ask the resident to explain it back to you.

 Collaboration and Mutuality

Practice trauma-informed care as a universal precaution.

As with infection prevention and control, taking a universal stance to trauma-informed care benefits all residents and minimizes risk for re-traumatization. 

 Safety