Trauma-Informed Care
Implementing TIC in nursing homes involves training staff to recognize trauma symptoms, creating supportive and non-punitive environments, and designing care plans that are sensitive to the trauma history of residents. This approach helps improve the overall well-being of residents by creating a more supportive and understanding care environment.
In 2019, the Centers for Medicare and Medicaid Services (CMS) began requiring nursing homes in the U.S. to provide culturally-competent, trauma-informed services to residents. This approach, while new to many nursing homes, is an extension of person-centered care. Similar to person-centered care, trauma-informed care is a strengths-based approach, placing residents’ needs, values, preferences, and aspirations at the center of our work.
Trauma-informed care (TIC) acknowledges and responds to the effects of trauma on residents' physical, mental, social, and spiritual well-being. It involves understanding, recognizing, and responding to signs of trauma, integrating knowledge about trauma into organizational policies and care practices, and seeking to avoid re-traumatization.
Intersection of Dementia and Trauma
Residents with dementia may have unique needs related to trauma. Past traumas can resurface or manifest differently in individuals with cognitive impairments. It is crucial to adapt TIC to address these specific needs, ensuring that care practices consider the cognitive and emotional states of residents with dementia. For example, creating a consistent and predictable environment can help reduce anxiety and prevent re-traumatization for residents with dementia.
Culturally Competent Trauma-Informed Care as Required by Regulation
Culturally competent care is a vital component of TIC, addressing the specific backgrounds and experiences of residents. TIC and cultural competency, which are required by CMS as approaches to service provision, share a common aim to ensure all residents feel safe, supported, and understood. This includes recognizing cultural and historical differences in trauma experiences and responses, ensuring care practices are offered in a way that fosters an environment where each resident can thrive.
Training staff in active listening, narrative practices, and understanding trauma histories, are essential steps in providing culturally competent, trauma-informed care, as required by CMS. For instance, staff should be aware of how different backgrounds, life histories, and experiences can influence a resident's experience of trauma and be prepared to adjust their care approaches accordingly.
Creating Safety and Ensuring Belonging for All Residents
What does it take to create a culture of safety and belonging in care environments? What does it take to make sure each resident feels at home? In nursing homes, where residents and staff alike carry personal histories and vulnerabilities, fostering trust and connection is essential. Person-centered, trauma-informed care helps us move beyond tasks to recognize the lived experiences that shape how people engage with care.
This podcast episode explores how understanding life histories, addressing power dynamics, and cultivating meaningful relationships can create safer, more welcoming and nurturing spaces in nursing homes—where everyone feels valued and supported.