Long-term care facilities require trauma-based care

carol estabrooks
Quoimedia

Canada needs trauma-based geriatric care, training, and strategies in long-term care facilities across the country.

“Trauma” is a heavy word, but it is the right word.

“Trauma” describes what is happening in long-term care facilities across Canada during the pandemic that has caused the majority of deaths from COVID-19. There, highly restrictive visitor policies and understaffing mean extreme isolation and deprivation of residents. live there.

However, long-term care often has two layers of trauma.

Overlooked in these discussions is how the pandemic can trigger symptoms of post-traumatic stress disorder (PTSD) in older adults who experienced trauma early in life. about it. Prior trauma may have resulted from a variety of events that caused deep psychological harm, for example car crashes, physical or sexual abuse, or fleeing armed conflict.

A recently published analysis and review highlights that PTSD in long-term care residents is far more common than previously understood, and how the pandemic is exacerbating PTSD in some residents. and recommends ways nursing homes can manage the effects of trauma.

Not everyone who experiences trauma develops PTSD, but those who do are more likely to experience recurrences of symptoms as they age, develop dementia, or are admitted to a long-term care facility. It can be a traumatic event in itself. For vulnerable older people in caregiving, deadly viral spread can also trigger intense PTSD symptoms such as intrusive thoughts, nightmares, and panic.

More than two-thirds of older people in long-term care have some form of dementia. Symptoms of PTSD can occur when household practices or environmental sights and sounds inadvertently provoke an individual. When this happens on top of dementia, it can lead to extreme behavior.

Additionally, symptoms associated with PTSD mimic behaviors exhibited by people with dementia, such as anger, aggression, and agitation. Because long-term care facilities do not routinely screen patients for traumatic histories upon admission, staff may struggle to identify behaviors attributed to PTSD and behaviors attributed to dementia.

All of this points to an urgent need for more person-centred care and well-trained staff capable of meeting the needs of residents.
Through trauma-based practice, ensuring the quality of life of residents becomes an achievable goal, ensuring that individuals living with PTSD receive the care they need.

With the right resources and training, nursing homes can be transformed into places worth living in.

So what is trauma informed care?

That means creating a safe environment, including proper staffing, workforce training, admission trauma screening, and taking a personal history to be used as the basis for future care. This means that the administrator consults the resident, her loved ones and staff on all aspects of the care plan, and provides staff with access to specialized services such as the Mental Health Her team.

This means incorporating body-sensing-focused strategies to support residents in coping with symptoms and behaviors associated with PTSD. This includes using weighted blankets, music, breathing techniques, or animal-assisted therapy to improve sleep quality, improve mental health, and reduce pain and agitation.

A trauma-based approach also means putting staff well-being at the center.

Severe restrictions on visits by caregivers and companions increased workloads for staff who no longer had time to provide adequate care to residents. In addition, staff have dealt with the moral injury of watching residents suffer and die alone.

Levels of staff burnout are approaching catastrophic levels, and supporting staff with trauma may require cognitive-based processes to adjust attention and set intentions, or modified yoga therapy and stress reduction strategies. means to introduce body-based processes such as

Policy makers are developing important industry-wide standards and practices, but there is a need to work locally to fully integrate trauma-based methods into long-term care facilities nationwide.

COVID-19 is a psychological wrecking ball, and only trauma-based practices and policies can build more robust systems that can withstand the next pandemic and catastrophic event. This requires those who manage long-term care facilities to commit to ensuring an informed approach to trauma in their facilities.

Staff should have basic knowledge of the effects of trauma and be trained on how to integrate this knowledge into their daily care routines. Additionally, supporting residents and staff means providing access to educators, nurses and people with mental health expertise.

Vulnerable seniors with LTC have suffered enough. It’s time for policy makers, funders and long-term care facility managers to prioritize trauma-based care for the elderly.

Dr. Carole Estabrooks is the Scientific Director of Translating Research in Elder Care (TREC) and Professor of Nursing at the University of Alberta.