10 2.1.3 Trauma-Informed Care

• Most LTC residents will have experienced traumatic events in their lives
• In the United States, 55-90% of adults report experiencing at least one traumatic event
• Trauma results from an event or series of events, or a set of circumstances an individual experiences as physically or emotionally harmful or threatening
• Trauma events may have lasting adverse effects on the individual’s functioning, mental, physical, social, emotional, or spiritual well-being
• Traumatic events can be experienced by an individual, a generation, or an entire community or culture

Sources of trauma for LTC residents can include:

• War
• Sexual abuse
• Starvation
• Restraints
• Seclusion
• Medical experimentation
• Childhood abuse
• Racism
• Homophobia
• Sexism
• Homelessness
• Hate crimes
• Natural disasters
• Violence^[1][2][3]

Older people may experience traumas related to:

• The aging process itself
• The loss of loved ones, of their own capacities (physical and mental)
• Loss of roles and identity and of their home, and
• Increased dependence on caregivers

Individual side effects of trauma can include:

• Depression, anxiety, PTSD
• Substance use disorders,
• Avoiding people/places/situations
• Decreased concentration, impaired short team memory
• Insomnia, flashbacks
• Trust issues with others & the health system

Trauma Informed Care (TIC):

• Recognizes the potential for long term side effects following a traumatic event & that most people do experience trauma in their lifetimes
• Recognizes the signs & symptoms of trauma for residents
• Understands that recovery is possible
• Responds by integrating knowledge about trauma into policies, procedures, and practices
• Seeks to actively avoid re-traumatization

Avoid thinking what is wrong with this person to what happened to this person.^[4]