The likelihood of experiencing a traumatic event during one’s life is high. Long-lasting psychological effects of trauma can remain later in life, resulting in post-traumatic stress disorder (PTSD). CMS issued regulations requiring skilled nursing facilities to document a diagnosis of PTSD and provide trauma-informed care. However, there is minimal guidance on how to provide trauma-informed care and educate staff, resulting in staff feeling unprepared to care for residents that struggle with PTSD.
To ensure the safety of all your residents, staff must be prepared and feel comfortable in caring for those with PTSD. Educating your staff is a top priority. Training on trauma-informed care and managing triggers should be provided upon hire and periodically. Consider developing interactive training that incorporates scenarios and simulation so that staff become proficient in skills that are necessary to care for residents with PTSD.
The best way to ensure residents’ needs are met is through a comprehensive assessment and person-centered care planning. Assessment tool(s) should screen for trauma and possible triggers. Interventions should focus on eliminating or mitigating triggers. Consistently evaluate the delivery of care and services and update the care plan as necessary to ensure that the resident is receiving optimal care.
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach offers a foundation for providing trauma informed care. Consider the following when care planning for residents with PTSD.
- Safety – Ensuring residents have a sense of emotional and physical safety.
- Trustworthiness and transparency – Efforts to establish a relationship based on trust, and clear and open communication between the staff and the resident.
- Peer support and mutual self-help – If practicable, it may be appropriate to assist the resident in locating and arranging to attend support groups which are organized by qualified professionals. It may be possible for the group to meet in the facility.
- Collaboration – There is an emphasis on partnering between residents and/or his or her representative, and all staff and disciplines involved in the resident’s care in developing the plan of care. There is recognition that healing happens in relationships and in the meaningful sharing of power and decision-making.
- Empowerment, voice, and choice – Ensuring that resident’s choice and preferences are honored and that residents are empowered to be active participants in their care and decision-making, including recognition of, and building on resident’s strengths.
While the goal is to eliminate and mitigate triggers, a resident may inadvertently experience one. Remember to prioritize safety for all. Ensure that you have procedures in place that support staff in safely helping the resident that is experiencing a trigger. Also make certain that your procedures include actions to keep other residents safe.
Ensuring that your facility has a comprehensive, trauma-informed approach to care for residents with PTSD will improve the residents’ outcomes and decrease your facility’s overall risk.