Trauma-Informed Care in Long-Term Care Settings: From Policy to Practice

Abstract

By older adulthood, nearly all older adults will have been exposed to at least one potentially traumatic event, and the majority (93%) of older veterans report exposure to at least one event. Some may have developed posttraumatic stress disorder (PTSD) during their lifetimes; however, most do not, as the prevalence of PTSD in later adulthood is low. Nevertheless, the long-lasting psychological effects of trauma may manifest in later life, exacerbated by the normative experiences of aging (e.g., medical illness, loss of loved ones, and retirement) and encounters with medical settings. Receiving care in skilled nursing settings may trigger traumatic memories or may aggravate PTSD of symptoms. As the population ages, more individuals will receive care in long-term care environments, leading to increased risk of worsening PTSD. Staff and facilities may not have skills or knowledge needed to address symptoms or reduce retraumatization. Implementing trauma-informed care practices can mitigate these effects and is mandated in skilled nursing facilities; however, no models of trauma-informed care practice in long-term care exist. This article reviews the effects of trauma and PTSD in later life, the effects of medical settings on PTSD, and provides a framework for implementing trauma-informed care in long-term care settings.