Concern About Past Trauma Among Nursing Home Admissions: Report From Screening 722 Admissions.
J Am Med Dir Assoc
; 23(9): 1499-1502, 2022 09.
Article
in English
| MEDLINE | ID: covidwho-2007807
ABSTRACT
OBJECTIVE:
Major life changes can trigger a traumatic stress response in older adults causing trauma symptoms to resurface. In 2019, the Centers for Medicare and Medicaid Services released the requirement, without specific guidance, for trauma-informed care (TIC) as part of person-centered care in long-term care.DESIGN:
Observational, cross-sectional. SETTING ANDPARTICIPANTS:
A total of 722 new admissions at one nursing home in metro Atlanta between November 2019 and July 2021.METHODS:
We developed a "TRAUMA" framework for TIC screening based on Substance Abuse and Mental Health Services Administration resources. The admissions nurse conducted TIC screening within 48 hours of new admissions, including reported trauma and necessary modifications to care plans. Demographic information was derived from electronic records. Analysis included independent sample t-tests, binary logistic regression, and χ2 tests. All data were analyzed using SPSS v. 28.RESULTS:
Of 722 new admissions, 45 (6.2%) indicated experiencing trauma. There was no significant association with being Black or non-White and experiencing trauma, but there was a significant association with being female and experiencing trauma (χ2 (1) = 5.206, P = .022). Only men reported child physical abuse and war trauma and only women reported adult sexual assault, child sexual assault, adult domestic violence, school or community violence, adult nonintimate partner violence, and other trauma. There was a small, significant negative association of age and trauma (ß = -0.037; SE = 0.11; P < .001). The most-reported trauma category was medical trauma, including COVID-related trauma. More than half (51%) requested spiritual intervention and only 2 requested medical intervention with medication as initial interventions. CONCLUSIONS AND IMPLICATIONS Our experience suggests that knowing the patient and their trauma history allowed the admissions nurse and interdisciplinary care team to modify the person-centered care plan to best meet the patient's needs. Our results also emphasize the need for using universal trauma precautions in all interactions.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
/
Nursing Homes
Type of study:
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
North America
Language:
English
Journal:
J Am Med Dir Assoc
Journal subject:
History of Medicine
/
Medicine
Year:
2022
Document Type:
Article
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