Perspectives of professionals on the safety and accessibility of aged care for Care Leavers and Forgotten Australians

Browne‐Yung, Kathryn; O'Neil, Diana; Walker, Ruth; Corlis, Megan; Smyth, Alison; Putsey, Peter; Laver, Kate; Fernández, Elízabeth; Cations, Monica

doi:10.1111/ajag.12948

Cited by 4 publications

(3 citation statements)

References 27 publications

(40 reference statements)

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“…8 This can increase the risk that common aged care behaviours (e.g., personal care) and environments (e.g., locked doors) trigger traumatic responses and associated behaviours that increase safety risks for users and providers of aged care. 9 These responses can be mistaken as behavioural problems to be managed rather than as indicators of psychological distress, particularly in people living with dementia and associated communication difficulties. 10 Trauma-informed care (TIC) is an evidence-based framework that extends the philosophy of person-centred care which recognises and values the individual perspectives of care recipients and those providing care, while promoting a positive social environment.…”

Section: Introductionmentioning

confidence: 99%

“…Unlike mental health services, 7 few aged care services have processes in place to identify the trauma‐related needs of residents or to deliver organisational responses to meet these needs 8 . This can increase the risk that common aged care behaviours (e.g., personal care) and environments (e.g., locked doors) trigger traumatic responses and associated behaviours that increase safety risks for users and providers of aged care 9 . These responses can be mistaken as behavioural problems to be managed rather than as indicators of psychological distress, particularly in people living with dementia and associated communication difficulties 10 …”

Section: Introductionmentioning

confidence: 99%

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Characterising trauma‐informed aged care: An appreciative inquiry approach

Cations

Perrelle²,

Klinge

et al. 2022

Int J Geriat Psychiatry

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Objective: While Trauma-informed care (TIC) has the potential to improve the quality of aged and dementia care, the challenge remains in translating the principles of TIC into practice. This study aimed to characterise what trauma-informed aged care looks like in practice, by learning from an aged care service acknowledged as delivering trauma-informed aged care effectively. Method:We conducted an appreciative inquiry study within a residential aged care service catering for veterans and others with trauma histories. Observation of care behaviours, interviews with staff and residents, and organisational policy mapping were used to identify elements that maximised care safety and accessibility for trauma survivors. Data were analysed and triangulated using a framework analysis approach. Results:The aged care provider embedded the principles of TIC into its staff training (i) to promote understanding of how trauma may affect experiences in care, and (ii) to adapt care when appropriate to promote safety. The service promoted a calm atmosphere where residents could make choices and felt safe. Uniforms and signage provided consistency, clarity, and transparency for residents. Staff behaviours demonstrated respect, fostered trust, and anticipated needs without unnecessarily imposing care. Staff consistently offered choices, used residents' names, sought permission before providing care, and offered reassurance. Staff reported high morale with a commitment to delivering high quality care, and feedback to management. Effective communication promoted information sharing and trust among staff. Conclusion:Trauma-informed practice was facilitated through organisational policy, a dignified environment, and thoughtful staff behaviour creating safety, choice, and control for residents. K E Y W O R D Saged care, mental health, organisational change, psychological trauma, trauma-informed care Key points� Trauma-informed care (TIC) is poorly characterised in aged care and staff require guidance in how to amend everyday practice to meet the needs of trauma survivors.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characterising trauma‐informed aged care: An appreciative inquiry approach

Cations

Perrelle²,

Klinge

et al. 2022

Int J Geriat Psychiatry

Self Cite

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“…In addition, the onset of dementia can trigger the re-emergence of traumatic stress symptoms even where these have been dormant for many years ( 8 , 9 ). Common hospital care practices (e.g., assisting with toileting and bathing) and environments (e.g., locked wards) have been identified as potential sources of distress for older trauma survivors ( 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Delivering Trauma-Informed Care in a Hospital Ward for Older Adults With Dementia: An Illustrative Case Series

Couzner

Spence

Fausto

et al. 2022

Front. Rehabilit. Sci.

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IntroductionUp to 70% of older adults have experienced a psychologically traumatic event in their life. Traumatic events can have lifelong effects on functioning and emotion regulation and can affect behavior and experiences in care settings. Common healthcare practices and environments can be re-traumatizing for trauma survivors. These features may trigger behavior change (e.g., aggression and agitation) particularly after the onset of dementia. However, very little research exists to understand how the effects of traumatic events manifest in aged care settings. Trauma-informed care is a framework in which the potential impact of trauma is acknowledged, and practices and procedures are adapted to maximize feelings of control and safety for the patient. Trauma-informed care is an innovative approach with little published evidence in acute geriatric settings.MethodsWe present a series of cases to demonstrate how psychological trauma can affect the experience of inpatient care for older people. The cases detail the patients' relevant background, triggers and behaviors followed by the steps taken by staff to support the patient and respond to their trauma-related needs. These cases describe how the principles of trauma-informed care can be applied to recognize when past psychologically traumatic events are impacting the older adult in hospital. The outcomes of these interventions are reported on in terms of their impact on challenging behavior, patient experiences and satisfaction with care, and/or staff confidence and skill.FindingsA range of past events negatively impacted the patients during their time in hospital, including childhood abuse, military service, and domestic violence. Staff implemented strategies to accommodate trauma-related needs while providing care that improved safety and reduced patient distress. Principles of trauma-informed care were applied where able, including providing choices and enabling autonomy. However, organizational and environmental features of inpatient wards continued to pose risks for re-traumatisation.ConclusionsTrauma-informed care is an under-utilized yet potentially beneficial approach to care for older adults in the hospital setting. The cases detailed here demonstrated that the impact of psychological trauma requires an individualized response from staff which when effectively implemented can promote staff and patient safety, reduce the risk of re-traumatisation, and minimize adverse events.

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Going from strength to strength at the Australasian Journal on Ageing

Sims¹

2022

Australas J Ageing

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Perspectives of professionals on the safety and accessibility of aged care for Care Leavers and Forgotten Australians

Cited by 4 publications

References 27 publications

Characterising trauma‐informed aged care: An appreciative inquiry approach

Characterising trauma‐informed aged care: An appreciative inquiry approach

Delivering Trauma-Informed Care in a Hospital Ward for Older Adults With Dementia: An Illustrative Case Series

Going from strength to strength at the Australasian Journal on Ageing

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