Q: How can we care plan for resident trauma?
A: Care planning to address past trauma requires understanding what happened to the individual and the effect it has on the person. Screening or assessing for past trauma can help to identify affected residents. Several screening tools exist.
Many ask residents what reminds them of a stressful event from the past, what triggers them to relive it, and what helps them cope. This information can then inform a care plan that addresses the person’s individual trauma.
To relieve trauma’s effects, a care plan must address triggers for re-traumatization and include interventions to avoid it.
Although there is no federal requirement for a specific care planning template, each care plan should address the problem, contain a goal, and include interventions that help achieve the goal. The problem statement should include the effect the trauma has on the person. For example, if a resident experienced an act of violence by a person of the opposite gender, the problem might be “Mrs. Smith is untrusting of male caregivers.”
The goal could be that Mrs. Smith will feel safe during ADL care, as evidenced by no verbal outbursts and allowing staff to assist with her care. Interventions may include requiring female staff for toileting and ADL care, using a soft tone of voice, and approaching her in a calm manner.
This is only one example. A proper care plan for trauma must be individualized to that specific trauma, what triggers it, and how the person responds. When trauma is complex, multiple interventions may be necessary for the resident to feel safe.
The key is to address trauma and prevent retraumatization by centering the plan on the person and his or her experiences.
Amy Stewart, MSN, RN, RAC-MT, RAC-MTA, DNS-MT, QCP-MT, is vice president of education for AAPACN. Send her your nursing-related questions at ltcnews@mcknights.com.
From the November 2022 Issue of McKnight's Long-Term Care News
