During COVID-19 Crisis and Beyond: Trauma-Informed Care Takes Center Stage

Trauma-informed care (TIC) was on everyone’s mind before COVID-19; but in recent months, this concept has taken on new significance. “Everyone is affected by COVID-19, and it is likely to be the case for a long time. We should be observing and identifying all kinds of distress in residents and care team members alike,” says Nancy Kusmaul, PhD, LMSW, who will present an AMDA webinar, Trauma Informed Care for the Provider, on May 19.

Phase 3 of the federal nursing home regulations that went into effect in November 2019 call for nursing homes to provide trauma-informed approaches as part of person-centered care. This is an area that previously had limited discussion in the aging services community. Providers need to know what TIC is and what it can look like for physicians, mid-level practitioners, and medical directors in post-acute and long-term care. The Centers for Medicare & Medicaid Services (CMS) still hasn’t released guidance about what elements TIC should involve, who should perform it, or how it should be conducted and documented. Nonetheless, it is important for practitioners to be thinking about TIC and how it can help their residents and teams alike, especially during these challenging times.

This program will present two common frameworks that make up TIC: Examples of the need for TIC in nursing home populations and ways in which nursing home medical care can be made trauma-informed.

Dr. Kusmaul says, “Trauma-informed care involves doing a little better every day than the day before in a systematic way.” For practitioners, she suggests, “it is important to step back, look through a trauma-informed lens and see what you are missing.”

“This pandemic has brought out the importance of trauma-informed care for staff and their fears about coming to work, staying safe and keeping their families and residents safe, and all of the losses they’ve dealt with,” says Dr. Kusmaul. “Team leaders must be able to support others, but they need to know that it’s okay—and understandable—for them to feel vulnerable and have their own fears,” she observes. “Everyone at every level is in this together, and facilities are doing what they can in the best interest of residents and staff. Leaders need to be able to communicate this.”

In the absence of regulatory guidance, Dr. Kusmaul will offer some basics. To start, she says, “It is important to shift communication from ‘What is wrong with you?’ to ‘What happened to you?’ We can’t assume that everyone’s trauma is the same or that everyone feels the same way about their past traumas. Everyone can start today by acknowledging their, their staff’s, and their residents’ fears and trauma.”

Whatever the CMS guidance on TIC ultimately says, Dr. Kusmaul stresses that webinar participants will be able to use and apply what they learn during this presentation. They also can bring their own questions and concerns to address. Afterwards, they can take the resources she provides and continue their own deep dive into this issue. As always, this webinar is free to AMDA members. Click here for more information or to register.