Trauma-Informed Care in Aged Care
Published: 24 March 2024
Published: 24 March 2024
Based upon the findings of the Royal Commission into Aged Care Quality and Safety, it was recommended that all workers involved in direct contact with people in the aged care system, as well as those providing care finder and assessment services, be provided with training on trauma-informed care (RCACQS 2021).
So, what does trauma-informed care involve, and how can aged care workers implement the principles of trauma-informed care in their interactions with clients?
The term trauma refers to the various psychological and neurobiological effects caused by a particular event or series of events wherein a person felt overwhelming fear, stress, helplessness or horror (RANZCP 2020).
Examples of events that may lead to trauma include, but are not limited to:
(Phoenix Australia 2021a, b; Wall et al. 2016; AIHW 2022)
In some cases, the effects of trauma are long-lasting. Trauma may affect the way in which people think, feel, and behave. People who have experienced trauma might have difficulty trusting others, feel like they’ve lost control of their lives, or feel isolated or alone (Phoenix Australia 2021a, b).
Trauma may also affect a person’s mental health, leading to anxiety, depression, anger, substance use, or post-traumatic stress disorder (PTSD).
While data on the prevalence of trauma is limited, it’s estimated that 75% of Australian adults have experienced at least one traumatic event during their lifetime (AIHW 2022).
With these statistics in mind, healthcare providers and staff alike need to consider the broad impacts of their care and consider the possibility that the people they are caring for have experienced trauma at some point during their lives (Wall et al. 2016).
Those who are at increased risk of experiencing trauma include:
(AIHW 2022)
Trauma-informed care (TIC) is an evolving practice in healthcare that recognises most people have experienced some kind of trauma during their lives and takes this into consideration when providing care (Phoenix Australia 2021a).
TIC involves understanding that trauma may cause lifelong repercussions for a person and impact their emotions and relationships (NSW Health 2022).
TIC avoids re-traumatising people or judging or blaming people for their responses to trauma. Rather than ‘symptoms’, responses to trauma are viewed as adaptive behaviors. TIC encourages empowerment, choice, and engagement on the client’s terms (NSW Health 2022; Health.vic 2015).
By acknowledging that trauma is a possibility in the lives of all the people they are caring for, healthcare professionals will be better positioned to recognise the diverse ways in which trauma presents, appreciate clients’ unique life experiences and reduce the risk of causing re-traumatisation (RANZCP 2020).
Standard 1: The Person - Outcome 1.1 Person-centred care (Action 1.1.2) of the strengthened Aged Care Quality Standards requires aged care workers to provide trauma-aware and healing-informed care to older people using evidence-based practice (ACQSC 2024).
This should include:
(ACQSC 2024)
Clients who are experiencing trauma might display signs such as:
(Phoenix Australia 2022a)
It’s important to remember, however, that trauma presents in a variety of ways - an important part of TIC is acknowledging clients’ diversity and unique experiences.
The main principles of providing TIC include:
(NSW Health 2022)
(Phoenix Australia 2022a)
People living with dementia may find it more difficult to cope with trauma than others. This may be due to the added stress of losing memories, independence, and relationships. In some cases, recent memories may fade and give way to stronger and more upsetting memories of past traumatic experiences (Phoenix Australia 2022b).
Furthermore, dementia can make it difficult for these clients to explain or make sense of their feelings, ask for help, or calm down when experiencing distressing memories (Phoenix Australia 2022b).
In some cases, trauma can present similarly to dementia. If you think a client living with dementia might be experiencing trauma-related distress, it’s important to check the client’s history and/or care plan and escalate your concerns to a manager, general practitioner, or geriatrician so that the client can receive extra support if needed (Phoenix Australia 2022c).
For more information on trauma and dementia, see Phoenix Australia’s resources for aged care workers.
Working with people who have experienced trauma can be distressing, difficult, and stressful, and this might affect your own health.
If you’re having difficulty coping, it’s important to exercise self-care and reach out to others (e.g. family and friends, health practitioners, colleagues) for support.
You can also contact Nurse & Midwife Support for free 24/7 support via their or by phone (1800 667 877).
Signs that indicate you might need support include:
(Phoenix Australia 2022d)
Question 1 of 3
Which one of the following statements about trauma-informed care is correct?