What Is Trauma-Informed Care?

In this article...
  • Trauma-informed care is a type of health care approach that acknowledges the role trauma may play in a person’s life and how it should be considered in that person’s various health treatments. Long-term care facilities (LTC) are required by Medicare to provide trauma-informed care.

Each of our lives is a story shaped by past and present experiences. For some, the past may be difficult and filled with trauma.

  • Perhaps you’re a Holocaust survivor or you experienced post-traumatic stress disorder (PTSD) after the Vietnam War.
  • Perhaps you recently underwent a major medical procedure and had an extremely difficult recovery.
  • Perhaps you almost lost your life to sever COVID-19 infection.

Seventy percent of adults in the United States have experienced some type of traumatic event at least once in their lives.

Various triggers can re-active memories of these and other traumatic events or experiences. This is particularly true during a time when people are moving into a long-term care (LTC) facility setting – a time when the loss of power, mobility and choice can potentially mimic previous traumatic experiences. End-of-life conversations can also exacerbate previous trauma or create new trauma.

Individuals need culturally competent caretakers who know how to avoid trauma triggers. This type of care is referred to as trauma-informed care. The Centers for Medicare & Medicaid Services (CMS) requires all long-term care (LTC) facilities to provide trauma-informed care, and failure to adhere to the guidelines can lead to financial penalties.

In this article, we’ll discuss the purpose of trauma-informed care and why it matters to you.

What Is Trauma?

Trauma refers to long-lasting adverse effects on your functioning and mental, physical, social, emotional or spiritual well-being stemming from an event, series of events or set of circumstances. These adverse effects can be seen long after the traumatic event, and the affects themselves may last for a short or long period of time.

For example, people can be traumatized after going through a flood or fire or after losing a spouse or child. They may be traumatized after domestic violence or childhood sexual assault or because they lived in poverty for much of their life.

Keep in mind that what’s traumatic for one person may not be traumatic for another. An individual’s experience of an event determines whether it is a traumatic event.

What Are Some Examples of How Trauma Can Be Triggered?

For example, a Holocaust survivor might be triggered by large group showers, certain medical uniforms, sudden loud noises or restrictions on food. Or someone who was a victim of childhood sexual assault might be triggered by a nursing assistant who resembles that person. Similarly, loud noises could trigger someone who experienced PTSD after war.

What Is the Purpose of Trauma-Informed Care?

The purpose of trauma-informed care is to ensure that individuals aren’t re-traumatized through intentional or unintentional acts.

Re-traumatization can occur in any situation or environment when that situation or environment literally or symbolically resembles the trauma. This resemblance can then trigger feelings or reactions associated with the original trauma. The goal of trauma-informed care is to eliminate or mitigate triggers that may cause re-traumatization.

What Are the Principles of Trauma-Informed Care?

There are six basic trauma-informed care principles:

  1. Safety: You must feel physically and emotionally safe
  2. Trustworthiness and transparency: The health care provider delivers services as promised
  3. Peer support: You have the opportunity to interact with others who have similar interests and experiences
  4. Collaboration: There is meaningful sharing of power and decision making
  5. Empowerment: You feel as though you have a voice and choice
  6. Humility and responsiveness: Your care provider recognizes and addresses historical trauma as well as biases and stereotypes based on race, ethnicity, sexual orientation, age, geography and more

Implementing trauma-informed care principles takes many forms. For example, it means that all LTC facility staff – including professional staff, administrators, clerical staff and housekeeping – receive cultural competency training to eliminate or mitigate re-traumatization. It means that LTC facility staff know how to recognize signs of trauma and can refer you for trauma-specific treatment. It means that your LTC facility addresses any potentially re-traumatizing policies and procedures. It ensures administrative commitment to integrating a trauma-informed culture.

How Can Trauma-Informed Care Principles Help You?

Trauma-informed care recognizes that trauma influences the effectiveness of care coordination and medical care. It’s about helping you receive the care you need in the most helpful way possible.

How Can You Learn More About Trauma-Informed Care?

Contact the ombudsman in your LTC facility. They can share the facility’s polices and explain any steps taken to ensure trauma-informed care principles are followed.

About the Author

Lisa Eramo is an independent health care writer whose work appears in the Journal of the American Health Information Management Association, Healthcare Financial Management Association, For The Record Magazine, Medical Economics, Medscape and more.

Lisa studied creative writing at Hamilton College and obtained a master’s degree in journalism from Northeastern University. She is a member of the American Health Information Management Association, American Academy of Professional Coders, Society of Professional Journalists, Association of Health Care Journalists and the American Society of Journalists and Authors.

Lisa currently resides in Cranston, Rhode Island with her wife and two-year-old twin boys.

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