Delivering Trauma-Informed Care in a Hospital Ward for Older Adults With Dementia: An Illustrative Case Series.
Leah Couzner, Natalie Spence, Karina Fausto and 5 others
PMID 36188945WHAT IT FOUND
In four cases of older adults with dementia, distress during personal care was linked to past trauma.
Staff identified triggers like showering or male caregivers and adapted care. This reduced distress, but the cases show what happened, not that the approach works.
Key findings
01Distress during personal care in four older adults with dementia was linked to past trauma, such as sexual abuse, torture, or loss.
02Staff adapted care by changing who provided personal care, altering language, offering choices, and modifying the environment.
03These adaptations were associated with reduced distress in the four cases, but the study design cannot show that the approach works.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a case series of four patients, so it cannot show that trauma-informed care works or is better than usual care. The cases were selected because they showed successful application of the approach, so failures or less positive outcomes are not reported. The patients received multiple interventions at once, such as staff changes, language adjustments, and environmental modifications, so it is not possible to tell which single change reduced distress. The wards did not have psychiatry, psychology, or mental health nursing staff, so the results may not apply to settings with different resources.
Declared interests
The study was funded by the South Australian Hospital Research Foundation and the Australian Government Medical Research Future Fund. The authors declared no commercial or financial conflicts of interest.
The easy way to misread this
Do not conclude that trauma-informed care reduces distress in older adults with dementia. This is a case series of four patients selected for successful outcomes, and it cannot show that the approach works or that any single strategy was responsible for the change.