With trauma-related F-tags beginning in less than two weeks, many providers have spent months training their staff and feel quite prepared to manage this sensitive aspect of resident mental health care.
For those who might not be completely ready for the Nov. 28 start date, I offer below some basics on trauma-informed care practices. While none of us know exactly how the survey process will play out, these fundamentals can make it less likely to run afoul of regulations.
The general idea of trauma-informed care is that residents who have had exposure to trauma can experience increased sensitivity to interactions in the long-term care setting that “trigger” old feelings and reactions. For instance, Bob, a resident who was physically assaulted several years ago, feels very unsafe and distressed when other residents become agitated.
An individual who has experienced trauma may have symptoms of Post-Traumatic Stress Disorder (PTSD), such as an exaggerated startle response or repeated intrusive thoughts of the event. Using our example above, Bob shouts loudly in alarm when other residents are noisy or frightening, showing an exaggerated startle response.
The new F-tags are an effort to increase awareness that the nursing home environment can trigger past experiences of trauma or exacerbate current traumas and to encourage facilities to make every effort to avoid re-traumatization.
The first step in complying with the regulations is to determine whether or not a resident has a current or past experience with trauma. The challenge of the interview is to avoid the possibility that the manner in which the questions are asked becomes traumatizing in and of itself.
To minimize this possibility, hold the interview in as private and discreet a manner possible and “normalize” the process, explaining to interviewees that all residents are being asked about their past experiences.
Increase the interviewee’s sense of control by offering them the option not to answer any items if they feel uncomfortable.