(Version française disponible ici.)

Long-term care (LTC) facilities are actually people’s homes. It’s where many Canadians live out their final days. But not all the residents in LTC receive the specialized care they need.

Often seniors’ behaviour that could be the result of past traumas is written off as a symptom of dementia. Care aides need training to identify the difference and provide trauma-informed care. Accrediting agencies and Canada’s new national long-term care standards include providing trauma-informed care. But that standard is voluntary. It must be made mandatory.

What does trauma look like in long-term care? A resident with dementia may become distressed or aggressive during personal care, particularly if they have a history of sexual abuse. Another may wander at night, repeatedly call for help or become increasingly difficult to reassure as communication becomes harder.

For someone who has lived through war, displacement or civil conflict, their behaviours in LTC may be connected to those earlier traumatic experiences.

How trauma can shape behaviour in long-term care

Sudden noises, unfamiliar touch, particular smells or other seemingly ordinary experiences can also provoke unusually strong reactions. A crashing meal cart, for example, might be distressing for someone who has experienced violence. The smell of smoke could trigger fear in someone who has survived a fire or another traumatic event.

There can be many explanations for these behaviours, including dementia, pain, anxiety, confusion or unmet needs. Trauma may be one factor among them.

That is why trauma-informed care does not require staff to diagnose trauma or assume a particular history. It asks them to recognize that past experiences may shape a resident’s response, avoid unnecessarily triggering distress and consider how care can be adapted.

Yet many long-term care workers receive little formal training in recognizing or responding to trauma-related behaviour.

Today more than 770,000 Canadians live with some form of dementia, and by 2030, there will be nearly a million. The vast majority of residents in LTC in Canada have dementia........

© IRPP - Policy Options