What is Trauma-Informed Dementia Care? 5 Key Guidelines

A blog post by Dr Lenore de la Perrelle, Research Fellow, ELDAC

As we grow older, we often think about the past, and people living with dementia may re-experience the past in the present. It’s not uncommon for older adults to have experienced traumatic events in their lives—up to 70% have faced something deeply distressing. These experiences may appear to fade but they can resurface, affecting mental health and even increasing the risk of developing dementia.

Trauma can take many forms - war, abuse, violence, or persecution - and its effects can linger for decades. When someone with a history of trauma develops dementia, the impact can be profound. The challenges of adjusting to aged care, where routines and environments are unfamiliar, can trigger distressing memories. Behaviours like agitation, aggression, or withdrawal might be more than just symptoms of dementia—they could be signs of re-experienced trauma.

This is where trauma-informed dementia care becomes crucial. Unlike traditional care, trauma-informed care considers a person’s past trauma in every aspect of their support. It’s about creating a safe, respectful environment that minimizes triggers and offers control and choices, helping all individuals feel secure and understood.

For example, knowing someone’s personal history might mean adjusting care routines to ensure privacy or avoiding certain practices that may unintentionally cause distress. It’s a way of acknowledging that the person’s behaviour may stem from past experiences, not just their dementia. This approach not only improves the quality of care but also enhances the well-being of both the person with dementia and the caregivers.

Incorporating trauma-informed care into dementia services extends beyond the individual to a whole-of-service perspective. It’s about training staff to recognise and respond to trauma, ensuring that every person feels safe, respected, and empowered to have care that suits them. By adopting this compassionate approach, we can make a real difference in the lives of those living with dementia, helping them navigate the complexities of ageing with dignity and care.

Guidelines for Staff

• Screen Life History: Always screen the person’s life history at entry to aged care, as they may have experienced traumatic events.
• Admission Protocols: Add a question to admission protocols to ask directly if the person has had previous traumatic life experiences.
• Identify Sensitive Behaviours: Ask the person or family to identify examples of sensitivity or reactions, such as not trusting strangers, a need to see exits, fear of certain places, sleep disturbances, a need for privacy, or discomfort with changes and noise.
• Clear Communication: Always use the person’s name and explain what you are doing before you do it. Offer choices to allow them some control.
• Maintain Calm: Always maintain a calm approach - don’t hurry or raise your voice, and always follow through on promises, such as returning when you said you would.

By following these tips, staff can provide care that is not only person-centered but also deeply sensitive to the impact of trauma on the individuals they support.

For evidence-based resources on palliative care and advance care planning the ELDAC Dementia Toolkit can assist you and your organisation in supporting the end of life needs of people with dementia, and their families.

 

Dr Lenore de la Perrelle
Research Fellow, ELDAC