(P16) Improving Long-Term Care: Strategies for Implementing Trauma-Informed Care

Objective/Aim: By June 2025, A.G. Rhodes Wesley Woods will implement trauma-informed care interventions for high-risk patients, aiming for over 90% to receive their preferred options. We anticipate improved patient and family satisfaction, along with reductions in NPI-NH scores and psychotropic medication use, enhancing person-centered care in long-term settings.

Background: The integration of Trauma-Informed Care (TIC) into long-term care facilities has become essential, particularly in light of the CMS mandate aimed at improving outcomes for vulnerable populations. Given the significant negative health impacts associated with trauma, it is critical for facilities to implement effective strategies that help patients cope with trauma's lasting effects. This approach seeks to minimize the risk of re-traumatization and enhance overall safety. Although standardized interventions for TIC are lacking, the 2019 CMS directive underscores the need for facilities to create customized strategies to address the unique challenges faced by older adults, especially during pivotal life changes that may trigger trauma symptoms

Quality Improvement Methods: To enhance person-centered care in long-term care settings and improve engagement with TIC, we developed a questionnaire based on literature and insights from social workers. This tool was used in interviews at A.G. Rhodes Wesley Woods in Atlanta, targeting high-risk patients—those with an NPI-NH score over 20, a history of trauma, or using two or more psychotropic medications. Of the 24 participants enrolled, 18 completed the surveys. These interviews explored participants' perceptions of TIC, comfort levels with the screening process, reasons for nondisclosure of trauma-related information, and suggestions for improving the process. Thematic analysis was employed to interpret the data.

Results : Participants, aged 67 to 102 (mean age 82), were predominantly female (86%) and white (60%). The survey included questions about comfort discussing trauma at admission, optimal timing for such discussions, barriers to disclosure, and recommendations for improvement. Most participants expressed comfort with the screening, but four suggested delaying it by 2 to 4 weeks post-admission. Key barriers to disclosure included memory issues and a lack of understanding of trauma. Notably, 67% recommended providing a brochure on TIC prior to screening. Participants preferred staffing, nursing interventions, music therapy, and spiritual interventions as initial supports related to their trauma experiences. We are currently implementing these interventions and will present data on their effectiveness once collected

Conclusions: In conclusion, tailoring interventions to meet patients' specific needs and preferences is vital. As we implement these strategies and analyze their outcomes, we aim to contribute to a more comprehensive TIC framework in long-term care. This ongoing work will enhance the understanding of trauma among caregivers and patients, promoting a more supportive and responsive care environment.