Targeted Practices and Policies Key to Care of Residents with Dementia and a History of Trauma

July 12, 2022

July 12, 2022
Contact: Ellen Mullally

Trauma has a lifelong impact, and its effects can be exacerbated in the elderly. In A Matter for Life and Death: Managing Psychological Trauma in Care Homes, an article in the July issue of JAMDA, the authors present a call to action for better care for older adults with dementia and a history of psychological trauma. They also urge the use of trauma-informed care practices and policies with this patient population.

Trauma affects 50-70% of all people and up to 90% of those with histories of mental disorders. While not all trauma results in post-traumatic stress disorder (PTSD), about 65% of nursing home residents who are veterans or Holocaust survivors experience PTSD. This condition—which affects the brain, mind, and body—doesn’t lessen with age. In fact, trauma’s impact can intensify with conditions such as dementia. For those older adults who have successfully managed past trauma, the authors noted, new stresses such as nursing home admission can reactivate or trigger late-onset PTSD.

“Those tasked with funding, administering, and managing [nursing home] systems should ensure trauma-informed aged care is available, with supports and resources,” the authors said. “This includes, at minimum, creating safe environments, identifying trauma in residents, and preparing a trauma-informed workforce. Residents, families, and direct care staff must be engaged in planning and delivery.”

The authors recommended policies and practices that ensure standards and regulations reflective of requirements for a trauma-informed framework, access to necessary services for both residents and staff, screening residents during admission for past traumatic events, and employee assistance programs. They also urged implementing evidence-based strategies for residents with a history of psychological trauma or with neuropsychiatric symptoms that don’t respond to general strategies. The authors also encouraged policies and practices that broadly support practical, evidence-informed strategies for staff to better self-manage and prevent stress. They also recommended targeted research in this area.

“These policy and research recommendations can only succeed with adequate staffing to meet basic resident needs, through both staffing quantity and mix. We can, however, begin now to incorporate knowledge and principles of trauma-informed aged care into policy, practice, and research,” the authors concluded. “Action is long overdue, even in normal times.”

The study was conducted by researchers at the Department of Psychology, Central Michigan University; Department of Internal Medicine, Mount Pleasant, MI; Palliative Care Service, Rush University Medical Center, Chicago, IL; and Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL.

Get more imformation on the findings above and more details about the study. To contact the researchers or JAMDA editor for an interview, please email





JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit for more information.


About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information.