By Edmund Boxley 

The Centers for Medicare and Medicaid Services (CMS) now requires nursing homes in the United States to provide trauma-informed care for residents. To provide educational support on this initiative, researchers at the Virginia Commonwealth University College of Health Professions’ Department of Gerontology and Virginia Center on Aging recently released a ground-breaking trauma-informed care toolkit, a no-cost online resource for nursing home communities that is the first of its kind in the nation. 

The VCU Trauma-Informed Care Toolkit, which features evidence-based guidebooks, assessments, training videos and organizational strategies, meets a vital need for organizational support of nursing home residents – grounded in innovative gerontological research. 

Implementing trauma-informed care in nursing homes involves training staff to recognize trauma symptoms, creating supportive environments and designing care plans that are sensitive to the trauma history of residents. This approach helps improve the overall well-being of people who live in nursing homes by creating a more supportive and compassionate care environment. 

“Hearing the experiences of [certified nursing assistants] CNAs, who provide 90% of hands-on care, inspired the toolkit,” said Gigi Amateau, Ph.D., assistant professor with the Department of Gerontology, equity faculty fellow with VCU’s Health Humanities Lab, and director of VCU Gerontology’s Person-Centered, Trauma-Informed Care Lab. “We hope this resource will help nursing home staff plan how to implement trauma-informed care and inspire them to imagine their communities as spaces where residents can heal, thrive and flourish.” 

Over three years, the Department of Gerontology and the Virginia Center on Aging partnered with Family and Children’s Trust Fund of Virginia, LeadingAge Virginia, Virginia Department of Medical Assistance Services (DMAS), nursing home staff and an advisory group of providers, subject matter experts and family members to create this toolkit. 

As Virginia’s leading authority on aging, the Department of Gerontology and Virginia Center on Aging stand at the forefront of innovative research. Amateau along with Tracey Gendron, Ph.D., and Annie Rhodes, Ph.D., conducted interviews and focus groups with certified nursing assistants (CNA) across the commonwealth to discuss their needs for optimally supporting residents. The researchers noted how CNAs understood the importance of person-centered, trauma-informed care, yet they described nursing home environments where lack of training and scarce structural support are common challenges. Many expressed difficulty in providing the level of care residents required without these resources. 

While nursing homes have been working from a framework called person-centered care for quite some time, the trauma-informed care approach, which is in many ways an extension of person-centeredness, may be new for some communities. This crucial need for training and structural support motivated DMAS to fund this toolkit through a Civil Monetary Penalty Fund grant to support trauma-informed care services and better outcomes for nursing home residents. 

One hundred nursing home staff responded to a nationwide survey where three short training videos were viewed, and feedback was collected to improve the toolkit. Additionally, in-person and virtual professional development workshops were conducted with several hundred nursing home staff to test the training approach and have conversations with about what resources would be helpful. 

“The toolkit is one way that we wanted to lift up trauma-informed care as an approach that is about organizational cultures of connection, equity and justice rather than a unilateral set of tasks and activities,” Amateau said. 

This extensive resource consists of dynamic content featuring evidence-based guidebooks, fact sheets, assessments, training videos, and strategies conveyed through multi-media elements and engaging writing. 

“There are many seminal reports and key scientific articles included or referenced in the toolkit,” Amateau said. “There are also some great multi-media jewels – podcasts, short videos – that can make training and professional development interesting and engaging.” 

Research demonstrates that showing the right support and care can help people feel safe and increase feelings of satisfaction. Utilizing the principles of trauma-informed care can guide us in creating and maintaining a safe, protective environment where all community members can thrive. 

If you have questions or want to learn more about the Department of Gerontology’s Person-Centered, Trauma-Informed Care Lab, please contact Gigi Amateau, Ph.D., at amateaugg@vcu.edu. 

Check out the VCU Trauma-Informed Care Toolkit, a comprehensive resource designed to empower nursing homes in fostering well-being among residents and staff. 

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