Assessing veteran perceptions of trauma-informed care in a U.S. Department of Veterans Affairs skilled nursing setting

Older veterans have an increased risk of lifetime trauma exposure compared to older civilians. Though few individuals develop posttraumatic stress disorder (PTSD), they may experience a reemergence of trauma symptoms or reengagement with past trauma as they age. This process may be exacerbated while in skilled nursing settings. Trauma-informed care (TIC) may alleviate or prevent the reemergence of symptoms or reengagement with past trauma; however, little is known about veterans’ trauma-related experiences and needs in skilled nursing facilities within the Veterans Affairs Healthcare System (i.e., community living centers; CLCs). This quality improvement project aimed to explore PTSD symptoms, how reengagement may occur, and perceptions of TIC during CLC admission. Older veterans (N = 31, M_age = 73 years) in a CLC completed measures of trauma-related symptoms, trauma reengagement, and TIC. Veterans with a trauma history experienced at least one PTSD symptom, and participants reported reengaging with positive and challenging aspects of their service. Veterans reported positive perceptions of TIC practices of promoting autonomy (M = 2.50, SD = 0.70) and recognizing strengths (M = 2.21, SD = 0.92). Ratings were less favorable for promoting connection among residents (M = 1.80, SD = 0.88) and providing information about the effects of trauma on cognition, memory, and relationships (M = 1.66, SD = 0.90). During CLC admission, veterans experienced trauma-related symptoms, reengaged with past experiences, and reported on elements of TIC.