Care aides' perceptions of caring for residents with a history of psychological trauma in Western Canadian care homes

Int J Geriatr Psychiatry. 2022 Oct 2;37(11). doi: 10.1002/gps.5818. Online ahead of print.

Abstract

Objective: To explore care aide perceptions of caring for residents who aides perceived had past psychological trauma.

Methods: Through cognitive interviews, we developed a definition of trauma for four survey questions about caring for residents with psychological trauma. We added these questions to our routine care aide survey in 91 care homes in Western Canada (September 2019 to February 2020). We asked if care aides perceived that they were caring for residents with trauma, how often, types of trauma experienced, and what indication led them to perceive a resident had experienced trauma. We analyzed data using content analysis (open-ended questions) and regression analyses (closed-ended questions).

Results: Three thousand seven hundred and sixty five care aides responded (70% response rate) to the survey, and 53% perceived caring for one or more residents with a history of psychological trauma in the previous 2 weeks. Within six categories of traumatic events, abuse (35%) and war exposure (26%) were most common. Most common indications of trauma reported by care aides (five categories) were reliving the experience or having intrusive symptoms (28%) and avoidant behaviors (24%). Care aides were more likely to report caring for a resident who they perceived had experienced past psychological trauma if they were younger, spoke English as their first language, self-reported experiencing more aggression from residents, or who worked in not-for-profit homes.

Conclusions: This preliminary study supports the need for further study of care aides' perceptions and experiences of caring for residents with past trauma, and the effects of caring for these residents on quality of work life.

Keywords: behavioral and psychological symptoms of dementia (BPSD); care aide; dementia; long-term care; post-traumatic stress disorder; psychological trauma; responsive behaviors.