A Trauma-Informed Approach to Caring for A Person with Dementia

Caring for a loved one with dementia is never just about taking care of their physical needs. It’s also about safety, trust, understanding, and preserving their dignity. Past trauma can shape behaviours in surprising ways. Recognizing the signs and sharing them with care providers can help create a calmer, more supportive care plan.

Trauma doesn’t simply fade with memory loss. In some cases, it can quietly shape how a person reacts to the world around them. In fact, for some people with dementia, old wounds can resurface in surprising ways. A certain sound, tone of voice, or even how someone enters a room can trigger fear, agitation, or withdrawal.

In our Meaning Behind the Behaviour story in August, we shared Ernest’s journey, where past trauma triggered severe distress, especially during bath times. His caregivers faced challenges, but through empathy and a commitment to understanding the root cause, they uncovered the deeper issues and implemented a lasting solution.

This month, as we reflect on Remembrance Day, we honour not only the bravery of those who served, but also the lasting impacts of their experiences. For many veterans, the trauma they endured continues to influence their lives, especially as they face the challenges of aging and dementia. Our commitment to understanding their needs and providing compassionate care can help ensure their dignity and well-being, just as we strive to do for all those who have given so much for our country.

What Trauma-Informed Care Means

Trauma-informed care begins with a fundamental understanding that past experiences, particularly those that are frightening, distressing, or overwhelming, can significantly influence how a person responds to the present.

For individuals with dementia, this becomes even more complex, as they may have difficulty expressing or even fully grasping the link between their past trauma and their current reality.

A person who has experienced abuse, neglect, or other traumatic events in their life might respond with fear, anxiety, or resistance to certain caregiving tasks, even if those tasks are not inherently harmful. Recognizing that these reactions may be rooted in past experiences rather than in the person’s current reality helps caregivers approach the situation with greater sensitivity, patience, and empathy. A consistent, caring approach can ultimately foster a safer and more supportive environment for the person in their care.

For a person with dementia, these traumatic responses might look like:

• Sudden anger or panic during personal care (e.g., bathing, dressing)
• Refusing help from certain people (e.g., gender-related fear)
• Physical flinching or pulling away when touched unexpectedly (e.g., not giving prior notice before changing their pads)
• Restlessness or anxiety in noisy or unfamiliar places (e.g., sounds of traffic outside, a noisy and crowded dining room, or the glare of headlights from through the window)

Creating A Sense of Safety

You don’t need to make huge changes to bring trauma-informed care into daily life. Small shifts in how we approach a person with dementia can have a big impact.

Here are a few simple steps:

• Announce your presence gently: Instead of approaching from behind, make eye contact and say their name.
• Explain before you act: A quick “I’m going to help you with your sweater now” can reduce surprise or anxiety.
• Watch for triggers: Notice what seems to cause distress: certain sounds, routines, or times of day, and see if adjustments help.
• Offer choices: Even small decisions, like which sweater to wear, can restore a sense of control.
• Self-Care: As a caregiver, if the situation or the person you’re caring for triggers memories of past trauma, it’s important to seek support through counseling or other resources to help manage those emotions.

Bringing Trauma Awareness Into the Care Plan

Understanding and integrating trauma awareness into a care plan is essential because it ensures that care is not only focused on the physical and cognitive aspects of the disease but also on the emotional and psychological well-being of the person.

Trauma-informed care promotes safety, trust, and respect, allowing individuals to feel seen and understood rather than just managed. 

Incorporating trauma awareness into a care plan helps caregivers, healthcare professionals, and care home managers approach caregiving with empathy, adjusting care strategies to meet the emotional needs of the person, while also fostering a healthier, more supportive care environment. 

It not only enhances emotional well-being but also plays a critical role in reducing the risk of injuries for both clients and caregivers. 

When individuals feel safe, respected, and understood, they are less likely to become agitated or resistant to care, which in turn decreases the likelihood of physical confrontations or accidents. By anticipating potential triggers listed in a care plan and responding with empathy, caregivers can manage challenging behaviours more effectively, promoting a safer environment for everyone involved. 

Here are a few tips for a more effective and robust care plan:

1. Share what you know – “Client/Mom gets very anxious during showers; she had a bad experience in the hospital years ago. Can we try sponge baths or music to keep her calm?”
   
   
2. Frame it as helpful information, not criticism – Care staff often appreciate insights that make their work smoother.
   
   
3. Request documentation in the care plan – Make sure these strategies are written down so that all staff know how to consistently approach.
   
   
4. Ask if staff are trained in trauma-informed care – If not, you can suggest resources or offer to share what works for your loved one.
   
   

When we recognize the ways in which the past influences our actions, we become better equipped to respond with patience and understanding. Trauma-informed care reminds us that every touch, every word, every kind gesture, every moment we share with those we care for can help heal, not just the body, but their heart and whole being.

As caregivers, we have the incredible opportunity and privilege to make a lasting positive impact on someone’s life. This awareness not only improves the care we provide but also allows us to heal and grow. In caring for others with kindness and respect, we may discover that we, too, are nurturing our own emotional well-being, fostering a mutual environment of healing, connection, and respect.

At Dementia Solutions, we’ve made it our mission to demystify dementia behaviour and continue to explore person-centred, creative, non-pharmacological solutions to manage dementia-related behaviours. We believe that awareness creation and skill-building through education is the most effective and powerful tool we have to promote and maintain the well-being of both the person with dementia and their caregiver.