Transfer Trauma – Tips for Administration

The evacuation of Adult Homes, Assisted Living Facilities and Nursing Homes in New Jersey and New York leaves vulnerable populations even more vulnerable. “Transfer Trauma” is potentially a real issue for many of the individuals who were quickly moved from their home to a different, safer location into the care of a staff, while qualified, are not familiar with them or their individual needs. It is hoped that the caregivers from the facility being evacuated were able to accompany the residents to their new location to assist the residents in maintaining, as best as possible, their daily routines and provide familiar caregivers. These moves, while beneficial on many levels, open the door for an elderly resident to suffer a stressful period of time. This “trauma” could last for days, weeks or longer and affected residents can exhibits a multitude of symptoms, including depression, anxiety, anger, resistance, crying, fearfulness, loss of trust, insecurity, withdrawal and neediness requiring excessive reassurance. Not only do these symptoms need to be monitored for and addressed, but responsible receiving facility staff needs to understand that they will also have to be on the lookout for decreased vigor, feelings of loss of control by the resident, sleep disturbances, appetite changes and a potential increase in falls. Coupling these health concerns with known negative outcomes including higher levels of mortality, morbidity, weight loss and delirium as well as the need for increased medical care, especially for Nursing Home residents, indicates the need for the receiving facility to educate their staff on the signs/symptoms of “transfer trauma.”

While it is not known if all of the residents will be able to return to the facility from which they were evacuated, this is the hoped for outcome. In the interim, emphasis should be placed on the following to help the residents in what must be a most difficult time for them; some residents may never fully understand what occurred. We also need to remember that many of the facilities that were evacuated held a variety of resident populations from a younger population with psychiatric diagnoses, to the frail elderly with or without complications of some level of dementia as well as a resident population with clinically complex medical issues.

Key points for the receiving facility’s Administration to address include:

  • Train the staff on “transfer trauma” signs/symptoms
  • Emphasize staff reporting responsibilities regarding these signs/symptoms
  • Implement interventions/adjust the plan of care for residents exhibiting signs/symptoms of “transfer trauma”
  • Allow the transferred residents, who are able to, to express their concerns and provide accurate information in response to any and all inquiries
  • Try to maintain each resident’s routine to the best of your ability
  • Monitor staffing levels and adjust as needed so all resident care needs can be met
  • As all personal belongings may not all have been moved with the residents, ensure that all belongings that did accompany a resident are safeguarded
  • Provide emotional support to your staff as well as to the evacuated residents and staff that may have accompanied them
  • Encourage transferred residents’ family and friends to visit to help allay resident fears/concerns and provide a sense of normalcy

3 Responses

  1. Rita Amigdalos

    These are excellent points to consider and add to the Disaster Preparedness Protocol. Many times we may review our policy annually without changes and modifications. This time around we should be able to on add a few items based on what we experienced or learned from others experiences.

  2. Pingback : Notification of Facility Closure: Revisions to Tags F203 & F204 and Issuance of New Tags F523 and F524 in SOM Appendix PP « CMS Compliance Group

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