Nearly three-fourths of frontline workers found to be at risk of toxic stress
Staffing company KARE has conducted an extensive study on how trauma affects today's careforce. The findings will be released as a three-part series, exploring the prevalence and severity of trauma in the post-acute workforce compared to the general population, the impact of trauma and the pandemic, and how toxic stress and social determinants of health adversely affect workplace wellbeing.
Part 1 of the KARE Trauma and Resilience Report delves into the profound effects of trauma on caregivers, particularly in senior care. It highlights that these professionals face more adverse events compared to the general population and stresses the need for Trauma-Informed Care and Cultural Competency.
Nearly three-fourths (73%) of 1,100 frontline workers surveyed were found to be at high or intermediate risk of toxic stress, according to study results released by staffing company KARE and the National Association of Health Care Assistants, in partnership with Radical Sabbatical. Registered nurses are particularly vulnerable, experiencing 3.2 ACEs (Adverse Childhood Experiences) on average, 0.5 higher than the rest of the sector’s frontline workers.
The study examines how ACEs contribute to trauma in later life. ACEs are traumatic events that occur during childhood (0-17 years of age), categorized into three domains: abuse, neglect, and household challenges. Research shows that experiencing adverse events such as neglect or abuse as a child has lasting effects. However, ACEs are not destiny. The negative impacts of ACEs can be mitigated through methods such as building nurturing relationships and creating safe, stable environments. The CDC’s Prevention Resources for Action provides strategies to reduce risks and outcomes associated with ACEs.
The careforce that dedicates their lives to seniors reports a higher number of average ACEs compared to the general population and the larger healthcare professional community. The careforce reported a significantly higher rate of mental illness (24%) compared to the general population (17%) in the BRFSS data from 2011-2020. With more than a third (34%) experiencing high toxic stress, the study emphasizes the urgent need to evaluate mental health benefits for professional caregivers.
Toxic stress takes cumulative toll
When toxic stress response occurs continually or is triggered by multiple sources, it can have a cumulative toll on an individual’s physical and mental health—for a lifetime. The more adverse experiences in childhood, the greater the likelihood of developmental delays and later health problems, including heart disease, diabetes, substance abuse, and depression. Supportive, responsive relationships with caring adults as early in life as possible can prevent or reverse the damaging effects of toxic stress response.
Toxic stress can be carried into adulthood through:
Unstable work histories and struggles with finances and jobs. (CDC, 2023)
Increased risk of hypertension, heart attack, and stroke. (Cudney, 2022)
Difficulty paying attention, making decisions, and learning. (CDC, 2023)
·Difficulty forming healthy and stable relationships. (CDC, 2023)
“The COVID-19 pandemic has forever altered the long-term care profession. Left in its wake is an industry struggling to find solutions to stop the bleed of frontline team members and professional nurses exiting the profession in record numbers. Meanwhile, the number of individuals that will require care in assisted living, memory care, and nursing home facilities is skyrocketing,” according to Jean Hartnett, founder of Radical Sabbatical.
“The study provides a first-of-its-kind look into the lives of employees outside of the workplace and serves as a starting point for managers and leaders to implement effective strategies and wrap-around services that support employees. Many organizations study the behaviors and experiences of employees while at work, but very few focus on the challenges employees face once they leave the worksite.”
Recognizing that 90% of older adults have likely experienced a traumatic event in their lifetimes, The Centers for Medicare and Medicaid Services now requires that skilled nursing facilities are trauma-informed (F-tag 699). The goal of the regulation is to mitigate the re-traumatization of older adults.
“This is a great first step; however, the regulation does not go far enough. For caregivers to recognize trauma in others, they must first understand their own. "My company, Radical Sabbatical, was created for that reason. I work with individuals and organizations to help them uncover and understand their past adversity while supporting the already hardwired positive coping mechanism that has led to resilience,” Hartnett adds.
Radical Sabbatical’s interactive workbook called “The Road to Resiliency: A Pathway to the Life You Want to Live” is available to download from their website is available for download from their website. The workbook provides an in-depth look at how trauma manifests in the body and the mind, changes brain chemistry, and leaves individuals susceptible to chronic disease.
“The good news about trauma is that a person can heal and change their lives and reverse the impact of adversity. I work with individuals and groups from the frontline of care to the C-suite, helping people unpack and heal from situations that have impacted their lives,” Hartnett adds.
Understanding these aspects is crucial for fostering resilience and better mental health support in caregiving roles. For more details, download KARE's Trauma Report.
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