Table 1 Strategies for delivering trauma-informed palliative care

Recognition of Undiagnosed Trauma

Healthcare practitioners, within a multidisciplinary team, should not rely solely on formal diagnoses of PTSD or other trauma-related conditions. Familiarity with signs of undiagnosed trauma and symptoms consistent with PTSD is crucial.

Fostering Trusting and Honest Relationships

Focus on developing trust through clear, honest communication and a non-judgmental approach. Encourage active listening, empathy, and validation of patient experiences to create a safe, respectful space for open dialogue.

Sensitivity to Patient Autonomy and Belongings

It is important to respect the significance of personal belongings and autonomy, particularly for patients with histories of homelessness or unstable living conditions. Handling personal belongings with sensitivity can improve a patient’s sense of security and autonomy.

Flexible Approach to Care Delivery

Adopting a non-traditional approach in palliative care delivery, accommodating the unique needs of each patient. This includes flexibility in scheduling and understanding that adherence to conventional appointment schedules may not be feasible for all patients.

Safety Netting Approach

Implementing a contingency plan in consultations by providing patients or their carers with actionable information for scenarios where the patient’s condition might worsen or if they have further health concerns.

Addressing Power Imbalances and Stigma

Awareness of potential power imbalances, stigma, and exclusion within healthcare settings is essential. Actions that may exacerbate feelings of mistrust and discomfort in healthcare institutions should be avoided.

Education and Training in Trauma-Informed Care

Training for healthcare providers on the link between trauma and multiple disadvantages across the life course is vital. Understanding the cyclical nature of trauma and socio-economic disadvantage can help in addressing the needs of such patients more effectively.

Recognising ‘Missingness’ as a Risk Marker

Not recognising patients who miss appointments or seem disengaged can inadvertently increase health inequalities. It is important to develop strategies to effectively engage these patients.

Adopting Innovation in Care Delivery

Emphasising the need for flexibility, responsiveness, and innovation in care delivery. Tailoring care to meet the unique needs and circumstances of each patient is key to fostering equitable palliative care.