Trauma Study Finds Almost 75% of Nursing Home Workforce Under Intermediate to High Levels of Stress

An alarming 73% of the nursing home workforce is facing “intermediate to high levels” of stress – the high risk group representing a rate that is double that of the general population at 34% compared to 17%, according to a new study.

Digital labor marketplace KARE, along with the National Association of Health Care Assistants (NAHCA), released the first of a three-part study focused on the impact of trauma on frontline senior and post-acute care staff, which included these findings. 

The first part examines Adverse Childhood Experiences (ACEs) and their influence on today’s nursing home workforce. ACEs refer to traumatic events that occur during childhood and are categorized into three domains: abuse, neglect and household challenges. The last domain could involve divorce or separation, substance misuse or incarceration.


Part two of the study will focus on the role of mental health and personal wellbeing in post-acute and senior care settings, while part three will investigate how social determinants of health shape the future of caregiving.

Registered nurses (RNs) had the highest average ACEs score at 3.2 compared to 2.7 on average. Adverse childhood experiences and the pandemic heightened rates of burnout and turnover among frontline staff, the report found, further exacerbating the labor shortage.

“The Bureau of Labor Statistics consistently ranks nursing and healthcare among the most stressful professions,” Katie Rhone, senior vice president of HERO and employee experience at KARE, said in a statement. “That’s why KARE’s study tackles frontline workers’ trauma—an absent but crucial industry conversation. With 34% experiencing high toxic stress, the study emphasizes the urgent need to evaluate mental health benefits for our careforce.”


It’s a critical moment to look at stress in the senior living and post-acute care community, which is still grappling with significant health care staffing shortages compounded by the pandemic, according to the study.

Nurses are leaving the industry as burnout sets in, and overtime expenses are escalating for the workforce that’s left, placing a strain on operating budgets.

The study was conducted in January and included insight from 1,142 workers in long-term care.

“KARE’s trauma survey serves not merely as data but as a reflection of the resilience and shared experiences of the careforce,” adds trauma-informed care expert and founder of Radical Sabbatical, Jean Hartnett.

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