In two recent interviews in newsletters for health care professionals, long-term care experts discussed ways of better supporting direct-care workers.

Interviewed in the summer issue of IGSW News,  (doc) the newsletter of Boston University’s Institute for Geriatric Social Work, PHI President Steven Dawson says: “The workforce crisis in long-term care is at last getting some attention, but we have a ways to go to reach policymakers and show them that solutions already exist.” Dawson says the key to getting policymakers’ attention is for coalitions including long-term care providers and workers of all kinds to speak with one voice.

That’s not easy either, he acknowledges, since each of the professional groups is “resistant to change, looks inward, and protects is own territory,” but it can be done. As examples, Dawson points to the Advancing Excellence in America’s Nursing Homes campaign and a “stakeholder table” currently exploring ways of implementing recommendations from the recent Institute of Medicine report on the health care workforce.

And in “Five Questions for Lynn Friss Feinberg: Perspectives on Aging From Capitol Hill,” Friss Feinberg (pictured) talks about direct-care workers in three of her five answers. Friss Feinberg, the deputy director of the Family Caregiver Alliance’s National Center on Caregiving, praises the proposed Caring for an Aging America Act of 2008 bill (S. 2708), in part because it would “expand career advancement opportunities for direct care workers by offering specialty training in long-term care services.”

The interview ran in the June issue of ASA Connection, a publication of the American Society on Aging.

Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org

A profile of Alice Hedt in one of the leading magazines for long-term care providers praises her ability to work well with providers without compromising her standards. That rare talent, says the article, has won the nursing home consumer advocate praise from “an industry she frequently seems to tweak.” The article ran in the July issue of McKnight’s Long-Term Care News & Assisted Living.

“She has very strong management skills and high expectations, but at the same time is very kind and forgiving. She’s soft-spoken but strong-willed. She doesn’t have a mean bone in her body,” said NCCNHR founder Elma Holder of Hedt, who is now the group’s executive director.

NCCHNR, which advocates for minimum federal staffing standards for nursing homes, stresses the importance of proper workplace systems and supports for nursing assistants.

Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org

If you want to reduce nursing assistant turnover at your facility, you need to improve working conditions — maybe hire more direct-care staff, give your supervisors management training, or include direct-care workers more in decision making and care planning. But motivating nursing assistants to stay in the profession long-term requires a whole different set of incentives. According to a new study, stemming the flow of workers from the profession will require system-wide changes like higher wages, better benefits, and more career advancement opportunities for all direct-care workers.

Many previous studies have analyzed nursing assistant turnover within a facility, but few have looked into why workers leave the profession. “Staying the Course: Facility and Profession Retention Among Nursing Assistants in Nursing Homes,” a study published in  the Journal of Gerontological Research Series B: Psychological Sciences and Social Sciences, used data for 2,328 nursing assistants (NAs) from the 2004 National Nursing Assistant Survey to compare the reasons for both.

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A newly awarded federal grant will fund continuing research and analysis on how to strengthen and support the personal assistance services workforce.

The University of California San Francisco’s five-year-old Center for Personal Assistance Services (PAS Center) learned last week that is has been funded for another five years by the National Institute on Disability and Rehabilitation Research. In a news release about the grant, Charlene Harrington (pictured), the Center’s director and principal investigator, describes the center’s goal as “providing support so that people with disabilities can live and work independently in their community, as opposed to being institutionalized in a nursing home.”

Starting this October, the center will focus on three areas under the $4.25 million grant: improving access to PAS by individuals with disabilities; improving the workforce to support individuals with disabilities, and understanding the complexities of the economics of PAS. The center has done research documenting low wages, a scarcity of health care benefits, and high turnover rates among PAS workers.

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“If I had only one sentence, this would be it: Direct support work is a highly skilled job,” says Amy Hewitt.

“It’s not viewed that way by society – or, frankly, by many employers – but not everybody can do this job. You have to be smart; you have to be able to problem solve; you have to be flexible and a quick thinker. You also need patience and empathy and creativity. We’re not going to get anywhere in terms of policy advocacy or getting the supports we need in place without clearly articulating that this is a highly skilled job.”

Hewitt is a senior research associate at the University of Minnesota’s Research and Training Center on Community Living. The center’s mission is to support community living for people with intellectual and developmental disabilities – and that has led to a focus on strengthening and supporting the direct support workforce.

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When long-term care opinion leaders were surveyed about the challenges facing our long-term care delivery and financing system, the challenge they named most often was the workforce.

The first national survey of what long-term care experts think about the state of long-term care in the U.S.A. and how it can be reformed tallied the responses of 1,147 people (44.5 percent of those polled) to an online questionnaire. According to The Commonwealth Fund Long-Term Care Opinion Leader Survey: Top-Level Findings, (pdf), a one-page summary of its findings, the survey was intended to “help move the LTC reform debate forward,” as we cannot afford to wait any longer to prepare for the coming baby boomer age wave.

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