The lead paper among a set of six issued by the SCAN Foundation (pdf) is a report titled “Direct Care Workers: Essential to Quality Nursing Home and Home Health Care,” arguing that the most important factor affecting quality of care is the quality of interactions between consumers and direct-care workers.

Authors Sarah Wells, executive director of NCCNHR, and Alice Hedt, a former director and now consultant for that organization, reference the landmark 1985 NCCNHR study that identified key aspects of nursing home quality from the consumer’s point of view.

They remind the reader that in this survey, “Nursing home residents throughout the country explained that the most important elements of quality in their day-to-day lives were the accessibility and attitude of the DCW,” and point out that this finding has been repeatedly confirmed over the last two decades.

This being the case, say Wells and Hedt, enhanced training for direct-care workers is of the utmost importance. They offer a breakdown of specific factors that need to be addressed or accounted for in worker training, including:

• the culturally diverse nature of the workforce and the senior population
• the need to teach workers how to implement individualized care plans, the need for enhanced supervisor training, and
• the need for specific training in how to care for people suffering from dementia

The authors also highlight the importance of addressing “systemic issues” such as worker pay and benefits, workplace safety issues, and inadequate staffing.

Other issue papers from the SCAN report include:

• “State of California Certification and Continuing Education Requirements for Certified Nursing Assistants and Home Health Aides” by Susan Chapman
• “Effective Strategies and Exemplary Ongoing Training Programs for Direct Care Workers” by Natasha Bryant
• “Developing Geriatric Curricula” by Annette Totten
• “Supporting Training for Direct Care Staff” by Lee Goldberg
• “Opportunities for the State of California” by Allison Ruff