The North Carolina Medical Journal’s March/April issue contains a suite of articles on long-term care, including two about the state’s direct-care workforce. Read the full story

Melanie Rogers Jones 12/15/1965 to 3/13/2010

PHI mourns the loss of Melanie Jones, a certified nursing assistant (CNA) who was a tireless advocate for direct-care workers in North Carolina and beyond. Read the full story

“I think the movement to improve the nursing home as a workplace and the movement to improve it as a place to live are coming together in a very positive way, so that a nursing home can be both a better place to live and to work,” says Thomas Konrad. “I think those tendencies reinforce each other.”

Konrad is one of the authors of the Workplace Interventions, Turnover, and Quality of Care Report (pdf) released in June 2009 that details the effects of three distinct workplace interventions aimed at improving staff turnover rates and quality of care in North Carolina’s nursing homes.

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Pinelake Health & Rehab

PHI’s thoughts and prayers go out to everyone affected by last Sunday’s mass shooting at Pinelake Health and Rehab, a nursing home located in Carthage, NC (“Suspect’s wife sorry for NC nursing home shooting,” AP, April 1).

According to the AP story, seven residents and one nurse were killed. Robert Stewart, 45, has been charged with first-degree murder in connection with all eight deaths.

Stewart’s estranged wife, Wanda Gay Neal, is a nurse’s assistant at the Pinelake facility and was present at the time of the shooting.

Dr. Saundra H. Spillman, executive director of the North Carolina Direct Care Workers Association, told PHI that the incident was an unexplainable act of violence and expressed her sympathies for the workers and residents there as they try to move on from this tragedy.

“I don’t know if people know how hard it is for staff when they lose residents to illness. To deal with it in a normal sense of aging and disease process is one thing, but to have to deal with this…you don’t even think about this happening to this group of people. …This work is a challenge in good times but in times like this, you really have to pull together.”

McKnight’s has published a column by Dr. Eleanor Feldman Barbera that offers strategies for dealing with a tragedy (“Coping in the wake of the North Carolina nursing home shooting,” March 30).

The July issue of The Gerontologist is devoted to findings from the Better Jobs Better Care research and demonstration project. BJBC, which began in 2002 and ended in 2006, was the largest initiative in the nation ever created to address the high vacancy and turnover rates of direct-care workers by improving the quality of direct-care jobs. The initiative involved changing both public policy and employer practice. Demonstration grants were made to groups in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont.

A nine-page overview lays out how and why the project came into being, the problems affecting the direct-care workforce, and how awareness of and responsiveness to those problems is changing. The essay is by Robyn Stone (pictured), executive director of the Institute for the Future of Aging Services, and PHI President Steven Dawson. FAS and PHI conceived of BJBC and provided technical assistance to the grantees. Funding was supplied by the Robert Wood Johnson Foundation and The Atlantic Philanthropies.

Among the findings detailed in the issue:

• Direct-care workers across long-term settings identified more pay, improved communication, better supervision, and being treated with respect as the most important things employers could do to improve jobs.
• After accounting for satisfaction with wages, benefits, and advancement opportunities — good basic supervision was most important in affecting CNAs to stay in their jobs.
• There is a positive correlation between CNA job commitment and resident satisfaction.
• After accounting for satisfaction with wages, benefits, and advancement opportunities, good basic supervision was the most important factor behind commitment to the job. Read the full story