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The Growing Importance of the Long-Term Care Workforce

The Russell Sage Foundation recently released a free new e-book that takes a look at the long-term care system in the United States. The authors examine both the current state of this care (including at nursing homes) as well as the likely future needs. Considering the aging of the nation, the importance of these issues will undoubtedly only grow. Lawyers, senior care advocates, friends, and family members will all need to completely re-think many of these issues if we want to seriously address the problem down the road.

The Importance of Quality Long-Term Care Workers
One chapter of the new book focuses on the critical role played by the caregivers who provide the support that seniors need. This includes direct care workers at nursing homes, assisted living facilities, and at-home service providers. At the end of the day, concerns about neglect or mistreatment begins with an examination of the total number (and quality) of direct care workers. These are the individuals who perform the actual tasks, helping with nutrition,grooming, mobility, and more.

There are many inherent challenges in ensuring this workforce is best suited to provide quality care. For one thing, as it now stands, the author notes that many enter this field “accidentally.” In other words, many workers do not strive to enter this exact field but only do so after first looking in other health care sectors. The consequence of not having a workforce striving specifically to provide service in these situations means that they often “lack the understanding, education, and training that is needed to work in this complex and rapidly changing environment.”

On top of that, one of the main problems–sometimes evident in nursing home neglect lawsuits–is the simple lack of numbers in this workforce. Recruitment is sometimes difficult, particularly because wages are kept low. For the same reasons, turnover is high. That means that not only are there often an insufficient number of employees, but they rarely have significant experience

The most recent national data from the AHCA found that there was a turnover rate of 66% yearly on top of a 9.5% vacancy rate for nursing and direct line care workers in nursing homes. That vacancy rate alone means that about 60,300 positions are not filled–positions which are crucial to ensuring the seniors and disabled who need quality long-term care actually receive it. And this is the situation now. It is widely known that the senior population is only growing as a percentage of the total population, meaning that these challenges will be exacerbated in the next few years and decades.

The book identifies many different problems which contribute to this situation. Working in this setting still maintains a negative image, which decreases desirability Compensation and benefits are usually not competitive. This is even though the work itself is quite challenging, both physically and mentally taxing.

These issues need to be addressed. Lawyers workers on neglect cases have pointed out time and again how direct line care workers are pivotal in preventing abuse and mistreatment. This reality has also been documented empirically. One of the more recent efforts, for example, identified that lower turnover rates correlated with fewer bed sores, less use of physical restraints, decreases in psychotropic drug use, and better nursing care survey reports.

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