Posted by Helen Hanson on January 15th, 2010 at 12:12 pm | No Comments »
A planning session with (L to R) Vicki Purgavie of Home Care & Hospice Alliance, Diana Scully and Doreen McDaniel from DHHS, me, Leo Delicata of Legal Services for the Elderly, and Louise Olsen from the University of Southern Maine, Muskie School
As I explained in an earlier blog post, Maine is putting four pieces of legislation that would affect the home- and community-based part of Maine’s long-term care system — including its direct care workers – through a LEAN process. The aim of the process is to make service delivery more efficient, address inequalities in the services provided, and hopefully gain some cost savings, which can be passed on to workers in the form of livable wages and benefits such as paid time off and health care coverage. We’ve made a lot of progress toward that goal in the last few weeks.
Two direct care workers, Julie Moulton and I, were appointed to the core team that will lead the process of coming up with a plan for a streamlined system. Another direct care worker, Cathy Bouchard, became an alternate, stepping up when Julie was unable to stay on the team. I am also part of a Direct Care Workers’ Task Force that was put together to recommend changes for the issues directly affecting home care workers. This is the first time workers have been involved at this high a level of working on system change in Maine. Continue reading »
Posted by Mike Harrison on November 25th, 2009 at 7:57 am | 1 Comment »
Mike Harrison
My name is Mike Harrison. I am a displaced factory worker who has found refuge in the direct care workforce.
I do what is called “in-home care” for a single quadriplegic client in his residence. It took me over two years to get the seniority to schedule myself for 40 hours a week. That leaves me 8 hours’ leeway to do emergency fill-in without accruing overtime, which my agency will pay but highly discourages. I am very fortunate to get this benefit, which I will expound on later.
In my job as a DSP (direct support professional), I cook, clean, shop, wet nurse, bathe, and take care of his dog. Basically, I fill in the gaps his spinal muscular condition creates. It’s a pleasure and a privilege to support my client, who is one of the smartest, most driven people I know. I strive to support his independent living and provide some dignity to an otherwise difficult situation.
There are many problems in the direct care world that I am immune to. My wife’s health care benefits from her job are superior and less expensive then the plan offered by agency. Without that option, I’d have to take the less desirable plan or seek another job that offers a better benefit package. Many of my colleagues across the country have no health plan offered, leaving them sick from not seeking treatment to running the risk of financial ruin by paying for pricey medical treatment. Fifty percent of the bankruptcies in this country are caused by medical bills. Continue reading »
Posted by Don Krutsinger on November 11th, 2009 at 12:53 pm | 4 Comments »
Don Krutsinger
I work as a direct support professional with developmentally disabled adults in residential settings. One thing I have in common with just about all my coworkers is that we need to work more than 40 hours a week to make ends meet – and even so, too many of us can’t afford our employers’ health care coverage.
With the recent cutbacks by our state (Minnesota), most of our residential programs have cut out overtime and cut down the number of full-time positions, reducing the number of positions that receive health insurance and paid time off. That means nearly all of us have to work two to three jobs to make ends meet. Chances are, we don’t get enough hours from any one of them to qualify for health insurance. That’s a difficult, demoralizing way to live, especially for those of us who are dedicated to direct support work and have invested years of our lives in our careers. Continue reading »
Posted by Victoria Johnson on October 27th, 2009 at 12:29 am | 4 Comments »
Victoria Johnson during her stay in the nursing home
It was the last week of this May and just starting to warm up when I checked myself into the Highlands Nursing Home in Fitchburg, Massachusetts. I am a 29-year-old medical student at the University Of New England College Of Osteopathic Medicine, and I was taking part in the Learning by Living Project, where medical students are admitted to nursing homes as residents for two weeks to gain insight into how it feels to be an elder in a nursing home.
My day-to-day care and well-being rested solely in the hands of my certified nursing assistants (CNAs). They would wake me in the morning, clean me, dress me, and make sure I ate. I would turn to them if I needed to use the bathroom, wasn’t feeling well, or wanted to go back to my room.
Right off the bat it was easy to see that these CNAs were not caring for the elderly for fame and glory, but because they wanted to help. They wanted their work to make a difference, and that’s what drove them to do their jobs well.
During my stay I saw many families thanking the staff, but it saddened me to know that they hadn’t had the opportunity to meet all of the amazing people taking care of their family members. Continue reading »
Posted by Elise Nakhnikian on October 8th, 2009 at 2:03 pm | No Comments »
For an academic but accessible take on what motivates – or demotivates – direct care workers, check out this month’s issue of The Gerontologist. The main focus is a section titled Direct Care Worker Job Satisfaction and Retention, which includes four reports on the factors that make direct care workers like or dislike their jobs.
“Intrinsic Job Satisfaction, Overall Satisfaction, and Intention to Leave the Job Among Nursing Assistants in Nursing Homes” reports that nursing assistants who feel supported by their supervisors and satisfied with their pay are likeliest to be satisfied with their jobs. “Other job characteristics, such as the workload structuring the time to assist residents with ADLs, also seem important aspect of NAs’ work experience [that are] amenable to change,” note authors Frederic H. Decker and colleagues.
In “Nursing Home Work Practices and Nursing Assistants’ Job Satisfaction,” Christine E. Bishop and colleagues analyze data from the recently released 2004 National Nursing Assistant Survey, finding that workers are more satisfied when they earn higher wages, get paid personal leave and sick days, and have enough time to complete their work (that last point is also associated with higher staffing levels). Also associated with higher satisfaction are feeling respected and valued by employers, having good relationships with supervisors, having challenging work, not being subjected to mandatory overtime, and working in a home where food is not delivered to residents on trays. Continue reading »
Posted by Elise Nakhnikian on October 8th, 2009 at 12:35 pm | 2 Comments »
From Home Care Workers: Keeping Granite Staters in Their Homes as They Age.
As Terry Lynch pointed out in his most recent blog post, the popular – and federally mandated – trend of using Medicaid to pay for less nursing home care and more home care cannot continue unless states can attract and keep more home care workers. A pair of recent papers from New Hampshire looks at just what that means for the state of New Hampshire.
In Home Care Workers: Keeping Granite Staters in Their Homes as They Age, (PDF) Kristin Smith of the University of New Hampshire’s Carsey Institute profiles home care workers. The 12-page policy brief provides a demographic and economic overview of the state’s licensed nursing assistants, personal care service providers, personal care assistants (PCA), and homemakers and companions. It also discusses the implication of low pay and high turnover among direct care workers for those who rely on their services. Continue reading »
Posted by Sarah Wells on September 19th, 2009 at 2:48 am | No Comments »
This blog post was adapted from a paper (PDF) published last month by NCCNHR at the request of The SCAN Foundation.
Sarah Wells
Direct care workers (DCWs) are essential to determining the quality of care and quality of life experienced by long-term care consumers. DCWs serve as a liaison to the nursing staff, reporting on the medical and emotional status of the person receiving care. They may also be the person’s key connection to the outside world.
Consider the following scenario:
You are an older adult receiving long-term care services who needs assistance with almost every aspect of your life. It is morning and you await the DCW assigned to you, who could decide the following:
- When and whether you get out of bed;
- How long you have to lie in wet pants;
- If you get to decide what you want to wear;
- Whether your teeth are brushed, your nails filed and your body washed;
- If the curtains are closed so that no one can see you naked;
- If the nurse is notified of the red spot on your heel that could easily become a bedsore;
- If you have enough to eat and are positioned correctly so that you will not choke;
- Whether the water by the bed can be reached and if there is a straw that you need;
- If you are taken to any morning activities;
- Whether you start your day hearing a few kind words;
- If you are rushed or relaxed; and
- Where you are able to call for help with a call bell or phone in reach.
Continue reading »
Posted by Elise Nakhnikian on August 7th, 2009 at 10:54 am | No Comments »
“Although Connecticut has expanded programming for services to meet the needs of older adults, persons with disabilities and persons with chronic health needs, we are losing the necessary labor force to properly provide these services,” says When No One Cares: Why We Need to Save Connecticut’s Direct Care Workforce. (PDF) The eight-page white paper outlines the state’s fast-growing need for direct care givers – particularly home care workers.
Connecticut’s “care gap” will be one of the more pronounced in the nation, with its population of elders is expected to increase by 69 percent by 2030, while the population that has traditionally supplied the great majority of direct care workers – women aged 25 to 44 – decreases by 10 percent. What’s more, home care, which is becoming more common as the long-term care system is “rebalanced,” requires more direct care workers than residential care, making it all the more urgent that the state find ways to attract and retain workers.
The paper organizes the roadblocks to building a stable and sufficient direct care workforce into three categories – recruitment, retention and reimbursement – and offers policy and practice solutions for each.
Continue reading »
Posted by Vicki Erickson on August 5th, 2009 at 3:02 pm | 3 Comments »
Vicki Erickson
One of the main reasons so many nursing assistants leave every year is that they don’t get enough orientation when they’re new to the job. I know because I had good mentors who trained me well, and now I’m working as a CNA mentor myself.
In my six years as a mentor, I’ve seen what a difference it makes to new workers to get a solid grounding. Even people who have done direct care before need time to get used to the new setting and the clients, residents, or consumers they’ll be working with there.
A lot of employers try to give everyone a week of orientation but often let that go by the wayside because someone calls in sick and there just aren’t enough people to do the work unless the new person carries a full load.
Those of us who have experience need to make time to slow down and teach new people. We need to nurture them, too. If someone you’re training does well, give them a little acknowledgement. I sometimes send someone a balloon with a snack that they like. And if they need a little more time, let the supervisor and the nurses know, so they can get a couple more days of orientation.
Continue reading »
Posted by Claire Curry on July 22nd, 2009 at 1:24 pm | No Comments »
On June 25, I took the DCA’s message to Washington, D.C.
I went there with a group of Virginia activists who were urging our legislators to support health care reform now. There were about 200 of us in all, brought together by the Virginia Organizing Project. I rode up on a bus with 56 other people from Lynchburg and Charlottesville. (That’s me in front in the yellow shirt.)
After attending a rally in the morning, we spent the afternoon visiting our representatives in Congress. Congressman Tom Periello (D-5th) greeted us all very warmly. He was busy on the House floor with votes and only got to meet with us briefly, but his staff got to hear many sad and compelling stories about the need for health care reform.
Our goal was to support comprehensive health care reform that includes a public health insurance option, but I made sure to talk to everyone I met with about the DCA’s health care reform principles. I told them our country won’t be able to meet its long-term care needs – either in institutions or in the home, where virtually everyone would prefer to stay as long as possible – until we make the jobs of direct care workers a realistic choice thanks to fair wages, benefits, and working conditions. Continue reading »
