scholarly journals Challenges Faced by Nursing Home Direct Care Workers During the COVID-19 Pandemic: A Comparison Across Care Settings

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 248-248
Author(s):  
Verena Cimarolli ◽  
Robyn Stone ◽  
Natasha Bryant
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Direct Care ◽  
Direct Care Workers ◽  
Health Crisis ◽  
Work Related ◽  
Care Workers ◽  
Direct Care Workforce ◽  
The Impact

Abstract The COVID-19 pandemic has generated awareness of the value of the direct care workforce to provide care in settings serving those most at risk from the disease. However, few studies have gauged the impact of COVID-19 on this workforce and their pandemic-related challenges. The purpose of this study was to examine the challenges and stress experienced by direct care workers (N=1,414) and their perceptions of preparation and quality of employer communication during this health crisis. Nursing home (NH) workers reported separation from family members and understaffing as the top external and work-related challenges. They felt adequately prepared and gave their employers high marks for communicating with them during the pandemic. NH direct care workers were more likely to report increased workload and understaffing as a challenge compared to workers in home and community-based settings. They also experienced a significantly higher number of work-related challenges compared to workers in assisted living.

scholarly journals Meaningful Engagement of Residents With Dementia in Assisted Living: The Role of Direct Care Workers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 254-255
Author(s):  
Jennifer Craft Morgan ◽  
Joy Ciofi ◽  
Candace Kemp ◽  
Andrea Hill ◽  
Alexis Bender
Keyword(s):  
Assisted Living ◽  
Daily Practice ◽  
Direct Care ◽  
Direct Care Workers ◽  
Observation Data ◽  
Factors Affecting ◽  
Care Workers ◽  
Meaningful Engagement ◽  
Using Data

Abstract Meaningful engagement has important implications for quality of care for persons living with dementia. Yet, little research has focused on direct care workers’ (DCWs) role in facilitating engagement opportunities for residents in assisted living. Using data from our ongoing NIA-funded study, “Meaningful Engagement and Quality of Life among Assisted Living Residents with Dementia,” we describe DCW approaches to engaging residents and the factors that influence the use and successful application of these approaches. Focal residents (N=33) were followed at four diverse assisted living communities for one year. Data includes care partner interviews (N=100), including 28 DCWs and 1560 hours of field observation data. DCWs interviewed had between 2 months and 12 years’ experience in their current position and were mostly African American and/or immigrant women of color. Findings suggest that DCW-resident interactions are key opportunities to engage residents in a meaningful way and can facilitate positive, trust-based relationships. This analysis elaborates on our previous work identifying four approaches: knowing the person, connecting with and meeting people where they are, being in the moment, and viewing all encounters as opportunities. We identified factors affecting opportunities for, and experiences with, meaningful engagement between residents and DCWs, including community staffing, consistent assignment, scheduling, DCW training and tenure, and community resources. We conclude with implications for practice emphasizing how elaboration of these approaches can inform the development of DCW training, opportunities for career advancement, and integration of approaches consistently into daily practice in an effort to support meaningful engagement of residents living with dementia.

scholarly journals From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Fixed Effects ◽  
Nursing Home Residents ◽  
Direct Care ◽  
Multiple Perspectives ◽  
Person Centered Care ◽  
Fixed Effects Panel Regression ◽  
Centered Care ◽  
The Impact

Abstract Advancing our knowledge related to honoring nursing home resident preferences is a cornerstone of person-centered care (PCC). While there are multiple approaches to providing PCC, we focus on resident preferences as assessed via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In this symposium, we explore the perspectives of a variety of stakeholders including nursing home residents, staff, and the impact of preference-based care on provider level regulatory outcomes. First, we present a comparative study of preference importance among n=317 African America and White nursing home residents that found more similarities than differences between the two groups. Second, a content analysis of the responses from n=196 interviews with nursing home residents details the barriers and facilitators connected to their levels of satisfaction with their preferences being fulfilled. Third, perspectives from n=27 direct care workers explore the concept of pervasive risk avoidance to the delivery of PCC. Fourth, systems-level practices, such as shift assignments and provider schedules are identified as barriers to successfully fulfilling resident preferences from the perspectives of n=19 staff within assisted living. Our final presentation utilizes a fixed-effects panel regression analysis with n=551 Ohio nursing home providers to explore the impact of PELI use on regulatory outcomes such as substantiated complaints and deficiency scores reported in the CMS Nursing Home Compare data. Discussant Dr. Kristi Williams will integrate findings, highlighting implications for policy, practice, and future directions. Research in Quality of Care Interest Group Sponsored Symposium.

scholarly journals It Is Time to Resolve the Direct Care Workforce Crisis in Long-Term Care

2020 ◽  
Author(s):  
Kezia Scales
Keyword(s):  
Long Term Care ◽  
The United States ◽  
Direct Care ◽  
Direct Care Workers ◽  
Term Care ◽  
Home Health Aides ◽  
Emerging Trends ◽  
Care Workers ◽  
Direct Care Workforce

Abstract Nearly 4.6 million direct care workers—including personal care aides, home health aides, and nursing assistants—provide daily support to older adults and people with disabilities across a range of settings in the United States, predominantly in long-term care (LTC). Even as the population grows older and drives up demand for LTC, the sector continues its decades-long struggle to fill direct care positions and stabilize this essential workforce. Recent events and emerging trends have converged, however, to produce new opportunities to address this longstanding workforce crisis, including the unprecedented attention generated by the coronavirus disease 2019 (COVID-19) pandemic and the systemic shifts to managed care and value-based payment in LTC. This Forum article outlines the pressing direct care workforce challenges in LTC before describing these potential levers of change, emphasizing the importance of not just expanding the workforce but also maximizing direct care workers’ contributions to the delivery of high-quality services for a growing and evolving population of LTC consumers.

scholarly journals Voices From the Frontlines in Longterm Care During COVID-19: Narratives of Direct Care Workers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 962-962
Author(s):  
Christin Wolf ◽  
Andrea Freidus ◽  
Dena Shenk
Keyword(s):  
Assisted Living ◽  
Direct Care ◽  
Direct Care Workers ◽  
Retirement Communities ◽  
Structured Interviews ◽  
Formal Caregivers ◽  
Longterm Care ◽  
Global Pandemic ◽  
Care Workers ◽  
Memory Care

Abstract Our study draws from the narratives of 30 staff caring for residents in congregate care communities in central North Carolina from June-September 2020. It is part of phase 2 of an on-going 3-phase rapid qualitative appraisal of workers providing longterm care to older adults with the purpose of disseminating findings to key stakeholders to inform policy, programming, and funding decisions. The 3-phase project involves semi-structured interviews with 60+ participants that were videorecorded using a web-based platform. We report on the emotional and visceral experiences of these direct care workers providing care during the pandemic. We organize the data into four affect categories: fear/anxiety, sadness/grief, anger/frustration, and trauma/stress. The 30 participants include nurses, activities staff, med techs, CNAs, housekeepers, dining staff, chaplains and administrators at nursing homes, assisted living communities, memory care units and continuing care retirement communities. We amplify the voices of these formal caregivers in order to demonstrate how their sensorial and emotive experiences can speak to the human suffering they bore witness to, the underlying ageism that permeates our culture, and the social hierarchy that devalues their labor and their worth as they serve on the frontlines during this unprecedented global pandemic.

scholarly journals BUILDING COHESIVE CONVOYS: IMPROVING STABILITY AND PREPAREDNESS OF DIRECT CARE WORKERS IN ASSISTED LIVING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S441-S442
Author(s):  
Jennifer C Morgan ◽  
Elisabeth Burgess ◽  
Christina Barmon ◽  
Candace L Kemp
Keyword(s):  
Assisted Living ◽  
Dynamic Environment ◽  
Direct Care ◽  
Direct Care Workers ◽  
Key Factors ◽  
Employment Practices ◽  
Career Opportunities ◽  
Care Partners ◽  
Care Workers ◽  
The Stability

Abstract Person-centered collaborative care arrangements that empower residents, families, and care partners require supports for resident and their “care convoys”—the evolving collection of individuals who provide formal and informal care. Direct care workers (DCWs) are essential in supporting resident needs within the complex and dynamic environment of assisted living. The stability and preparedness of this workforce is central to improving quality of life for residents. This paper identifies key factors influencing the integration of DCWs in the convoys and explore supportive employment practices to strengthen the convoy. This analysis uses data from a 5-year mixed-method qualitative study of eight assisted living communities. Time pressures, AL policies and practices, work overload, lack of training, and turnover impact whether direct care workers are empowered as full members of the care convoy. Supportive employment practices (e.g. training, onboarding, career opportunities, rewards and recognition) are discussed as potential solutions for building consensus and collaboration.

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