THE IMPORTANCE OF THE LONG-TERM CARE WORKFORCE ON QUALITY OUTCOMES FOR INDIVIDUALS RECEIVING SERVICES

Abstract A strong, supported long-term care (LTC) workforce is vital to quality outcomes of individuals receiving LTC. With the sector facing issues around recruitment and retention, it is important to understand factors impacting the workforce. This symposium includes four presentations, a mix of both quantitative and qualitative research. First, Scales and colleagues will provide an overview of the workforce crisis using extensive policy analysis of home and community-based services (HCBS) in the US. Factors impacting the HCBS direct care workforce (DCW), including training, supply and demand, models of care and compensation, will be addressed. Next, Carder et al. will compare workforce recommendations from the 2003 Assisted Living Workgroup (ALW) report to current regulations. Many states have incorporated recommendations including criminal background checks and training while few have required staff performance evaluations and policies to improve retention. Morgan et al. examine AL residents’ care convoys’ impact on resident outcomes utilizing data from interviews with AL staff, external health care professionals, residents and family members (n=219). Policies, practices, work overload, time constraints, lack of training and turnover impacted DCW involvement in care convoys. Bender et al. analyze data from 14 DCWs and 16 executive directors from 4 ALs to examine how staff implement and understands end-of-life care policies and procedures. Limited training and communication around death present opportunities for improvement to support DCWs experiencing grief and bereavement. The discussant will address the importance of workforce as part of the network providing quality of care and improving quality of life of individuals receiving LTC.

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Ethical Considerations in the Conduct of Electronic Surveillance Research

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2006.00075.x ◽

2006 ◽

Vol 34 (3) ◽

pp. 611-619 ◽

Cited By ~ 30

Author(s):

Ashok J. Bharucha ◽

Alex John London ◽

David Barnard ◽

Howard Wactlar ◽

Mary Amanda Dew ◽

...

Keyword(s):

Assisted Living ◽

Long Term Care ◽

The United States ◽

Assisted Living Facilities ◽

Ethical Considerations ◽

Term Care ◽

Baby Boomer Generation ◽

Demographic Shifts

Nearly 2.5 million Americans currently reside in nursing homes and assisted living facilities in the United States, accounting for approximately five percent of persons sixty-five and older. The aging of the “Baby Boomer” generation is expected to lead to an exponential growth in the need for some form of long-term care (LTC) for this segment of the population within the next twenty-five years. In light of these sobering demographic shifts, there is an urgency to address the profound concerns that exist about the quality-of-care (QoC) and quality-of-life (QoL) of this frailest segment of our population.

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Improving Quality of Life in Long-Term Care

Perspectives on Gerontology ◽

10.1044/gero14.2.37 ◽

2009 ◽

Vol 14 (2) ◽

pp. 37-41 ◽

Cited By ~ 2

Author(s):

Margaret P. Calkins ◽

Jennifer Brush

Keyword(s):

Quality Of Life ◽

Nursing Homes ◽

Assisted Living ◽

Staff Training ◽

Long Term Care ◽

Assisted Living Facilities ◽

Term Care ◽

Management Structure

Abstract The entire field of long-term care is under tremendous pressure to change. Traditional environmental approaches based on staff-centric or medical models are no longer considered appropriate in long-term care settings. The new emphasis is on person-centered or self-directed care. This is reflected in settings where people can live comfortably and feel at home, as opposed to feeling like they are in a hospital. Increasingly, nursing homes are working to be more like assisted living facilities, which emphasize privacy, dignity, and choice. These changes affect all aspects of care from structure of governance to staff training to management structure and facility design. This article will cover the issues and the possible solutions to ensuring that long-term care living is more like a home than a hospital.

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Job Satisfaction in the Long-Term Care Workforce: How Ageism Plays a Role

Innovation in Aging ◽

10.1093/geroni/igaa057.1236 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 384-384

Author(s):

Alex Hennessa ◽

Tracey Gendron ◽

Verena Cimarolli ◽

Jennifer Inker ◽

Annie Rhodes ◽

...

Keyword(s):

Job Satisfaction ◽

Assisted Living ◽

Long Term Care ◽

Cross Sectional Study ◽

Direct Care ◽

Cross Sectional ◽

Term Care ◽

Staff Members ◽

Aging Anxiety

Abstract Prior research has demonstrated that ageism, specifically negative attitudes and behaviors about growing old, can be barriers to delivering high-quality long-term care (LTC), but little is known about how ageism may be related to job satisfaction – an important driver of workforce retention in LTC. Hence, the purpose of this study was to examine the role of ageism in job satisfaction in LTC. Our cross-sectional study used data collected from 265 staff members of aging services organizations (e.g. nursing homes, assisted living) representing the continuum of job types in LTC. The study examined the relationship between ageist attitudes (i.e. internalized and relational aging anxiety; affinity for older persons) and ageist behaviors, and job satisfaction when controlling for socio-demographic (i.e. age; gender; ethnicity) and employment-related variables (i.e. years of employment; advanced training in gerontology; direct care vs. managerial position). Results of a regression analysis showed that lower internalized aging anxiety and higher affinity for older people were significantly associated with higher levels of job satisfaction. Findings suggest addressing ageism to improve job satisfaction in LTC and provide some evidence for incorporating ageism screening and training into recruitment and onboarding of staff to enhance job satisfaction and to mitigate turnover.

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Adults: Group Care

Encyclopedia of Social Work ◽

10.1093/acrefore/9780199975839.013.505 ◽

2013 ◽

Author(s):

Robin Bonifas

Keyword(s):

Family Involvement ◽

Assisted Living ◽

Long Term Care ◽

Psychosocial Care ◽

Care Needs ◽

Term Care ◽

Group Settings ◽

Residential Long Term Care

This article presents information about group settings that provide residential long-term care for older adults, focusing on nursing homes and residential care/assisted living communities. It provides an overview of both settings and describes their scope of services, funding, and clientele. The section “Issues in Residential Long-Term Care” addresses issues of special relevance to social workers: dementia and other psychosocial care needs; quality of life and quality of care; access to and disparities in care; end-of-life care; family involvement; and abuse and neglect. The article ends with a section on the role of the social worker in residential long-term care.

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Organizational Factors Associated With Retention of Direct Care Workers: A Comparison of Nursing Homes and Assisted Living Facilities

The Gerontologist ◽

10.1093/geront/gnaa130 ◽

2020 ◽

Author(s):

Katherine A Kennedy ◽

Robert Applebaum ◽

John R Bowblis ◽

Jane K Straker

Keyword(s):

Nursing Homes ◽

Assisted Living ◽

Long Term Care ◽

Direct Care ◽

Retention Rates ◽

Direct Care Workers ◽

Retention Strategies ◽

Term Care ◽

Care Workers

Abstract Background and Objectives Low retention of direct care workers (DCWs), either certified nursing assistants in nursing homes (NHs) or personal care assistants in assisted living (AL), continues to be an unresolved problem. While numerous studies have examined predictors of DCW retention in NHs, little attention has been paid to differences between settings of long-term care. This study compares the predictors of DCW retention rates across both settings. Research Design and Methods The 2017 Ohio Biennial Survey of Long-Term Care Facilities provides facility-level information from NHs and ALs (NHs = 739; ALs = 465). We compare the factors that predict retention rates of DCWs utilizing regression analysis. The factors are structural, financial, resident conditions, staffing, and management characteristics, as well as retention strategies. Results Average DCW retention rates were 66% and 61% in ALs and NHs, respectively. Not-for-profit status was significantly associated with higher retention rates across settings. While the percent of residents with dementia and less administrator turnover were associated with significantly higher DCW retention in NHs, these were not significant for ALs. However, in the AL context, a higher county unemployment rate and DCWs’ participation in resident care planning meetings were positively related to DCW retention after controlling for all other covariates, while DCW cross-training was negatively associated. Discussion and Implications Retention strategies for DCWs may need to differ by setting, as a result of differing working environments, resources, and regulations.

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Abstract P326: Health Status and Frailty in Assisted Living and Nursing Home Residents

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_1.ap326 ◽

2011 ◽

Vol 4 (suppl_1) ◽

Author(s):

Amrit Kanwar ◽

Ryan J Lennon ◽

Kalyan Ghanta ◽

Mandeep Singh ◽

Veronique L Roger

Keyword(s):

Quality Of Life ◽

Health Status ◽

Assisted Living ◽

Long Term Care ◽

Physical Component Score ◽

Term Care ◽

Component Score ◽

Sf 36

Objectives: To determine the prevalence and relationship of frailty and health status measures among residents of long-term care [nursing homes (NH) and assisted living (AL)] facilities. Resident and methods: Residents ≥ 65 years who are residents of NH and AL facilities at La Crosse county, Wisconsin, were assessed for frailty (gait speed, unintended weight loss, and grip strength), comorbidity (Charlson index), and quality of life (QOL) [Short Form (SF)-36]. Results: Among 96 participants (57 from NH and 39 from AL), 78% were frail. The prevalence of frailty (77% vs. 79%), comorbidity (2.0 vs. 2.0), and poor health status did not differ between residents of NH and AL living facilities. Frail residents were older and had higher comorbidity index (2.0 vs. 0, p=0.02), including diabetes mellitus, hypertension, and heart failure. Frailty had the strongest correlation with the SF-36 Physical Component Score (r=-0.45), Figure. It exhibited weaker associations with comorbidity and the SF-36 Mental Component Score. Overall, SF-36 for physical component was lower among frail residents (33 vs. 48, p<0.001). Following adjustments by linear regression, compared to those without frailty, frail residents had lower adjusted quality of life scores. Conclusion: Frailty was highly prevalent among residents of long-term care facilities and did not differ between NH and AL facilities. We noted significant correlations between frailty, comorbid conditions, and poor quality of life.

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Communication Disordered: Program Implementation in Long-Term Care

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig15.64 ◽

2016 ◽

Vol 1 (15) ◽

pp. 64-67

Author(s):

George Barnes ◽

Joseph Salemi

Keyword(s):

Program Implementation ◽

Long Term Care ◽

Family Satisfaction ◽

Regulatory Compliance ◽

Care Staff ◽

Term Care ◽

Staff Members ◽

Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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