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Workforce Issues in Long-Term Care

Future Directions

To upgrade the quality of the long-term care workforce, and to solve the problems of recruiting and retaining enough qualified workers, several options have been proposed.

Increasing minimum staffing requirements. One solution to staffing problems is to increase the number of caregivers in nursing homes. There is considerable consensus among researchers that higher staffing levels are positively associated with better outcomes for nursing home residents. This is particularly the case with RN staffing, but is also applicable to CNAs. Increasing staffing in nursing homes is likely not only to improve the quality of care but also to benefit staff morale, satisfaction, and retention by reducing the stress of providing care (Harrington et al.).

Increase and upgrade training. Although a body of rigorous evaluation research is lacking, there is evidence that training programs of various kinds improve the performance of CNAs and thus leads to improved outcomes for residents (Beck et al.).

Improve salaries and benefits. Many nursing homes and home health agencies have very devoted, long-term employees. However, some individuals do not consider long-term care work, or leave it after trying it, because the salaries are inadequate. Raising the salaries of workers and improving benefits is now a goal in many states.

Expand the range of roles. A number of experts suggest reexamining the official role of the frontline worker, and expanding what is now a monolithic job category into a career ladder of increasing responsibilities. In particular, new job categories can be developed in the nursing home, ranging from an entry-level resident attendant position, to several categories of CNAs. Workers can then can advance to positions of greater responsibility within the facility.



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Additional topics

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