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June 21, 2006
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In This Issue:
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A Caring Model for Nursing Home Environments
An article in the June 2006 issue of the Journal of Gerontological
Nursing analyzes the results of focus groups conducted with long-term
care staff to develop a caring model for nursing home environments.
In
"Staff Perceptions of Caring: The Importance of a Supportive Environment",
author Suzanne Sikma discusses findings from focus groups with
nursing assistants and other staff at two long-term care facilities
in the Pacific Northwest. "Nursing homes are expected to provide the
desirable commodity of caring to residents," Sikma notes. "Yet often
staff employed to provide this caring service complain that the
organization itself leaves them feeling used, abused, and burned-out
rather than cared about. It is essential to identify strategies to
develop nursing homes as caring places that minimize caregiver stress
and optimize positive connections, capacity, and commitment of the
caregiving staff."
Participants identified five themes - valuing individuals and the
work, belonging, having the knowledge necessary to understand a
situation and its context, acting together, and promoting quality -
as critical components of feeling valued. In addition, they
identified three characteristics of supportive organizations:
- Providing resources to do the work;
- Creating an environment of trusting support; and
- Ensuring that the channels of communication - both vertical and
horizontal - remain open.
Sikma says her Model of Caring in the Organizational Environment,
which was based on her findings, can be used "to assess and improve
the caring environment of nursing homes as well as to develop caring
managers and staff."
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Participants Give Washington Home Care Authority Programs High Marks
The Home Care Quality Authority (HCQA), a Washington-based agency
that supports people who need long-term in-home care, recently
evaluated the results of two of its support programs for home care
workers: a peer mentor program and a professional development
program. The preliminary findings were positive for both, although
some changes and more study were recommended to help ensure their
effectiveness.
Click here
for the rest of the story.
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New Association Formed for Assisted Living Nurses
The
National Association Directors of Nursing Administration /Long Term Care
(NADONA/LTC) has formed a new professional association for registered
nurses and licensed practical nurses in assisted living. Dee
McGinnis, RN, BSN, is chairperson of the National Assisted Living
Nurses Association (NALNA). Membership had already reached 700 by the
organization's official launch.
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Health Care Committee Calls for Coverage for All Americans
The
Citizens' Health Care Working Group,
a committee established by Congress in 2003 to address health care
reform, has issued an interim report stating that the federal
government should ensure that all U.S. residents have basic health
insurance that is "portable and independent of health status, working
status, age (and) income." The report recommends that funds to cover
the cost of universal health insurance come from sources such as
enrollee contributions, income taxes, "sin taxes," and payroll taxes.
The committee will present its final report to President Bush and
Congress this fall, after which the president will submit a response
and five congressional committees will conduct hearings on the issue.
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NIA Booklets Explain Alzheimer's in Plain English
Two free booklets from National Institute on Aging (NIA) help people
with limited literacy skills learn about Alzheimer's disease and
memory loss. Plain language, stories, photographs, and other features
help readers understand the content.
Understanding Memory Loss covers topics such as the difference
between mild forgetfulness and serious memory problems, causes of
memory problems and how they can be treated, and what a person should
do when worried about memory.
Understanding Alzheimer's Disease covers signs of the disease,
the importance of seeing a doctor early, available treatments, and
help for caregivers.
Click here or call
1-800-438-4380 to order copies (bulk orders welcome).
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Governors Call for New LTC Funding Mechanisms
The National Governors Association's (NGA) Medicaid working group is
calling on the federal government to make a number of changes to the
long-term care services and payment systems. A
June 12 letter
to the Medicaid Commission builds on earlier recommendations, many of
which were enacted in the Deficit Reduction Act of 2005. The letter
calls for finding other ways of funding long-term care outside the
Medicaid program, including expanding incentives for purchasing
long-term care insurance and increasing coordination between Medicare
and Medicaid.
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Dear Friend
If you think you've missed a copy of
Quality Jobs/Quality Care, or if you deleted a recent issue
that you'd like to refer back to, you can always find the last four
issues on the
Clearinghouse.
The easiest way to get to the saved issues from the home page is to
click on the yellow "Stay Informed" box. You can also get there from
the home page - or anywhere else in the Clearinghouse - by clicking
first on News and Events, then on the "learn more" link in the blue
newsletter sign-up box.
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Report to Congress Urges Action to Support and Grow DSP Workforce
"One of the challenges facing the U.S. in the 21st century will be to
ensure that individuals of all ages receive, throughout their lives,
the health and social support services they need to live with dignity
as fully included members of our society," notes a report to Congress
from the U.S. Department of Health and Human Services (HHS). "For the
estimated 4.3 million Americans of all ages with intellectual
disabilities and/or developmental disabilities (ID/DD) living in
residential settings, their own homes or with members of their
families, ensuring access to and quality of direct support
professionals (DSPs) is key."
Ensuring an adequate supply of DSPs, according to
The Supply of Direct Support Professionals Serving Individuals with Intellectual Disabilities and Other Developmental Disabilities: Report to Congress,
means improving retention as well as recruitment. And that means
improving cooperation between federal, state, and local governments;
education and training institutions; workforce investment systems;
faith-based organizations; service provider organizations; and DSPs
themselves to ensure that DSP positions offer "sufficient opportunity
and respect" to be considered "a viable career decision."
Click here
for the rest of the story.
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Other Factors May Affect Nursing Home Staffing More than State
Standards
Establishing minimum staffing ratios for nursing homes does not
necessarily increase staffing levels, according to an article in the
February issue of the
Gerontologist.
This anomaly may be partly explained by the low staffing
requirements in many states, which some facilities treat as ceilings
rather than floors. A high staffing standard may increase facility
staffing, the researchers found, but a low standard may have a
negative effect, since "some facilities may treat staffing standard
minimums as if they were maximums, and lower their staffing
accordingly." But it also reflects the fact that many factors other
than government standards affect nursing home staffing levels.
Click here
for the rest of the story.
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NADCWOC Conference Focuses on Emergency Management
"Saving Lives and Serving the Community" was the theme of the second
annual
National Association for Direct Care Workers of Color
conference and awards luncheon. Direct-care workers from Indiana,
Michigan, and across the country converged in South Bend, Indiana, on
June 10 to celebrate National Nursing Assistant Week and learn about
how to respond more effectively to large-scale disasters or
emergencies like last year's Hurricane Katrina. Attendees and guest
speakers also discussed the shortage of affordable health insurance
for direct-care workers and the racial barriers that workers of color
often face on the job.
After a panel discussion moderated by City Council member
Charlotte Pfeiffer, attendees participated in break-out sessions
designed to help direct-care workers think proactively when working
either with supervisors and emergency responders or alone in the
aftermath of a large-scale emergency or disaster. Attendees developed
a list of best practices, which they agreed that direct-care workers
in all settings should learn and practice. They plan to form a
national leadership team and to invite people with expertise in
training to join them in teaching others what they have learned.
The luncheon and awards ceremony was hosted by Jeni Gipson, the
co-founder of National Nursing Assistant Week and president of the
National Network of Career Nursing Assistants.
The South Bend Tribune covered the conference in its
June 11 issue.
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Direct-Care Wages, Benefits Obstacle to Rebalancing LTC Services in
Rhode Island...
A study of community-based long-term care services in Rhode Island
found a shortage of qualified direct-care workers to be an obstacle
to "rebalancing" the state's long-term care offerings from nursing
home care to community-based services.
The problem, says
Community-Based Long-Term Care Services in Rhode Island,
is due largely to the differential in wages and benefits between home
care and nursing homes and other institutional settings. "Overall,
hourly wages and employee benefits decline on the provider continuum
as it moves from institutional care toward community care and home
care," the authors report, with CNAs in hospitals earning the most
and homemakers, chore workers, and other home-based direct-care
workers earning the least. Tables illustrate average wages by setting
in Rhode Island and five neighboring states.
The same decline is seen in benefits, with the institutional
providers contributing more to employee health insurance and
providing more paid vacation and sick leave. Other competitive
disadvantages for home care staff include unpaid time spend traveling
between clients, unpredictable hours, and the difficulty of working
full-time if desired.
The report, which was prepared for the Rhode Island Department of
Human Services, also reviewed service rates and rate methodologies
for four types of community-based services and recommended ways of
restructuring state funding to support assisted living, home care,
respite care, and adult day care.
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... and California
"California's network of person-centered services for people with
developmental disabilities is experiencing a staffing crisis that
affects the quality and availability of person-centered services,"
says
Quality Services and Quality Jobs for Supporting Californians with Developmental Disabilities,
a report by Carol Zabin of the University of California at Berkeley
Center for Labor Research and Education. "Low wages, inadequate
access to health insurance, and lack of training and career
opportunities all lead to high rates of turnover and longstanding
vacancies."
The state's shift from serving people with developmental
disabilities mainly through large public institutions to creating a
community-based system committed to person-centered services, the
report notes, has had negative consequences for direct-support
workers.
Click here
for the rest of the story.
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Help Wanted
The Oregon Center for Applied Science is looking for nursing
assistants, home health aides, and people studying to become either
nursing assistants or home health aides to help test a new online
training program for professional caregivers who deal with residents
with aggressive behaviors.
Participants will be asked to provide feedback and opinions on
two online surveys. In exchange for their time, they will be
compensated $50. Activities will take up to 90 minutes and must be
done from a computer.
Click here to read
more about this federally funded test - or to sign up as a
participant.
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Family Caregivers Unprepared for Loss of Home Health Assistance
A study of family caregivers of stroke and brain injury patients
finds they are poorly prepared for the ending of short-term home care
services.
For
"This Case Is Closed: Family Caregivers and the Termination of Home Health Care Services for Stroke Patients,"
researchers at the United Hospital Fund followed a sample of 99
unpaid family caregivers in New York. The subjects were taking care
of stroke or brain injury patients after they were discharged from a
hospital or short-term nursing home stay.
While most of the patients were eligible for some services from
home care agencies, the family caregivers shouldered three-quarters
of the care responsibilities even when agency services were being
delivered. Between a third and a half of the caregivers reported
being inadequately prepared to be without support from home health
aides, nurses, and therapists when the services ended, which was
typically after six or seven weeks.
Click here
for the rest of the story.
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In Search of Exceptional Caregivers
The Wisconsin Association of Area Agencies on Aging and the Wisconsin
Long Term Care Workforce Alliance are seeking nominations for this
year's Spotlight award. Nominations are due by July 15. Four
Wisconsin caregivers will be awarded the Spotlight award, as well a
$250 cash award. To be eligible, nominees must be direct caregivers
(CNAs, resident assistants, home health or home care aides, personal
care workers, rehabilitation aides, adult day care workers,
medication aides, etc.).
Click here
for information on how to submit a nomination.
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Care for the Caregivers
Two recent stories illustrate the grave need for affordable child
care for direct-care workers struggling to balance their obligation
to the people they assist - and their need to earn a living - with
their own families' needs.
On the personal side,
"One Mother's Struggle,"
an article in the May 24 issue of the
Smoky Mountain News, tells the heartbreaking story of a CNA
whose son died of heat exhaustion in the car where she left him while
working a double shift, since she could not afford child care.
From the policy perspective,
Women's Work Supports, Job Retention, and Job Mobility: Child Care and Employer-Provided Health Insurance Help Women Stay on Jobs,
a research brief published by the Institute for Women's Policy
Research, looks at factors that help or hinder job retention among
low-income mothers and work supports that may improve their
employment stability. Author Sunhwa Lee concludes that
"employer-provided health insurance, child care, and education are
critical supports for mothers' retention and advancement" and
recommends policies that encourage more employers to provide benefits
to low-wage workers and make affordable child care more accessible.
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August 2, 2006
The Pioneer Network's 6th National Conference, Philadelphia,
Pennsylvania
August 6, 2006
N4A 31st Annual Conference and Tradeshow, Chicago, IL
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