Long-Term Care Workers Struggle with Elderly Population Boom

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As America’s aging population increases, so does its need for long-term care. And the workers who provide these services often lack the support they need – particularly in the area of pay and work relationships, according to “Better Jobs Better Care: New Research on the Long-Term Care Workforce,” the latest special issue of The Gerontologist (Volume 48, Special Issue 1).

Those aged 65 and older are projected to represent at least 20 percent of the total U.S. population by 2030, with the number of those 85-and-older increasing the most. The growth of this demographic will have a major effect on the demand for and supply of long-term care services.

Better Jobs Better Care (BJBC) was the nation’s largest single initiative created to reduce the high vacancy and turnover rates of direct care workers and improve workforce quality through both policy and practice changes.

With funding from the Robert Wood Johnson Foundation and the Atlantic Philanthropies, this four-year program was directed and managed by the Institute for the Future of Aging Services at the American Association of Homes and Services for the Aging, with technical assistance from PHI (formerly the Paraprofessional Healthcare Institute).

“The effort was to see what ideas are out there for improving direct care work “” to make sure people have what they need to stay in their homes and communities,” said special issue editor Susan C. Reinhard, RN, PhD, FAAN.

Through two-types of grants – state-based demonstration projects and applied research projects – BJBC tested new approaches to providing a more stable and qualified long-term care staff and systematically evaluating what works best to achieve this objective. The special issue, which contains 12 articles, represents the findings of the BJBC program.

In addition to a need for better pay and improved work relationships, the studies found that recruitment and retention is an industry-wide problem, not just limited to nursing homes; greater job satisfaction translates to a better quality of life for patients; and older people themselves have roles to play in the long-term care workforce.

Funding for the special issue came from the Robert Wood Johnson Foundation. Purchase information is available at www.geron.org.
The table of contents is as follows:

The Origins of Better Jobs Better Care

Better Jobs Better Care: A Foundation Initiative Focusing on Direct Care Workers


What Do Direct Care Workers Say Would Improve Their Jobs? Differences Across Settings

Implementation of the Better Jobs Better Care Demonstration: Lessons for Long-Term Care Workforce Initiatives


Nursing Assistants’ Job Commitment: Effect of Nursing Home Organizational Factors and Impact on Resident Well-Being

Love, Money, or Flexibility: What Motivates People to Work in Consumer-Directed Home Care?

The Impact of Stress and Support on Direct Care Workers’ Job Satisfaction


A Mixed-Method Evaluation of a Workforce Development Intervention for Nursing Assistants in Nursing Homes: The Case of WIN A STEP UP

A Facility Specialist Model for Improving Retention of Nursing Home Staff: Results From a Randomized, Controlled Study


Older Workers: An Opportunity to Expand the Long-Term Care/Direct Care Labor Force

Retention of Paid Related Caregivers: Who Stays and Who Leaves Home Care Careers?


Development and Initial Testing of a Measure of Person-Directed Care

The Gerontologist is a refereed publication of The Gerontological Society of America, the nation’s oldest and largest multidisciplinary organization devoted to research, education, and practice in the field of aging. The principal mission of the Society “” and its 5,000+ members “” is to advance the study of aging and disseminate information among scientists, decision makers, and the general public.

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