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9 Essential Publications from 2018 on the Direct Care Workforce

November 15, 2018

Nonprofit and government leaders are increasingly shining a spotlight on direct care workers, analyzing their experiences and needs, as well as their relationship to the long-term care system.

This year, a variety of reports explored the direct care workforce across an array of topics, from workplace safety to transportation, and much more.

Here are nine reports that caught our eye.

1 | Workplace Injuries and the Direct Care Workforce


Direct care work can often lead to injuries, including sprains, tears, soreness, and pain. This study showed that injury rates are alarmingly high for direct care workers, especially among nursing assistants who often overexert themselves while repositioning multiple clients a day. In 2016, the injury rate (per 10,000 workers) for nursing assistants was 337, compared to 100 among all occupations.

2 | Benchmarking the Eldercare Workforce: A Community Focus


How should we measure the need for eldercare workers in a geographic community, taking into account the population’s needs, worker availability and caseloads, and hours of support (among other variables)? This report tackled this question by devising a method that estimated workforce need in the Washington, DC area, and provided a thoughtful benchmark that could yield more data and better measures in the years ahead.

3 | Using Telehealth to Improve Home-Based Care for Older Adults and Family Caregivers


Telehealth has the potential to lower costs and to improve access and care outcomes among older consumers in home care. This publication examined various telehealth strategies in home care, including transitional care for heart failure, palliative care, and more. It also encouraged policymakers to better reimburse the costs of telehealth in home care and to limit harmful restrictions regarding its use.

4 | The Part-Time Dilemma for Direct Care Workers


The combination of low wages and part-time hours forces many workers into poverty. This study revealed that one in three direct care workers works part time, many of whom are supporting family members, retired, enrolled in school, or dealing with health conditions that prevent full-time hours. One in four part-time workers works part time due to conditions at their place of workplace or in their local economy.

5 | An Unhealthy Commute: The Transit Challenges Facing New York City’s Healthcare Sector


In a given week, the typical home care worker in New York City travels hours through public transit to multiple homes. Unfortunately, many of these trips are extremely long, highly stressful, and costly—all of which contributes to high turnover. These challenges also threaten the quality of care for consumers. This report examined the transportation concerns facing healthcare workers in the largest city in the country.

6 | Filling the Care Gap: Integrating Foreign-Born Nurses and Personal Care Assistants into the Field of Long-Term Services and Supports


The sharp growth in older people–both domestically and abroad–has compelled significant demand for long-term care workers around the world. This report examined the potential of foreign-born workers to fill this gap, reporting on workforce data across occupations, identifying strategies to hire and retain immigrant workers, and offering a slate of recommendations to strengthen this critical segment of the workforce.

7 | Competency Guide for Dementia Care: Direct Care Workforce Development


Approximately 5.7 million people in the United States live with dementia, a population that requires urgent and tailored support, particularly from direct care workers. Unfortunately, these workers are rarely trained in dementia care, leaving many people without proper care. This competency guide outlines the main topics and competencies related to dementia care, as well as key training elements.

8 | Across the States 2018: Profiles of Long-Term Services and Supports


For 24 years, this valuable reference book has provided annual state data, rankings, and national averages across a range of topics related to long-term services and supports, including age demographics and projections, costs of care, disability rates, and more. One notable finding from this year: state Medicaid systems are dedicating a higher percentage of spending for home- and community-based services.

9 | Direct Care Worker Racial Disparities Series

Asian and Pacific Islander Direct Care Workers

Black/African American Workers in Direct Care

Hispanic/Latino Direct Care Workers


This research series took a closer look at the unique challenges facing people color who work in direct care. Two examples: the series found that nearly half of Hispanic/Latino direct care workers are immigrants, and U.S.-born Black/African American workers are more likely to live in poverty than white workers and Black immigrants. This data argues for race-explicit workforce strategies to address these racial inequities.

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Our new policy report takes an extensive look at today's direct care workforce—in five installments.

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