Sign Up to Receive PHI Alerts

Key Takeaways from the Gerontological Society of America’s Annual Conference

January 5, 2024

In November 2023, thousands of national and international researchers and other experts gathered in Tampa, Florida for the Gerontological Society of America’s (GSA) annual conference. More than ever before, the recent GSA conference included a keen focus on the direct care workforce. Research presented on this critical workforce ranged from turnover in nursing homes and assisted living to workers’ experiences of racism in long-term care, home care workers’ perspectives on their training, strategies to engage direct care workers in research, and more.

Here are four key takeaways from across the many symposia, papers, and posters that focused on paid caregiving at the recent GSA conference.

Care Justice is Possible

Dr. Nancy Hooyman, professor and dean emerita at the University of Washington and recipient of GSA’s prestigious Donald P. Kent Award, highlighted the urgent need for “care justice for unpaid and underpaid caregivers” in her award lecture at the conference. Care justice, according to Dr. Hooyman, requires addressing the racism, sexism, ageism, xenophobia, and other injustices faced by caregivers and care recipients—and building a system that appropriately recognizes and values care work. Frequently citing PHI’s research and the Direct Care Worker Story Project, Dr. Hooyman proposed a range of feasible strategies for supporting both family caregivers and direct care workers—stating that “policies that advance care justice exist, given the political will to move them forward.”

Workforce Challenges Remain Urgent

As part of a symposium on the long-term care workforce in the era of COVID-19, PHI’s Dr. Kezia Scales presented the findings from a study on the use of contract (i.e., temporary) certified nursing assistants (CNAs) in nursing homes. This study, conducted by PHI in collaboration with researchers from the Health Workforce Research Center on Long-Term Care at the University of California, San Francisco, looked at trends in contract CNA staffing in nursing homes from 2017 to 2022 and the implications for resident care. The study found increasing reliance on contract CNAs from 2017 onward, with a dramatic acceleration in this trend in 2020 and 2021—and identified statistically significant associations between higher levels of contract CNA staffing and worse care outcomes for nursing home residents. (The full report will be released in early 2024.) Other presentations in this symposium featured research on outcomes of the Special Focus Facility program, which aims to improve low-quality nursing facilities, competencies and skill-building techniques for direct care workers in dementia care, and a review of the literature on direct care workforce management, with key examples of successful management practices. Workforce strategies discussed in the symposium included improving training for long-term care managers and leaders; supporting choice and empowerment for workers; strengthening worker scheduling and consistent assignment; improving staffing ratios and training; and creating more supportive workplaces.

Caregiving Networks Should Be Prioritized

PHI’s Dr. Jessica King presented at the GSA conference in a symposium on strengthening paid and unpaid caregiving networks. In her presentation, Dr. King described the overlapping and interconnected systems of care that family caregivers and home care workers provide and underscored the importance of supporting and strengthening the relationship they share as caregivers. To support this relationship, King talked through one example of PHI’s innovative efforts to address this challenge, the Partnering for Quality Care project. Created in conjunction with Florida State University, Home Instead, and the Florida Pioneer Network, this training intervention aims to improve communication and enhance the relationship between direct care workers and family caregivers in the home care setting. Findings from this project revealed that both family caregivers and home care workers learned important strategies to improve communication from this intervention, though there were some challenges in recruitment and the technological rollout of the intervention largely due to the COVID-19 pandemic that will be addressed in future iterations of the training. Other presentations in this symposium focused on how family caregivers of people with dementia manage paid caregivers as part of the broader care team, a feasibility study of a community-based intervention that connected care partners of veterans to resource navigators during the COVID-19 pandemic, and a project that used care maps to identify the care networks of older veterans and discover where there may be critical gaps that need to be addressed. A clear message from across these presentations was that high-quality, person- and family-centered care requires that all care providers—including paid direct care workers and family caregivers—are meaningfully included in the interdisciplinary care team.

The Assisted Living Workforce Requires Attention, Too

PHI’s Scales also served as discussant for a symposium on the assisted living workforce. Presenters in this symposium highlighted an array of research, including a national study on assisted living staff training requirements, state-level studies on workforce recruitment and on staffing levels and resident outcomes, and research on direct care staff experiences with stress and coping. Assisted living and other residential care settings play a vital role in the long-term care setting, supporting a growing population of residents with increasingly complex care needs. This symposium emphasized how crucial it is to understand the confluence of policies and practices in these settings that impact recruitment, retention, and care outcomes.

These are four highlights among the extensive showcase of direct care workforce research at the 2023 GSA conference. PHI was glad to be part of the exciting and generative discussions and look forward to even more research on this critical topic in years to come. A searchable directory of all the GSA 2023 conference abstracts can be found here.

Contributing Authors

Caring for the Future

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

Workforce Data Center

From wages to employment statistics, find the latest data on the direct care workforce.