Creating Career Paths for Direct Care Workers







Direct care workers are home health aides, personal care attendants, certified nursing assistants or caregivers.  They provide a wide range of necessary services, include helping with activities of daily living, such as bathing, dressing and eating to helping cleaning homes, prepare meals, managing medication regimens, companionship and much more.  Direct care workers play a critical role in aging services and provide the bulk of long-term care. Despite their importance, they often provide care under stressful working conditions, do not have opportunities for career advancement and are among the lowest paid workers. 

Let's look at the future needs in the US for direct care workers. According to a recent study by PHI:

  • The (BLS) Bureau of Labor Statistics projects there will be 7.8 million direct care job openings from 2016 to 2026: 3.6 million workers will leave the labor force, 2.8 million workers will leave the field for other occupations, and 1.4 million new positions will be created due to rising demand.
  • The direct care workforce will grow more than any single occupation in the country.
  • Based on the most current BLS projections, PHI expects the direct care workforce to grow by 1.4 million workers from 2016 to 2026. To put that figure in perspective, the direct care workforce will grow more than registered nurses and fast food workers combined, which are ranked second and third for net job growth according to the BLS. Of note, the total direct care workforce will be larger than any single occupation in 2026.

It's no surprise that we have to address the needs of the direct care workforce.  Leading Age has laid out  comprehensive advocacy goals, as have many stakeholders,  who are working hard with public and private sectors to address the urgent crisis by developing partnerships, helping aging service providers to create benefits packages, higher pay scales, better training and career opportunities.   While these are a few of their many advocacy goals,  let's specifically address the need to do a better job of creating career paths.  

How can this benefit aging service providers?  First, we should look at the cost of turnover.  Estimates range from a low of $2,200 to upwards of $5,000 to replace a direct care worker.  Turnover ranges from a very minimum of 45% to over 100% across the long-term care spectrum.  Often the very best care workers are leaving because their employer offers no defined path to better pay or career advancement.  The result is highly trained and valuable caregivers who are leaving to join another aging service provider who does offer a career ladder.  Sadly, many are leaving the profession all together.  This is a tragedy and is what is keeping CEOs and other leaders up at night!

Quality training that provides more than the "basics" is a great start.  Training should address the needs of the modern learner, be engaging, and not an information dump.  Caregivers need tools to address the pressing issues of understanding and responding to the needs of their care partners.  Communication skills training is critically important yet often overlooked.  Caregivers want to deserve to receive training that will help them be better at their jobs, alleviate their stress and empower them with skills that will make a positive difference in the lives of their care partners and themselves.  

Career ladders need to include a defined step-up plan that workers can embrace.  Pay increase, certificates, titles, additional responsibilities and coach/mentoring roles are some of the ways that direct care workers can feel rewarded and valued by their employers, while offering them opportunities to move into other positions.  It's time for aging service providers to take a laser focus on embracing their direct care workers - for the good of those whom they serve,  their employees and their businesses.  

Pam Brandon is CEO and Founder of AGE-u-cate® Training Institute, a global company whose mission is to ignite change in aging services by delivering effective caregiver education and meaningful life enrichment programs, improving the quality of life for older adults.  Find out about AGE-u-cate's Reveal Aging quality of life workforce training courses.