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Shadow shortage in LTC workers creating care gap: demographic trends are driving the growing crisis. (Newsfronts).

THE LONG-TERM CARE INDUSTRY IS SUFfering a growing shortage of CNAs that shadows the nursing crisis, which gained national attention in August when the Joint Commission on Accreditations of Healthcare Organizations issued its warning about the critical shortage of nurses. According to Patrick Brady, executive director of Citizens for Long Term Care, a Washington D.C.-based advocacy organization, the CNA shortage is just as bad as the nursing shortage and will create a care gap as the 77 million baby boomers continue to age.

Brady says the labor shortage in long term care facilities is the result of the same demographics trends that are driving the nursing shortage. "Twenty to thirty years ago job opportunities for women were very different than they are today," he says. "Far fewer women are going into caregiving professions. At the same time significant numbers of workers are leaving the profession because the job has drastically changed. They find themselves doing paperwork instead of providing care. That's not why they choose this profession." In addition, the women who are primarily occupying these positions today are getting older and--like most baby boomers--will be retiring soon and leaving the workforce.

Several parity issues complicate the picture. These workers typically perform physically demanding work--lifting, dressing, bathing, washing, and transferring people--often without the benefit of a health care plan. "Advocates want providers to secure health care benefits, so when workers are injured they don't just leave the workforce. They can get treatment and come back to the job," says Brady. Another still is that long term care facilities usually pay less than hospitals.

"Money is a big issue," according to Allison Lepage, assistant director for California Advocates for Nursing Home Reform in San Francisco. "The work is not high-paying enough to draw enough people. They make $7 to $10 an hour and sometimes work double shifts just to make ends meet. CNAs have told me they have been given a choice of rate increase or health benefits. They can't get both."

What can be done? While the nursing crisis is being addressed nationally, most action at the CNA level is taking place at the state or community level. "Some states have wage pass-throughs," says Brady, "so that when there's an increase in reimbursement payments to providers the increase gets passed through in terms to wage increases to (nursing assistants) in the facility.

Another short-term solution is community aid to the worker. "Many people who do these jobs are in lower income brackets and have entered the position through welfare-to-work partnerships," says Brady. "They need community help like baby sitting."

Extended emigration of workers from abroad is another short-term solution but comes with a moral dilemma. "When you pull in qualified nurses from other countries," says Brady, "you're suddenly draining that country of its care structure. It has serious implications for the Philippines and South Africa where we get a lot of labor."
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Title Annotation:long term care
Author:Cotter, Marianne
Publication:Contemporary Long Term Care
Geographic Code:1USA
Date:Sep 1, 2002
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