Geriatric Care Staff Want More Training On-Site—And It’s More Feasible Than You Think

By Emily Eilers | Posted on 03.06.2018 | 0 comments

Geriatric-focused, on-site education is not only a vital resource for health care workers, but a way to help them stay anchored in their careers.

A recent study in the journal Geriatric Nursing noted that when it comes to on-site, geriatric-focused education, nurses and CNA’s rated classroom-style training more highly than any other mode of instruction. And while staff understandably had some differing degrees of interest regarding the topics covered in geriatric care training, they tended to agree that training could help them combat burnout and fatigue, as well as improve their ability to deliver care.
In short? On-site, geriatric care training for direct-care partners is far more feasible than many organizations think it is.
This study is one of many attempts to formally gauge the relationship between geriatric-focused care training and staff turnover, and how supplying one can ameliorate the other. Care partners have long reported that they look to their leadership to provide them with the resources to thrive in their careers.
Sustainable cultures of safety, those that allow staff to facilitate meaningful elder care, can only be built with the active support of an organization’s leadership. When staff don’t get that support, optimally in the form of on-site, practical dementia care training, they tend to succumb to the wear and tear that come from being ill-equipped to cope with the unique challenges of caring for individuals with dementia.
An organization that actively trains staff in how to interpret behaviors and tailor care accordingly, tends to enjoy better retention of direct-care partners like CNA’s, nurses, and therapists. In fact, in a 2017 survey, health care workers identified “building culture” as the most important leadership skill needed as the industry evolves, well ahead of values like communication, team building, process management, and even decision-making skills.
Why? Because that culture allows organizations to live their values and those in their care to benefit.
The case for a culture of Dementia Capable Care has been building steadily as the largest generation of Americans crosses into retirement. Ten years ago, the Institute of Medicine (IOM) released a comprehensive report called Retooling for an Aging America: Building the Health Care Workforce. It diagnosed several of the factors that need improvement if our society is to provide meaningful support to its elders, and identified critical staff and training deficits that must be addressed to support the 20% of our American population that will be 65+ by the year 2030.

The term “health care workforce” no longer applies solely to medical professionals—we all have a critical role to play in a Dementia Capable Society.

In the IOM’s report brief, the Committee on the Future Health Care Workforce for Older Americans proposed that to provide meaningful care for our elders, the definition of “health care workforce” needed to be expanded well beyond medical professionals—it needed to include direct-care workers and care partners like family members, and most importantly, our elders themselves.
The IOM proposed a concerted effort toward three critical goals: enhancing the geriatric competence of the entire workforce, increasing the recruitment and retention of specialists and care partners, and improving the way that care is delivered.
Why are we all responsible for being an active part of the “health care workforce?” Because we must work as a society to successfully empower care partners and improve care delivery. Medical professionals can’t singularly facilitate a culture of Dementia Capable Care—in fact, the IOM report pointed out that there simply aren’t enough of them. At the time of data collection:
  • Less than 1% of RNs were known to hold a geriatric specialization or certification
  • Less than 1% of pharmacists were known to hold a geriatric specialization or certification
  • Less than 1% of physician assistants were known to hold a geriatric specialization or certification
This means that direct-care partners and front-line staff, from therapists to family members to housekeeping, are the critical bridge to this culture change. And what’s so exciting about this latest feasibility study is that we now know without a doubt that it’s possible to get vital training to these care partners on-site, right where they perform their duties.

The cost of doing nothing is a gamble that no organization will win.

Investing in on-site dementia care training and consulting, which might involve taking front-line staff off the floor, can seem like a significant expense to decision makers, particularly in facilities that are already feeling budget constraints. But that cost pales in comparison to the fines, penalties, and incurred workers’ compensation expenses accrued by communities where adverse outcomes stem from a lack of proper training.
For example, CMS has established critical policies that organizations must adhere to, and OSHA tracks worker illness and injury (which can stem from burnout, fatigue, and lack of training)—targeting organizations with high incident rates for inspection. Inspections and citations culminate in fines that range into the high thousands. And the heightened exposure to liability can cost organizations their funding and accreditation—not to mention costs associated with litigation and settlement.
And we can’t forget that there is an even greater risk associated with spiked staff turnover—far greater than any financial expense—and the residents staff care for face the brunt of it. In one study, hospitals with lower RN turnover also tracked lower risk-adjusted mortality and shorter patient stays. In another, 71% of health care workers saw a connection between disruptive behaviors (which can be proactively prevented or mitigated with training) and medication errors. We also know that CNA’s alone have a turnover rate of nearly 125%, so there is definite and preventable risk associated with these direct-care providers that needs to be urgently addressed.
Ultimately, there’s no question that preventable stressors drive talented individuals out of long-term careers—and those they care for are the most vulnerable to adverse outcomes from that reality.


You might be surprised how ready your staff are for focused training.

A recent survey of home health care partners (which included staff ranging from CNA certification holders to doctoral-level professionals and MDs) found that 52% of staff are considering getting more education. Why does this matter? Bachelor’s degree-level and CNA certificate-level direct-care partners made up more than half of the total group seeking further training—aligning with the findings of that separate feasibility study mentioned at the beginning of this post.
An aging and sizeable American population is about to profoundly increase demand for direct-care workers with geriatric-focused training. And on the other end of the spectrum, the millennial generation is going to make up the largest chunk of our workforce as those baby boomers enter retirement, and they’re extremely vocal about their desire for increased education to help sustain their careers.
Staff retention is deeply interwoven with staff development, which combats compassion fatigue and professional burnout. Without the training to create safer and more supportive environments in which disruptive and challenging behaviors are prevented or effectively mitigated, staff turnover continues unabated. While we can roughly estimate the cost of replacing a single employee, we can’t put a price on a person—the care partner employed, or the individual they’re caring for.
And most importantly, we know that a culture of safety belongs to each of us, and that we each have a personal responsibility to create a supportive environment for our elders to successfully provide quality care to them. We’re all, in our own way, a participant in the “health care workforce”, which is why we must each adjust our individual paradigms to do our part in collectively moving our culture forward and realizing a Dementia Capable Society.
Your staff are ready, and your organization can’t afford to wait. Amazing outcomes are possible when organizations invest in geriatric-focused education for their staff.

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