Direct care workers play an essential role in the lives and care of older adults receiving long-term services and supports (LTSS). Yet, despite decades of research, advocacy, and incremental policy and practice reform, these workers remain inadequately compensated, supported, and respected. As a result of these issues and other factors (such as the stresses of an ongoing pandemic), turnover and attrition are rampant, and it’s challenging to attract new people to the field. The authors of this article suggest steps for transforming direct care jobs and stabilizing this workforce.
Specifically, the authors determined that a strong, stable direct care workforce requires a number of changes and innovations:
- Competitive wage and adequate employment benefits.
- Updated training standards and delivery systems that prepare these workers to meet increasingly complex care needs across settings.
- Enhanced career mobility and workforce flexibility.
- Investment in well-trained frontline supervisors and peer mentors to help direct care workers navigate their challenging roles.
- Elevated position for frontline workers in relation to the interdisciplinary care team.
The authors urged more federal action and suggested that the U.S. Department of Health and Human Services could convene an advisory council comprising representatives from relevant federal agencies and departments, as well as LTSS payers, providers, workforce development experts, worker advocates, consumers and family members, and direct care workers themselves. Among its efforts, the authors proposed, the council could develop recommendations for improving direct care workers’ compensation, raising standards across settings, and occupations, establishing recognized career pathways, strengthening supervision, enhancing team integration, and overcoming gaps in direct care workforce data collection.
