Why do they stay? Job tenure among certified nursing assistants in nursing homes. Wiener, Joshua M., et al.. April 2009. The Gerontologist , Vol. 49, No. 2.

Using data from national surveys, this study identified factors related to job tenure among certified nursing assistant. It found extrinsic rewards, such as wages, time off, and pensions, to be the most consistent determinants of job tenure. The article's authors conclude that wages, fringe benefits, job security, and alternative choices of employment need to be addressed in order to reduce turnover and improve quality of care.

Enhancing relationships in long-term care through story sharing. Heliker, Diane. June 2009. Journal of Gerontological Nursing, Vol.35, No. 6.

Based on interviews with nurse aides (NAa) and residents in six nursing homes, this articles reports on the results of a 'story sharing' intervention -- an interactive teaching-learning strategy that enhances reciprocal ways of caring in long-term care settings. The author argues that story sharing enhances the relationships between NAs and residents by helping them connect and understand one another.

Nurses involvement in nursing home culture change: Overcoming barriers, advancing opportunities. Burger, Sarah Greene, et al.. Spring 2009. Hartford Institute for Geriatric Nursing, New York University College of Nursing, Coalition for Geriatric Nursing Organizations, The Pioneer Network.

This paper frames the competencies that need to be developed for nurses who are involved in culture change and resident-directed care in nursing homes. It also examines the direct impact of culture change themes -- such as autonomy in personal choices for the residents, consistent staffing, and a less vertical organizational approach -- on nurses and their practice. It also offers specific recommendations regarding nursing practices and academic programs that prepare professional nurses.

Is New York prepared to care? A comprehensive coverage solution for home care workers. PHI Health Care for Health Care Workers. May 2009.

This report offers a statewide review and analysis of insurance coverage of home care workers in New York, including an analysis of data collected from a survey of home care employers; an assessment of key state-specific health insurance initiatives targeted at home care; and background on the workforce, structure and financing of the home care industry. The report's authors recommend that New York State address the weaknesses within the current state-supported plans, and at the same time, create a more targeted, quasi-public option that would comprehensively address the unique needs of this workforce.

Health insurance coverage of New York State's home care aides: Findings from a 2008 survey outside of New York City. PHI Health Care for Health Care Workers. April 2009.

Using surveys and focus groups from 90 agencies that employ about 13,000 home care aides, this study was conducted to help policymakers understand the extent to which health insurance is offered, eligibility requirements and enrollment rates for health insurance, and the cost to both employers and employees. Findings indicate that only 25% of aides are enrolled in health insurance programs, due in large part to strict eligibility requirements and high cost of coverage.

Vermont's Direct-Care Workforce. PHI. March 2009.

This fact sheet discusses the state of the direct-care workforce in Vermont and shows that while demand for these jobs is at a historic high, the traditional labor pool from which these workers have been drawn is declining. It argues that an injection of public and private investment to reshape the structure and quality of direct-care jobs can help to bolster the workforce, the local economy, and quality care.

Long-term care: Options in an era of health reform. Wiener, Joshua. March 2009. Alliance for Health Reform.

This paper puts forward reform options available to policymakers in long-term care, focusing specifically on financing, service delivery, quality assurance, and the long-term care workforce. The section on the workforce discusses recruitment, training programs and career ladders, extrinsic rewards, and organizational culture.

The need for monitoring the long-term care direct service workforce and recommendations for data collection. Edelstein, Steven, and Dorie Seavey. February 2009. National Direct Service Workforce Resource Center.

This paper discusses the state of the direct service workforce and its role in long-term care systems change. The paper proposes that states collect a minimum data set of information on the workforce, including numbers of direct service workers, turnover and vacancy statistics, and average worker compensation. It argues that this information is essential in order to assess the magnitude of workforce issues, design appropriate responses, and measure the impact of policies over time.

The need for national training standards/guidelines for privately paid geriatric home caregivers. Wright, Larry D.. 2008. The Caregiver Project for Older Americans.

This issue brief calls for the development of national training standards and a caregiver certifying organization that provides national oversight. It argues that there is an urgent need for a large cadre of trained caregivers who can provide a high level of care for older adults who live at home. It outlines four recommendations to create such standards.