Physicians, nurses, consumers, and others agree that staff who work with long-term care facility residents directly provide vital, valuable services. But there is no consensus about what to call these people. Now, stakeholders in the Eldercare Workforce Alliance, representing 25 national organizations including AMDA, are working on establishing a commonly accepted term and definition that will encourage policymakers and others to understand and appreciate the role of these individuals.
The alliance was formed following the publication of the Institute on Medicine's report “Retooling for an Aging America: Building the Health Care Workforce.” Representing consumers, family caregivers, direct-care workers, and health care professionals, the group's goal is to propose practical solutions to the issue the IOM report addressed and to strengthen the eldercare workforce.
“We were working on a document to detail who we are and why we were formed, and this debate arose. It was interesting because there are connotations to the wording that I wasn't aware of but that have implications for the way people view these individuals and interpret the work they perform and their role in long-term care,” said AMDA Executive Director Lorraine Tarnove. This discussion is important, she emphasized, because “direct-care workers have an equal place at the table. What these people have to offer and bring to their facilities is huge.”
Direct Care Alliance Executive Director Leonila Vega said, “Direct-care workers generally do what they do because they want to help people, and they take great pride in their work. We need to show that we respect what they do by giving them respectful titles. At the same time, from a policy level, we need to ensure this work is defined appropriately and identify key areas of work.
Getting consensus on a term is important but complex, said Steven L. Dawson, president of PHI, which is represented in the alliance. “There are many subcategories of workers who perform some job related to direct care. Each group may want to be called something related to its specific setting or other aspect of work,” he said. “It would be interesting to survey workers and find out what they want to be called generically. Our challenge is to come up with something to which everyone can say ‘yes.’”
Jay Sackman, a consultant to the Service Employees International Union, said, “I think it is great that we are having this conversation. We should find out what the workers think. Many resent being referred to as nursing assistants or other titles that don't define who they are or what they do. … We can begin with a name that shows respect and appreciation, then move to other issues such as pay,” he said.
Mr. Dawson pointed out, “There are more of these people working than there are grade 8-12 teachers, convenience store workers, or waitresses. We need to make the power of these numbers known to strengthen the public policy argument.”
Ms. Vega sees a positive conclusion to these discussions. “The timing is right, and thanks to the alliance, we have an opportunity to include everyone in this discussion,” she said. “This will stay on the front burner because there is a care crisis in this country. I see more attention to this and greater willingness of people—such as policymakers—to listen.”
Firefighters followed a similar path years ago to change the perception of these individuals, Ms. Vega noted. “People used to think of these people as volunteers—committed and hard working but not professionals.
“Now everyone sees firefighters as real paid professionals with specific roles and responsibilities, salaries and benefits, and opportunities for advancement. … The same evolution needs to happen for direct-care workers.”
This article intentionally avoids titles other than “direct-care workers.” Send your suggestions to caring@elsevier.com. Senior contributing writer Joanne Kaldy is a freelance writer in Hagerstown, Md., and a communications consultant for AMDA and other organizations.
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