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 To Support the Workforce, Focus on Flexibility, Growth, and Engagement: Report

Long term/post-acute care (LT/PAC) providers should focus on flexible schedules, career growth, and family engagement to develop and support workers caring for individuals with Alzheimer’s disease and other dementias, according to a new report in the February issue of The Gerontologist.

The report, Long-Term Care Workforce Issues: Practice Principles for Quality Dementia Care, highlights evidence-based approaches in the areas of staffing, staff training, compensation, supportive work environments, career growth and retention, and engagement with family. While not all LT/PAC settings may require attention to the principles, the report proposes them as best practice recommendations for dementia care providers.

The report is one of 10 that covers the Alzheimer’s Association’s 2018 Dementia Care Practice Recommendations​, released on Jan. 18. There are 56 recommendations total aimed at helping providers deliver person-centered care for those living with Alzheimer’s and other dementias. Other reports include recommendations focusing on nonpharmacological practices, transitions in care, medical management, person-centered care, and assessment and care planning, among other topics.

According to the report’s authors, the study and recommendations emphasize the staff perspective of what is needed. “Staff need and want training and education, to be part of the organization and involved in decisions, ongoing and consistent communication, and to be part of a team,” says Susan Gilster, PhD, RN, LNHA, founder and owner of the Gilster Group, the consultancy group specializing in dementia care that conducted the study. “All of this will help to increase staff retention,” she says.
The Alzheimer’s Association has posited that the single most important determinant of quality dementia care across all care settings is direct care staff. The six practice recommendations for the dementia care workforce are: 

1) Provide a thorough orientation and training program for new staff, as well as ongoing training;
2) Develop systems for collecting and disseminating person-centered information;
3) Encourage communication, teamwork, and interdepartmental/interdisciplinary collaboration;
4) Establish an involved, caring, and supportive leadership team;
5) Promote and encourage resident, staff, and family relationships; and
6) Evaluate systems and progress routinely for continuous improvement.

“While much of the research is focused on singular topics and the relationship to training, the study points out that the workforce issue is really multifaceted,” says Gilster. Implementing the recommendations will support direct care workers and have benefits for improved residents care, resident, family and staff satisfaction, and financial outcomes, she says.

The report also proposes future research considerations to improve the lives of those who live and work in LT/PAC settings. Citing nursing facility administrator turnover as ranging from 41 to 45 percent, the report says that a high rate of leadership turnover is associated with high numbers of deficiencies and increased direct care worker turnover. The Gilster Group advises that further research be conducted to determine the reasons for leader turnover and what may need to be done to prepare leaders for the future to improve staff competencies.
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