Health

California offers paid training and personal care to in-home caregivers

One afternoon in November, Chris Espedal asked a group of caregivers to describe what happens to them when their work becomes too heavy. Participants in the Zoom meeting — 13 caregivers from across California who work with people who have cognitive disabilities, mental health issues, or complex physical needsThey said they were experiencing nausea, anxiety, shortness of breath, elevated heart rate and other signs of stress.

“I want to scream,” said one. “I feel exhausted,” expressed another.

Espedal, who has been training caregivers for 18 years, proposed a relaxation exercise: “Inhale four times, hold your breath four times, exhale four times.” He taught them to take time for themselves, such as reading a book from cover to cover, and reminded everyone to eat, sleep, and exercise. “Don’t be afraid to ask for help,” Espedal said. He added that one of the best ways to take care of his patients—often a loved one—was to take care of themselves.

The class is a bit sentimental. But it’s one of many offers from the California Department of Social Services that the agency says is needed to attract and retain caregivers in a state-funded assistance program that helps 650,000 low-income elderly or disabled people to grow old, usually at home.

As part of the $295 million initiative, thousands of classes, both online and in-person, will begin in January and focus on dozens of topics, including dementia care, first aid training, medication management , fall prevention and self-care.

Caregivers will be paid for the time they spend developing their skills.

Whether it will help alleviate the caregiver shortage remains to be seen. According to a 2021 state audit of the In-Home Supportive Services program, 32 of the 51 counties that responded to a survey reported caregiver shortages. Separately, auditors found that clients waited an average of 72 days to be approved for the program, though the department said most application delays were due to applicants’ lack of information.

The home care programme, which has been in existence for almost 50 years, is characterized by high staff turnover. About 1 in 3 caregivers drop out of the program each year, according to Heather Young, a researcher at the University of California-Davis who worked on a 2019 government report on California’s health care workforce needs.

It doesn’t help that the pay is low. According to the state, the median hourly rate for caregivers in the in-home assistance program is $15.83. Fees vary because the program is administered locally and each county sets its own.

“The training is very helpful,” said Doug Moore, executive director of United Domestic Workers of America AFSCME Local 3930, which represents about 150,000 caregivers in California. “But when wages are low—and you can make more at Target or McDonald’s and get a bonus—then you’re going to be doing that job versus a tougher job, which is taking care of someone with a disability or someone who is getting old”.

The training initiative grew out of Governor Gavin Newsom’s Aging Master Plan to improve job quality. Theresa Mier, a spokeswoman for the Department of Social Services, said the state hopes the financial incentives will help attract new workers, and keep them longer caring for people with specific needs.

In addition to hourly pay to take classes, caregivers will receive incentives starting at $500 for 15 hours of training. They can earn up to $3,500 if they spend at least 40 hours a month working with a client for at least six months. Before, counties offered some training, but didn’t pay workers for their time.

The state awarded grants, including $16 million to Homebridge, a San Francisco-based caregiver organization, to coordinate the trainings. Classes will be taught in Spanish, Cantonese, Mandarin and Armenian, in addition to English, to reach more workers. And state officials are planning a social media campaign to recruit new caregivers.

But the incentives are allocated only until the end of 2023.

Greg Thompson, executive director of the Personal Assistance Services Council, the public authority that manages Los Angeles County’s in-home program, would like to make the paid training permanent. “There has to be, in my opinion, some kind of accountability, structure, supervision and ongoing training,” he said.

Many of the caregivers who attended the first courses care for family members who have physical and behavioral needs. In fact, 3 out of 4 caregivers in the home care program are relatives of patients.

But the state needs to prepare for a shift in the workforce, which requires people to look outside of their families. The number of seniors in California is expected to be nearly 8.5 million by 2030, an increase of more than 40% from 2019. Many of them will be living alone.

The state will need more caregivers like Luz María Muñoz, who has been working in the home assistance program for six years. This Bakersfield resident has faced difficult situations at her job. An older patient was taking 30 medications. Another had bed sores, which can be fatal if not treated properly. Muñoz peppered the patient’s nurse with questions about how to treat the wounds and felt responsible for her well-being.

“Those wounds had to be cleaned daily,” he said.

Muñoz was interested in training. The department said she sent notices about the classes to all participating caregivers and will follow up with updates. Counties also helped spread the word online, with newsletters and brochures.

The first sessions filled up immediately. Leslie Kerns, the home care registration manager for Connecting Point, the public authority for the program in Nevada, Plumas and Sierra counties, said some classes filled up in three hours. State officials indicated that registration for next year’s classes should open soon.

Angelina Williamson cares for her disabled mother in San Diego and attended a course on patient mobility and transfer. She said that she learned to use her body to break a fall and that if her mother falls, it is better to bring her a chair than to lift her, because she has enough upper body strength to get up on her own, with help. of williamson.

Recent surveys suggest that caregivers are likely to be interested in self-care. In an analysis of California nonprofit caregiver resource centers, 35% of caregivers reported that their health had worsened while serving, and 20% had experienced symptoms of depression.

Some caregivers also reported feeling lonely, which could include a lack of company, feeling left out or isolated. And a 2020 report from the National Alliance for Caregiving and AARP revealed that 26% of caregivers had difficulty managing their stress.

Robbie Glenn, a single father from Anaheim, attended Espedal’s self-care class and learned to take time for himself. By day, Glenn cares for his 11-year-old son, Edin, who has birth defects from alcohol exposure and nonverbal autism. Edin needs help to go to the bathroom and take a bath. He has epilepsy and sometimes sleepwalks. At night, Glenn freelances on post-production tasks such as film editing and color grading.

Now he uses a watch to remind himself to take a break. “And,” she says, “I do those breathing exercises a lot.”

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