Direct care workers experience pandemic challenges, but rate employer preparation, communication high: study

Originally published in McKight’s Senior Living on 11/19/2020

By Kimberly Bonvissuto

Direct care workers have encountered many work-related challenges during the pandemic, but they say their employers have prepared them and communicated well about COVID-19, according to the results of a recent study.

Researchers with the LeadingAge LTSS Center @UMass Boston discussed the study, which explored the overall stress and specific challenges direct care workers experience during COVID-19, their perceived preparedness and the quality of their employers’ communications around the pandemic, Wednesday during a presentation at the LeadingAge Annual Meeting Virtual Experience.

Verena Cimarolli, PhD

The study involved 852 current and former direct care workers in 45 organizations across the country, representing assisted living, independent living, home- and community based services, nursing homes and healthcare services. Responses were drawn from specific research questions embedded in ongoing WeCare Connect surveys used by 155 aging services providers across the country.

Verena Cimarolli, Ph.D., a senior health services research associate at the LTSS Center, said the most frequently reported work-related challenges direct workers reported were an increased risk of transmission of the virus to or from residents, workload demands and understaffing.

A higher percentage of workers who resigned their position (31%) reported a lack of personal protective equipment as an issue compared with current employees (19%). A “strikingly higher” percentage of workers (24%), Cimarolli said, reported that a lack of protocols or guidance from organizations about caring for residents was a challenge compared with current employees (8%).

Overall stress level ratings, on a scale of 1 to 5, with 5 being the most stressed, were 3, on average, for current employees and 4 for those who had resigned.

Using that same scale, direct care workers gave their employers an average rating of 4 on preparedness and communication. Overall preparedness was rated 4.1, communication about caring for residents was 4.3, and communication about protecting oneself and one’s family was 4.3.

“This indicates employers adequately prepared for and communicated well with employees during the pandemic,” Cimarolli said.

Looking at external challenges by care setting, direct care workers in assisted living reported that their biggest overall challenges were separation from family (33%), managing personal needs and family demands (31%) and financial hardship (27%). In comparison, HCBS workers reported financial hardship as their top overall challenge (42%), whereas nursing home employees reported separation from family (35%) as their top challenge.

Top work-related challenges in the assisted living setting were reported to be increased risk of transmission of COVID-19 to or from residents (20%), increased workload demands (18%) and understaffing (16%), although 53% of respondents working in assisted living reported no work-related challenges. The top-reported work-related challenge among HCBS employees was increased risk of transmission (35%), whereas nursing home employees cited understaffing (44%) as their top challenge.

Natasha Bryant, managing director and senior research associate at the LTSS Center, said that employees who resigned their positions reported experiencing challenges more frequently and also recorded higher stress levels. Nursing home employees in particular, she said, more often face understaffing challenges than do employees in other care settings.

Natasha Bryant

The findings of the study, Bryant said, highlight the need for “wraparound services” to help direct care workers better manage family needs and financial hardships. Separation from family members may be difficult to counteract, however, because it could stem from the need to isolate or work more hours due to the pandemic, she added.

“Participating organizations have provided adequate training and communication around the pandemic,” Bryant said.

Cimarolli said the LTSS Center received funding from Aging in America and the Donaghue Medical Research Foundation to conduct additional studies focusing on the effects of COVID-19 on certified nursing assistants and employee retention at nursing homes.

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