Job satisfaction and career commitment among Alzheimer's care providers: addressing turnover and improving staff empowerment.

This study investigated the relation between job satisfaction and career commitment among 262 Alzheimer's care staff working in long-term and community-based care settings. It was anticipated that the results would suggest whether career commitment could be enhanced to positively influence job satisfaction, and conversely, if improvements in job satisfaction might contribute to a deepened sense of vocational empowerment. Participants attended dementia-specific training and completed 2 short work-related questionnaires that measured job satisfaction and career commitment. The results of stepwise regression revealed interrelations between the 2 constructs. Congruence appeared to be reciprocal with respect to the overall scale scores and the intrinsic job satisfaction measure. Unexpected relations appeared in analyses of the extrinsic job satisfaction measure and the career planning subscale. Results are indicative of the fundamental distinction between job satisfaction and career commitment. Implications for efforts to reduce turnover and improve staff empowerment are also considered.

The value of geriatric care enhancement training for direct service workers.

This study reports on the evaluation of a skills-enhancement training series for direct service providers in home care that was part of a federally funded state-level initiative to improve employee recruitment and retention. The gerontological training curriculum included content to improve problem-solving, communication, and stress management skills in order to increase professionalism and self-efficacy. While the first year of training utilized a network of "real-time" compressed video-teleconferencing broadcast to satellite sites statewide, these broadcasts were videotaped and accompanied by trained moderator-led scripted case study discussions at each of the sites during the second year. As the training series progressed, there was a linear increase in the likelihood that training would change the way participants performed their jobs in the future. Importantly, the training was more highly rated by the participants who had a greater commitment to pursuing their care work with geriatric clients. The merit of the program and implications of the results for the issue of employee retention are discussed.

Job satisfaction and career commitment among nursing assistants providing Alzheimer's care.

As part of a statewide dementia-specific training collaborative, data were collected from nursing assistants and aides who provide paid Alzheimer's care. This study explored the relevance of previous education and practical experiences to specific constructs associated with worker recruitment and retention. Direct-care providers with prior training in gerontology and geriatrics had lower levels of extrinsic job satisfaction and career resilience than those without this kind of continuing education. Program participants who were currently or previously the primary caregiver for a friend or relative with Alzheimer's disease had higher levels of intrinsic job satisfaction but lower levels of career resilience than those with no informal caregiving experience. Current or previous informal caregiving experience may enhance intrinsic job satisfaction by increasing personal commitment to pursue formal care work and providing a kind of inoculation against the demoralization that is too often suffered in these very challenging jobs.

Enhanced care assistant training to address the workforce crisis in home care: changes related to job satisfaction and career commitment.

Changes in job satisfaction and career commitment were observed as a consequence of a geriatric case management training program focusing on skills development among personal care attendants in home care. A comparison of pretraining and posttraining scores uncovered a statistically significant increase in Intrinsic Job Satisfaction scores for participants 18-39 years of age, whereas levels declined among the group of middle aged participants and no change was observed among participants age 52 and older. On the other hand, a statistically significant decline in Extrinsic Job Satisfaction was documented over all participants, but this was found to be primarily due to declines among participants 40-51 years of age. When contacted 6-12 months after the training series had concluded participants indicated that the training substantially increased the likelihood that they would stay in their current jobs and improved their job satisfaction to some extent. A comparison of pretraining and posttraining scores among participants providing follow-up data revealed a statistically significant improvement in levels of Career Resilience. These results are discussed as they relate to similar training models and national data sets, and recommendations are offered for targeting future educational programs designed to address the long-term care workforce shortage.

The development of an educational collaborative to address comprehensive pressure ulcer prevention and treatment.

The prevention and treatment of pressure ulcers is a growing public policy concern. Driven by a more informed consumer and the exploding costs of care, policy makers are looking for ways to integrate health-care research and long-term care practices in an effort to improve the quality of care and ultimately reduce costs. This paper presents a case study that demonstrates how training is being integrated at the facility level, utilizing a collaborative. The collaborative was a joint public-private partnership supported through resources from state, federal, and private agencies, with an overarching goal of delivering high-quality, easily accessible geriatric education and training. Direct care providers and other practitioners were recruited to attend a live, interactive videoconference that featured nationally known experts. The content of the educational program was drawn from nationally accepted guidelines that discuss appropriate procedures for wound cleansing, dressings, positioning techniques, proper nutrition and risk assessment protocols. Evaluation of the program indicated that the highest-rated objectives related to the application of training content in the implementation of treatment and prevention procedures important to quality patient care. An examination of publicly available data revealed that an escalating increase in the percentage of facilities in the state cited for deficiencies because of the incidence of pressure ulcers from 1996 to 1999 was reversed in 2000, subsequent to the videoconference. Future programs are planned to sustain the availability of opportunities for practitioners to get critical updates from the experts in the field via live interactive sessions.