American Association of Therapeutic Community Professionals

An Association for Certified Residential Counselors in Direct-Care Service image001.jpg

Long-term care consists primarily of assistance with the activities of daily living (dressing, bathing, eating, moving about) and the instrumental activities of daily living (money management, medication administration, moving in the community).  Direct care workers perform these services in client homes, nursing homes, assisted living residences and group homes.  In this labor-intensive field, the quality of long-term care depends largely on the availability of workers and the ability of the direct care worker to meet the specific needs of clients.  The direct care workforce is the heart of long-term care services. 

Despite their fundamental role in caring for seniors and people with disabilities, the direct care worker is poorly cared for by our society.  Direct care workers receive low wages and few, if any, health and other fringe benefits. They often work multiple jobs because of the low salaries. The District of Columbia where we are based, like the rest of the country, faces two major problems regarding its long-term care workforce. Workers are hard to recruit and to retain.  This shortage of workers results in services not provided because there are not enough workers to provide them in both nursing homes and in the community. 

Limited availability of direct care workers results in short-staffed long-term care facilities and underutilized Medicaid home and community-based waiver services.  High turnover rates affect the continuity and quality of care and means that workers do not know the needs and preferences of individual clients. The training curriculum of direct care workers does not adequately prepare them to serve persons with disabilities.  In addition, varying training requirements for persons working in nursing homes and home and community-based services makes moving from nursing homes to home and community-based services difficult to accomplish.............




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