California's Center for Caregiver Advancement Emphasizes Skills Needed for Caregivers, Nursing Home Staff

The center's Career Pathways Program allow caregivers to earn credit for prior learning and lived experience to further their career.

Training by the Center for Caregiver Advancement (CCA) not only equips nursing home workers and caregivers with the skills they need to do their work effectively, but through its Career Pathways Program is enabling them to further their career as a caregiver.

Calling the work caregivers do “unskilled” is offensive and doesn't do justice to the intimate nature of their role, said Corinne Eldridge, CEO and president of the CCA, which has trained more than 20,000 nursing home workers and caregivers in the state of California since it was founded in 2000.

The “unskilled” label may also stem from structural racism and sexism, particularly around the fact that women of color and immigrant women are the main demographic who do this work, she said.

"It isn't done outside of the home or seen to be more skilled with degrees associated," she said to HealthLeaders. "You can see that framing based on how the workers were initially left out of the Fair Labor Standards Act, how there hasn't been sick pay, [and why] it's taken so long to get a level of benefits. It's taken a long time for the workforce to get to where it is today, and yet there's still a long way to go."

The vision behind the Career Pathways Program builds on the organization's idea of what should happen within home care and nursing homes overall—a progression of skills that caregivers learn while receiving credit for prior learning, which would enable them to further their career from caregiver based on their lived experience and competencies they develop through the different training programs.

The program has 120 hours of custom-built curriculum throughout five pathways, with 30 hours dedicated to their basic training. Results of the program thus far have shown reduced feeling of depression and isolation in caregivers, and an increase in skills and feelings of self-efficacy. These results have also led to a reduction in emergency room visits and hospitalizations for clients and patients.

The five pathways are: general health and safety; adult education; cognitive impairments and behavioral health; complex physical needs; and transitioning to home and community-based living. Courses on Alzheimer's disease and related dementias, as well as autism, have been popular options among caregivers.

"The caregivers know so well what their day-to-day experience is. They are a second set of eyes for the consumer that they care for," Eldridge said.

"Oftentimes, they are with the consumer that they care for more than anybody else, and so we trust what they say because their lived experience dictates where the need is,” she said. “Then we couple that with subject matter expertise in whatever subject it is that we know we need to pivot to."

The courses are completed over the duration of multiple weeks. California has also regulated the program where caregivers can enroll in however many classes they want in the order they want.

Courses are also taught in eight languages, with Vietnamese and Russian being added for the Career Pathways Program.

"The workforce is a middle-aged, predominately female workforce and our information and experience with the workers has shown us that with immigration patterns, they are they are not new [to the United States]," she explained. "They are monolingual speakers in their native language, and they are not learning English to become their predominate language."

While the CCA is based and focuses on caregivers in California, Eldridge said there are similar organizations in 10 other states. With the growing demand for aging services, organizations like CCA support the caregiver workforce, providing them with the training they need.

"They bring those skills back to the broader health system,” she said, “which results in lower turnover for the workers and better care for the consumers."