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Set Your Caregivers Up for Success: Q&A with Aishling Dalton-Kelly, Part 2

Analysis  |  By Jasmyne Ray  
   March 03, 2023

In part two, Dalton-Kelly advises foundational change in how caregivers are viewed.

Aishling Dalton-Kelly is a private duty consultant, as well as president and CEO of Aishling Care Academy. Having previously owned an agency, Dalton-Kelly understands the importance and necessity of setting caregivers up for success and helping them see a future for themselves within an agency.

In the first part of the our interview, we noted the high turnover rate—57%—of caregivers leaving an agency within the first 90 days. In part two, Dalton-Kelly reiterates the need to equip caregivers with the tools and knowledge they need, as well as what should be done so more potential employees people will see a fruitful career path in the sector.

This transcript has been lightly edited for brevity and clarity.

HealthLeaders: How can agencies encourage or establish a cooperative relationship between management and caregivers?

Aishling Dalton-Kelly: Caregivers should be invited into meetings with upper management. There should be a caregiver present to represent other caregivers for everyone to be on the same page about the challenges and difficulties they face, because that's where they stem from–what happens in the field. They're never given a voice to say what they need to say.

HL: What needs to change within the sector in how caregivers are viewed?

Dalton-Kelly: The "unskilled" descriptor has to go. Think about how that makes them feel. It makes them feel like they're worth nothing and they're never going to amount to anything. In my opinion, that's what those words say. However, if we were to change it to be a caregiver and to go into the home and do what they need to do -getting someone in the shower, dressing them, making sure that they're eating properly- that takes intense skill, and there's no recognition for that. There has to be more respect at the entry level.

This is a great career. If you're someone who wants a career in healthcare, this where you can start. There are even apprenticeship programs where the employer doesn't even have to pay for the worker; they come through the program. If for some reason after getting their certificate they can't continue with being a CNA, all they have to do is keep it up to date and they can come back when they're ready.

There is no tracking mechanism for nonactive CNAs in the state of Illinois, and it’s a shame. The very people that can't afford to go to school went through the trouble of completing CNA school, getting their certification, and through miscommunications and not being told how to keep it, they left it and don't know how to get back in.

We should be looking for seniors who are willing to work as caregivers, as well. They have the life skills, and we can teach them the CNA skills. People at home love elderly caregivers because they've been through life. They get it.

We're not communicating the possibilities and we're not telling the caregivers where we can help them find money, and employers aren't investing in their caregivers because of the turnover. What I say to that is, why would they stay? You haven't encouraged them to do better. They're just a number in your agency.

HL: What are some areas necessary for training?

Dalton-Kelly: Focusing on the caregiver's rights; making sure they understand that they do have rights. Helping them understand that abuse isn't something that comes only in a physical format, because caregivers get physically abused, mentally abused, verbally abused. They don't know how to recognize that, how to report that. They think it's something they have to tolerate. Teaching them how to speak up for themselves, correctly, in the right way, is very important. There should be a self-defense component, from chair grabs to choke grabs, wrist grabs. Caregivers aren't taught that either.

I'm not saying all jobs are bad, but these are things that are missing from what we're trying to teach our folks. On top of that, we're saying they're unskilled, but we have to throw this training at them to make them be successful for the clients we put them with, whether it's in a facility or home-care setting.

“There should be a caregiver present to represent other caregivers for everyone to be on the same page about the challenges and difficulties they face, because that's where they stem from–what happens in the field.”

Jasmyne Ray is the contributing editor for revenue cycle at HealthLeaders. 


Caregivers should be included or given a voice in upper management.

The "unskilled" descriptor is harmful and takes away from the neccessary skills a caregiver must have.

Agencies should also ensure that their caregivers know their rights and how to advocate for themselves on job.

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