The high costs of bad health among front line caregivers

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Elizabeth Newman
Elizabeth Newman

We are what we eat, and there's a lot of evidence that our nursing home workforce is struggling to be good.

In a recent study, healthcare support workers — certified nursing assistants, therapy aides, etc. — were found to have extremely poor dietary habits. One commenter noted that this is partially due to having five minutes to eat. (She also asked us to write more about awesome things healthcare workers do, so here is a story about workers caring for a child with hypothermia, a story about a robotic seal helping dementia patients, and one about success in telehealth.)

The lack of time to eat certainly doesn't help, but it's a little more complicated than that. Healthcare practitioners, such as physicians, can be grouped with managers, architects and engineers as having some of the best results in the study. I'm not sure you can argue that a hospitalist has more time or less stress than a therapy aide, but what they do have, overall, is a lot more money. The problem of poor overall health is multifaceted for low-wage workers. As the researchers noted, barriers to better eating and a lower cardiovascular risk are “time, poverty, job stress, workplace injury and excessive physical job demands.”

Let's put aside how, if you are making $10 an hour and working two jobs, there's not going to be extra time to hit the gym. Add on the stress of taking care of the sick and elderly, the possibility of injury related to helping a resident, and the physical demands of being on your feet all day. The final nail in the health coffin is that fresh fruit and vegetables, not to mention organic food, all costs more money than crummy processed food.

People in the Chicago area have long known access to quality food has been a barrier for many of our neighbors. Eliminating food desserts was part of Rahm Emanuel's plan when he ran for mayor, as he noted that more than 600,000 Chicagoans at the time lacked access to adequate fresh fruit and vegetables. That's dropped 28%, according to a Chicago Tribune analysis, in this story about a Whole Foods opening in a traditionally rough part of the city. I'm well aware that there's still a long way to go, and that Chicago has a multitude of other problems, but it's worthwhile to occasionally note successes in our Second City.  

A lack of access to quality food is often met with a shrug. How does it affect your bottom line? Well, administrators and executives should be well aware of the costs of poor cardiovascular health among their workers. Everyone in the study was over age 45, and sooner or later, those who smoke, eat badly or have high blood glucose are going to cost you money.

So what could we do better?

The American Journal of Preventive Research authors note a variety of options, some of which are easier than others. Administrators argue that a universal smoke-free policy means people will sneak off to smoke in their cars, but I'm not convinced.

Trickier are living wage legislation, paid sick leave and restrictions on mandatory overtime. All of those have to be approached from a long-term risk benefit analysis. In general, research has indicated that at the very least, offering paid sick leave means workers are less likely to infect their colleagues or ill residents. It's estimated flu rates would drop 5% nationally with paid sick leave, according to this New York Times round-up of the potential costs and benefits of that policy.

Without additional funding, the easiest path forward is to encourage healthy activity and reduce job hazards. This means everything from spending the money for floor and ceiling lifts, to holding a weight-loss challenge to bringing in a fruit basket instead of pizza. Clear your halls of all the stuff residents and employees run into, and find ways for your local yoga or pilates instructor to come into the facility to offer a class. I've written before about the importance of strength training, which was in the news this week in relationship to its benefits for seniors.

Finally, better health also means taking a look in the mirror. When it comes to one's health, everyone is generally doing the best he or she can. But I have bad news, which is that you may not be as healthy as you thought.

Let's take the food you eat daily. In order to understand how the participants in “Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years” were evaluated, I took one of the screeners related to their food questionnaires.  

To give you a sense of what I eat, I generally have two pieces of fruit a day, a salad at lunch and yogurt at some point. But the screener said that I'm not eating enough fruits and vegetables, and it is true that while I believe I eat a lot of healthy food, I probably often fall short of the recommended five servings a day. I did better on the fat intake screener, but part of that is due to not eating red meat or fried foods.

Whether or not it's eating more fruit yourself, try tackling one thing you can change in your facility, even if it's changing what is offered in a vending machine or bringing in that fruit salad.

As with all issues in long-term care, by doing better as a leader, you act as a role model for your employees.

Follow Elizabeth Newman @TigerELN.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.