Major problems with the pipeline of LTC workers, report states

Aides frequently injure themselves on the job, putting them at risk of leaving the LTC field.
Aides frequently injure themselves on the job, putting them at risk of leaving the LTC field.

Workers are leaving long-term care at a faster rate than they are joining the field, according to a new report from the University of California, San Francisco. And many people experience poverty after leaving long-term care jobs, suggesting that employers and policymakers urgently need to ensure the safety of these workers and boost professional development efforts, report authors argue.

The investigators examined 2003-2013 data from the federal government's Current Population Survey, which collects people's self-reported information about job transitions. On average, for any year during the study time period, about 13% of long-term care workers said they had newly entered the field, while 21% said they had left.

This trend is concerning because demand for long-term care workers is expected to dramatically increase due to the aging U.S. population, the study authors note. They were not able to determine the reasons why people left their LTC jobs, or whether the departures were voluntary.

However, low wages might be one contributing factor; the report noted a “high rate of poverty observed” among LTC workers. Injuries sustained on the job might also be at play. Licensed practical nurses and personal care aides in particular reported high levels of work disability after leaving their jobs. The Bureau of Labor Statistics consistently reports that nursing homes are among the most dangerous workplaces in the country.

The fate of long-term care “leavers” is also concerning. Across nearly all LTC occupations, roughly one-half to two-thirds of people who left their jobs in a given year ended up unemployed or leaving the labor force, according to the UCSF findings. Furthermore, few people reported staying in LTC but changing occupations, which might signal limited upward mobility.

Better education and training programs are called for, the authors concluded. “Well-crafted training programs not only can improve the job skills of direct-care workers but also reduce occupational injury rates and job turnover,” they wrote. The Affordable Care Act created funds for training programs in nursing facilities and other LTC settings, they noted.

The report was written by UCSF's Joanne Spetz, Ph.D., and the University of Washington School of Medicine's Bianca Frogner, Ph.D. Click here to access the complete document, which was released Tuesday.