caregiver with resident

Lattices and ladders are two of the key tools for attracting and keeping employees to ease the burdens of staffing shortages in the long-term care sector.

Lattices deepen employees’ current knowledge and skills while ladders help them pursue different disciplines, listeners were informed during Wednesday’s LeadingAge webinar, “Career Ladders and Lattices: Grow the Aging Services Workforce.”

The sector’s current staffing shortage predates the COVID-19 pandemic, which only worsened it. Future demographics offer no let up, as between 2016 and 2060 the number of people aged 65 and older will double to 94.7 million. Further, the number of those 85 and older will triple to 19 million, noted speaker Jenna Kellerman, LeadingAge’s director of workforce strategy and development.

PHI, a direct-care workforce consultant, estimates 7.9 million job openings will exist between 2020 and 2030.

“That’s a lot of jobs to fill and a lot of people to take care of,” Kellerman said. “We want to engage people in our field and then retain them, because if we can retain people we have and grow them and keep them, hopefully we can make an impact on the 7.9 million open positions we anticipate.”

Progressing a career through a clinical path is a common approach, but entry-level caregivers also might be interested in culinary or social work, Kellerman observed. It’s vital that leaders communicate such options, she added.

Lattices to improve caregivers’ skills will be more important as the population ages and care becomes more specialized, she explained.

It’s crucial for organizations to develop custom advanced roles for caregivers, specifically direct care workers who want to add skills and responsibilities and earn more money, said presenter Kezia Scales, senior director of policy research with PHI.

She said the first steps in career lattices are recognizing employees’ skills, then strengthening and leveraging them. Examples of advancement for direct care workers include senior aide roles, peer mentors, assistant trainers, schedulers, coordinators, condition specialists and transition specialists.

“All of these type of positions can be implemented at the employer level and on a broader scale without coming up against practice regulations and other rules that govern what direct care workers can and cannot do,” she noted. “These are the kinds of roles we can create right now.”

Natasha Bryant, LeadingAge’s senior director of workforce research and development, pointed out that many direct care workers don’t want to commit to years of training to be nurses. Organizations need to be able to satisfy these non-nursing ambitions by providing ladders to positions in areas such as scheduling, she said.

Direct care workers who become schedulers show more empathy and understanding of the direct care workers they work with, Bryant said research has shown. Also suitable for direct care workers are managerial positions in social work. They may become good care managers or service coordinators, behavioral health specialists or activity professionals.

“Offering incremental advancements would allow for a career endpoint for those who really don’t want to or aren’t able to pursue that four-year degree, but also gives steps up the ladder for someone in advancing to either a bachelor’s or master’s degree in social work,” Bryant noted.

Whether the choice of the organization is lattices or ladders, or both, communication is the root of all retention, Scales emphasized.

“The near-term strategy, the thing that can happen today, is asking staff themselves what they’re looking for in terms of career advancement. Whether that’s one-on-one conversations, group huddles, a survey … start by getting a sense of what folks are looking for. Are they happy where they are? What kind of opportunities are they looking for?” she said. “Every time, start with them. Ask staff first.”