Enabling and empowering certified nursing assistants for quality dementia care.
Currently, 1.2 million full-time equivalent employees (FTEs) care for more than 1.5 million residents in nursing homes where 75% of residents have dementia. By the year 2010, the number of residents in these institutions may double. Registered nurses (RNs) make up less than 7% of a home's total FTEs. In contrast, certified nursing assistants (CNAs) account for more than 40% of total FTEs. Thus, CNAs serve as the primary caregivers in nursing homes. Typically, CNAs have a high school education or less, and receive little more than minimum wage. Their extensive contact with residents has a tremendous impact on quality of life, but significant barriers limit their caregiving effectiveness. These barriers include poor pay, minimal long-term benefits, and insufficient training, recognition and support for their physically and emotionally labor-intensive care. This paper addresses the issues of training CNAs for dementia care by suggesting an organizational framework within which to view dementia training; providing an overview of barriers to empowering CNAs to provide quality care to dementia residents; reviewing research that has addressed a specific barrier; making recommendations for future research; and suggesting research approaches to address these recommendations.
Beck
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C
College of Nursing, University of Arkansas for Medical Sciences, Little Rock 72205, USA. beckcornelia@exchange.uams
Ortigara
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A
Mercer
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S
Shue
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V
D000368:Aged; D017028:Caregivers; D003695:Delivery of Health Care; D003704:Dementia / Q000451:nursing*; D006801:Humans; D009728:Nursing Assistants; D009735:Nursing Homes; D013192:Staff Development; D000078329:Workforce