Personal care aides need improved training: reports

Improved training for personal care aides (PCAs) is crucial given the anticipated increased demand for the services they provide, according to the authors of two complementary research reports issued by the University of California, San Francisco, Health Workforce Research Center on Long-Term Care (HWRC).

Most states have extremely weak or non-existent standards for training PCAs, especially compared with standards for certified home health aides and nursing assistants, according to Abby Marquand, MPH, director of policy research at PHI (formerly the Paraprofessional Healthcare Institute), and Susan A. Chapman, PhD, RN, FAAN, co-director of the HWRC. Forty-five percent of states have one or more programs with no PCA training requirements, and 22 percent have no PCA training requirements, according to one of their reports, titled “The National Landscape of Personal Care Aide Training Standards.” Four states have implemented rigorous PCA training standards that are uniform across all Medicaid-funded programs.

The number of people in the United States needing personal assistance services is expected to grow from 13 million in 2000 to 27 million by 2050, according to the report, which details that PCAs provide paramedical services such as oral medication administration and dressing changes; assistance with activities of daily living, including bathing, dressing, preparing meals and shopping; and support for community participation.

“With projected demand for PCAs skyrocketing and states reporting difficulty attracting and retaining enough high-quality workers, we are fast approaching a crisis,” Marquand says. “We believe that improving training standards is a critical first step in meeting the coming demand.”

‘Leader states’

Seven “leader states”—Alaska, Arizona, Arkansas, Idaho, Minnesota, Virginia and Washington—have achieved rigor and consistency in their PCA training programs, say Marquand and Chapman in companion research brief, “Leader States in Personal Care Aide Training Standards.”

“There is no ‘one size fits all’ approach to improving standards,” Chapman says. “All of these states provide different examples for how to begin to go about this process.”

Marquand adds: “The diverse routes taken by the seven leader states may prove useful starting points for those states that are developing or reforming their standards.”

The reports, funded by the U.S. National Center for Health Workforce Analysis, are the inaugural reports issued by the HWRC, which was created to examine the supply, demand, distribution and capacity of the healthcare workforce to meet the needs of older adults and those with disabilities.

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