Lodi News-Sentinel

To attract in-home caregivers, California offers paid training — and self-care

- Laurie Udesky

One November afternoon, Chris Espedal asked a group of caregivers — all of whom work with people who have cognitive impairment­s, behavioral health issues, or complex physical needs — to describe what happens when their work becomes too much to bear. The participan­ts, 13 caregivers from all over California, who had gathered in a Zoom room, said they experience­d nausea, anxiety, shortness of breath, elevated heart rates, and other telltale signs of stress.

“I want to scream!” one called out. “I feel exhausted,” said another.

Espedal, who has been training caregivers for 18 years, guided the class through a self-soothing exercise: “Breathe in for four counts, hold the breath for four, exhale for four.” She taught them to carve out time for themselves, such as setting the goal of reading a book from beginning to end, and reminded everyone to eat, sleep, and exercise. “Do not be afraid to ask for help,” Espedal said. She added that one of the best ways they can care for their clients — often a loved one — was to care for themselves.

The class is a little touchy-feely. But it’s one of many offerings from the California Department of Social Services that the agency says is necessary for attracting and retaining caregivers in a statefunde­d assistance program that helps 650,000 low-income people who are older or disabled age in place, usually at home. As part of the $295 million initiative, officials said, thousands of classes, both online and in-person, will begin rolling out in January, focused on dozens of topics, including dementia care, first-aid training, medication management, fall prevention, and self-care. Caregivers will be paid for the time they spend developing skills.

Whether it will help the program’s labor shortage remains to be seen. According to a 2021 state audit of the In-Home Supportive Services program, 32 out of 51 counties that responded to a survey reported a shortage of caregivers. Separately, auditors found that clients waited an average of 72 days to be approved for the program, although the department said most applicatio­n delays were due to missing informatio­n from the applicants.

The in-home assistance program, which has been around for nearly 50 years, is plagued by high turnover. About 1 in 3 caregivers leave the program each year, according to University of California-Davis researcher Heather Young, who worked on a 2019 government report on California’s health care workforce needs.

It doesn’t help that the pay is low. According to the state, the average hourly rate for caregivers in the in-home assistance program is $15.83. Rates vary because the program is administer­ed locally, with each county setting its own.

“Training is very helpful,” said Doug Moore, executive director of the United Domestic Workers of America AFSCME Local 3930, which represents roughly 150,000 caregivers in California. “But when the wages are low — and you can make more at Target or McDonald’s and get a signing bonus — then you’re going to go and do that work versus harder work, which is taking care of someone with a disability or a person that’s aging.”

The training initiative came out of Gov. Gavin Newsom’s Master Plan for Aging to improve the quality of caregiving careers. Theresa Mier, a spokespers­on for the Department of Social Services, said the state hopes financial incentives will help attract new workers and keep them caring for people with specialize­d needs longer. In addition to their hourly pay for taking classes, in-home caregivers will receive incentive payments that start at $500 for 15 hours of training. They can earn up to $3,500 if they go on to work at least 40 hours a month with a qualified client for at least six months. Previously, counties offered some training but did not pay workers for their time.

The state issued grants, including $16 million to Homebridge, a San Francisco-based caregiving organizati­on, to coordinate training. Classes will be offered in Spanish, Cantonese, Mandarin, and Armenian, in addition to English, to reach more workers. And state officials are planning a social media campaign to recruit new caregivers.

But the incentives are committed only through the end of 2023.

Greg Thompson, executive director of the Personal Assistance Services Council, the public authority that manages Los Angeles County’s in-home program, would like to see paid training become permanent. “There needs to be, in my opinion, some kind of accountabi­lity, structure, supervisio­n, and ongoing training,” he said.

Many caregivers who attended early courses care for family members with a mix of physical and behavioral needs. In fact, 3 out of 4 caregivers in the in-home assistance program are relatives of clients. But the state needs to prepare for a workforce shift, one that requires people to look outside their families. The number of California seniors is expected to be nearly 8.5 million by 2030, an increase of more than 40% from 2019. Many of them will be single.

The state will need more caregivers like Luz Maria Muñoz, who has worked in the in-home assistance program for six years. The Bakersfiel­d resident has navigated challengin­g situations on the job. One older client was on 30 medication­s. Another had bedsores, which can be life-threatenin­g if not properly treated. Muñoz peppered the client’s nurse with questions about dressing the wounds and felt responsibl­e for the client’s well-being.

“Those wounds needed to be cleaned daily,” she said.

Muñoz said she’s interested in the training. The department said it sent notices about classes to all participat­ing caregivers and will follow up with updates.

 ?? DREAMSTIME/TNS ?? California Department of Social Services will start thousands of paid classes, both online and in-person, in January, focused on dozens of topics, including dementia care, first-aid training, medication management, fall prevention, and self-care.
DREAMSTIME/TNS California Department of Social Services will start thousands of paid classes, both online and in-person, in January, focused on dozens of topics, including dementia care, first-aid training, medication management, fall prevention, and self-care.

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