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Resilient.
Compassionate.
Caregiving.
The career of a direct care worker (DCW) helps people in need. Direct care workers (DCWs) with years of experience assisting people hands-on become skilled caregivers.
Being a caregiver becomes part of your identity.
A caregiver seldom enters the direct care profession with expectations for high salaries. It’s true, there are easier jobs in service work which earn more money than direct care.
Caregivers who stick with the job demonstrate stronger compassion and healthier resilience than most people.
My opinion is, direct care workers are the frontline workers of caregiving.
Today, I’m discussing direct care workers (DCWs) with special regard for caregivers to the elderly and disabled who receive compensation for their work.
Every year in Michigan, 18,000 new direct care worker jobs open up for job titles like Home Health Aide (HHA) and Personal Care Aide (PCA), before job titles with higher certification required, such as Certified Nursing Assistant (CNA) or Registered Nurse (RN).
Source: Center for Healthcare Strategies
Direct care workers provide “personal care” mostly categorized as non-medical services, however, higher certification enables a direct care worker the ability to also perform medical services and earn higher wages.
These three categories of direct care workers commonly serve seniors and adults with disabilities:
PCAs (Personal Care Aides, PCA) offer non-medical “personal care” assistance activities of daily living (ADLs), such as bathing, toileting, and dressing. PCAs may also do light housework, laundry, meal preparation, and similar tasks.
HHAs (Home Health Aides, HHA), in addition to “personal care” like the PCAs before them, HHAs provide a mix of “the personal” and basic medical care, such as changing bandages or administering medications.
CNAs (Certified Nursing Assistants, CNA), in addition to the “personal care” like the PCAs and HHAs before them, CNAs offer more advanced medical services under the guidance of licensed nurses such as checking vital signs.
Source: National Academy for State Health Policy
Direct care workers want wages, training, and access to career advancement. On the job, they want manageable workloads and good employee benefits like health insurance and paid sick leave.
For healthcare careers with lower salaries than most, a positive and respectful work environment goes a long way to increase direct care worker retention rates.
Some direct care workers change jobs frequently.
The number of jobs divided by the number of separations equals the direct care worker turnover rate.
Then take a peek at the positive side to see the direct care worker retention rate.
If some direct care workers are leaving their jobs, then some other direct care workers are keeping their current jobs.
It’s a good idea to understand the reasons direct care workers quit working at your organization, and then come up with solutions to reduce turnover and increase retention.
🩶 Complaint: “My wages aren’t high enough with all this inflation.”
💛 Solution: When a direct care worker thinks they’re compensation is too low, then maybe they’d like a raise in wages. A direct care agency which pays high wages for direct care work generally attracts a highly qualified direct care workforce. Prospects for wage increases of PCAs and HHAs are especially grim.
Source: Michigan Health Council
🩶 Complaint: “I hear CNAs get $15 per hour.”
💛 Solution: When PCAs and HHAs are willing to upskill and earn extra wages with CNA certification, they prefer an employer who coordinates CNA training or other career advancement opportunities to their best performing PCAs and HHAs.
🩶 Complaint: “I’m too busy at home to work direct care full time.”
💛 Solution: Michigan DCW wages on the lower-end equals under $15 per hour, meanwhile DCWs have families of their own to take care of and take on more of the family responsibilities themselves. When direct care workers are too busy to work a full 40 hours per week, they lose access to full-time employment benefits like health insurance, paid vacation, and sick leave.
Source: U.S. Department of Health and Human Services
🩶 Complaint: “I’m exhausted after running between clients all day.”
💛 Solution: Take a look at your organization’s ratio of caregivers to clients. The more clients require direct care, the more direct care workers are needed to support rising demand from direct care service recipients.
🩶 Complaint: “I enjoy the direct care part of my job description.”
💛 Solution: If qualified direct care workers spend time from time to time documenting work done - asking clients supervisors for signatures - then that’s less time to support clients. Could a shift in administration’s role to reduce documentation and other paperwork boost direct care workers’ engagement?
🩶 Complaint: “I drove thirty minutes to know they canceled.”
💛 Solution: Especially for home care agencies dispatching DCWs into the homes of their clients, the logistics of scheduling caregivers who drive themselves gets complicated when you’re not supposed to talk or text while driving. Could clients who prefer a particular direct care worker be more regularly scheduled with their favorite?
🩶 Complaint: “My paycheck this week was less than expected.”
💛 Solution: When different clients pay more or less per hour of direct care services, based on their individual needs and participating qualification in programs like Medicare, then it’s difficult to account for the hourly rate of a caregiver with a variety of clients. Could caregivers see a new client’s hourly rate before they accept the hours?
