I-1163 Restores Basic Minimum Training Standards for Workers
Hairdressers must receive 1,000 hours of training. Nail technicians must get 600 hours of training. Meanwhile, home care workers, who do a difficult and important job, visiting seriously ill seniors and people with disabilities to help them dress, bathe, clean, get out of bed, and cook so they can remain in their own homes, will not be getting the training and the state certification that they need to provide quality care for their vulnerable clients. Nursing home caregivers must get 85 hours of training — home care workers, who provide the same kind of care, but in a more isolated setting, should be getting similar levels of training as well.
In the recent report “Retooling for an Aging America,” the Institute of Medicine wrote: “Direct-care workers are the primary providers of paid hands-on care and emotional support for older adults, yet the requirements for their training and testing are minimal. Furthermore, even though patient care has become much more complex… very little is done to ensure the competence of personal care aides. The committee concluded that current federal training minimums are inadequate to prepare direct care workers and that the content of the training lacks sufficient geriatric-specific content.
Training deficiencies have manifested themselves in several ways:
- • Failing to give proper medication to residents
- • Failing to respond to medical emergencies in a timely manner
- • Not properly identifying and treating bedsores
- • Residents leaving the home and wandering unattended
- • Allowing caregivers with disqualifying criminal backgrounds access to vulnerable residents
A Seattle Times investigation detailed several cases, including one where a home care worker pleaded for help:
Jay Caulfield’s complaint is about neglect rather than abuse. In September 1995, the 51-year-old, long-haul truck driver was bedridden with multiple sclerosis. He could no longer move his arms and legs enough to get out of bed, clean or feed himself, and needed help shifting positions. Caulfield was determined to stay out of a nursing home, so DSHS arranged for a live-in caretaker, through a cooperative program with Kitsap County’s Agency on Aging. James Sellars III, a nurse’s aide, moved in to care for Caulfield. Although he had had several years’ experience as an aide, it quickly became clear to both Sellars and Caulfield that he didn’t have the specialized training needed for this situation. Sellars said he alerted DSHS and county caseworkers that Caulfield wasn’t eating or drinking and had become delirious after taking his mix of medications. He reported a worsening bed sore that couldn’t be controlled. He and Caulfield say they repeatedly appealed to both agencies for help.
In late October, DSHS caseworker Debbie Mark-Corpolongo visited Caulfield’s Bremerton home to check on him. She found Caulfield’s condition deteriorating and Sellars in serious distress. The caretaker told her he was working seven days a week, 24 hours a day, and needed the state to send someone to spell him. Immediately after the house call, she arranged for the county to assume day-to-day supervision of Caulfield’s care. The county’s intake notes described Caulfield’s as a “caregiving situation that needs immediate attention.” According to Caulfield’s lawsuit, nothing happened. “He was losing weight. He was hallucinating,” Sellars recalls now. “It was more than I could handle. But nobody took my pleas. Nobody took his. They listened to us and then left us alone.”
I-1163 requires the restoration of the most basic training, a baseline to ensure that home care workers are qualified and trustworthy when they are charged with caring for our most vulnerable.
