What to Look for in Staff Training Part 4: Consumer Questions


  1. How does the staff interact with the residents?   Is there an overall climate of respect?
  2. Does the staff look content?   Are they rushed or irritated?
  3. Do they address the residents by their names?   Calling an elder “honey” or “sweetie” is not acceptable, unless that is the resident’s preferred nickname.
  4. How much training has the staff received?   Ask to see the training logs.  Do they have some measure of competency showing that not only did staff attend a training session, they actually understood the material?   Pressure ulcer prevention, elder abuse education and dementia care are essentials that all staff should master.
  5. How is training delivered?  Is it lecture or computer-based “PowerPoint”?  Is there a hands-on or a multimedia computer program that brings life to the training sessions?
  6. What is the staff turnover rate in the facility?   Is it more than 30% per year?  More than 50%?  How does this compare to other facilities in the region?
  7. Is there potential for good employees to move up the ladder?  How does good work get rewarded?

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What to Look For in Staff Training Part 3: The Training Differential

trainingWhy is poor training such an important issue?   Is there any evidence that effective training would improve quality of care for the residents?  A recent study reported a 70% reduction in pressure ulcers when staff were properly trained and given incentives to perform better. (1,2)  Other studies have shown a direct effect on resident care or safety as a result of education on reduction of restraints without increasing injuries. (3,4) In addition, researchers also found reduced resident aggression through staff behavioral training as well as the ability to use behavioral interventions with aggressive residents. (5)

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What to Look For in Staff Training Part 2: The Plight of CNAs

The statistics do not bode well for those working in nursing homes.   The direct care workers   are usually the lowest paid workers in the healthcare industry.(1)  The Bureau of Labor Statistics estimates CNA salaries ranging from $7.78 to $12.80 per hour.(2)   Unmarried minority women with at least one dependent child comprise a healthy cross-section of the profession.(3)  CNAs thus have built-in family stressors such as financial worries, finding daycare and caring for sick children. Multiply this with on-the-job stress due to long hours, frequent overtime, lack of respect, little time off and generally poor training; it is easy to see why staff turnover is so high.  The opportunities for career growth of direct care staff are limited when looking at their average education. CNAs usually have a high school diploma but their education most likely stopped there.(4)

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What to Look for in Staff Training Part 1: Importance of Preparation

It makes sense to check out the décor before sending a loved one to a long term care (LTC) facility.   Maybe even try the food in the cafeteria, check the comfort level provided in the beds, observe the cleanliness of the bathrooms, and determine whether the lighting is appropriate. Yet the most important aspect of LTC does not come from the outward appearances but from the caregivers.

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Introducing Contributing Writer Debra Fox

One of the more frequently asked questions I receive from families involves training of assisted living community staff.  What are the training requirements?  How to do communities train their staff?  What tools are used?  What expectations should families have regarding training?

I’d like to introduce an addition to our group of contributing writers  — a true expert in the field of elder care and assisted living training.

Welcome, Debra Fox!

Debra is the founder and CEO of Fox Learning Systems, a company dedicated to changing the culture of elder care through e-learning that uses engaging, documentary-style video to connect with both caregivers and consumers. Debra founded the company in 1997 after personally observing the overwhelming challenges providers face in training and retaining staff to care for vulnerable older adults.

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