All Stories

CCA Instructor Andrew So: Changing Lives One Student at a Time

Andrew So is a dedicated educator and mentor whose diverse experiences have shaped his unique approach to teaching. As a bilingual (Cantonese) instructor at the Center for Caregiver Advancement (CCA), he brings a natural flair for teaching to his in-home caregiver training courses. Andrew feels that he is enriching the lives of his students through education and personal connection.

Transitioning from Entrepreneur and Music Teacher to Caregiving Teacher

Born and raised in Hong Kong, Andrew moved to Los Angeles for his studies. He spent eight years there before returning to Hong Kong. He later married and worked in his home city. He even started his own business — a café offering specialty coffees. However, he and his wife decided to raise their family in the United States, settling there after briefly considering Canada.

With a degree in music composition, Andrew has a strong background in the arts. He has taught music extensively. He transitioned into providing training for in-home caregivers at CCA through a mixture of luck and personal experience. A friend told him to consider applying to CCA because of his role as an in-home caregiver for his grandfather, who had dementia. This firsthand exposure to caregiving fueled Andrew’s interest in learning more about the field. He now finds great fulfillment in equipping students with the knowledge and skills needed to care for others effectively.

“I see that I am having an impact on my students and on the care consumers they serve.”

Andrew has discovered that teaching, regardless of the subject, is his true calling. Whether he is mentoring college students in music, training people in coffee brewing, or educating caregivers, Andrew finds fulfillment in sharing his knowledge. Today, he teaches in-home caregiving courses to Cantonese-speaking students at CCA. He also conducts coffee brewing workshops for at-risk youth, providing them with practical skills and a constructive outlet.

Teaching Caregiver Students of All Levels Has Challenges and Rewards

For Andrew, the most rewarding aspect of teaching caregiving is witnessing the impact it has on his students. He often receives messages of gratitude from graduates who have successfully applied his teachings in their caregiving roles. The heartfelt messages he receives, especially during Chinese New Year, affirm the value of his work. He takes pride in knowing that he is helping caregivers provide compassionate and competent care, particularly for individuals with dementia.

“In-home caregivers are not very highly paid workers, but they are people with good hearts. I am very touched by my students, and I’m grateful for the connections I form with them.”

Teaching Cantonese-speaking students at CCA comes with its challenges, due to the wide disparity in educational backgrounds among his students. Some students have advanced degrees, while others struggle with basic literacy and technical skills. Andrew addresses this challenge by taking a step-by-step approach in his classes. This ensures that all students, regardless of their starting point, become proficient in digital learning technology by the end of a 6-8-week course.

Andrew has developed a deep appreciation for the emotional connections he forms with his students. Although he considers himself an unsentimental person, he finds the compassion and care that his students bring to their work very moving. Reflecting on his own caregiving journey, he wishes he had received the type of training that CCA provides, which would have better equipped him to care for his grandfather.

CCA Training Offers Value, Resources, and a Community of Supportive Caregivers

In addition to CCA’s caregiving courses for the elderly, Andrew highlights CCA’s unique offering of courses on autism and spectrum disorder care. He sees these as invaluable resources for parents and caregivers alike. Beyond providing essential caregiving knowledge, CCA classes also serve as a support network, where caregivers can share their experiences and challenges in a safe environment. The sense of community fostered in these classes helps caregivers navigate the emotional and physical demands of their work.

With a deep commitment to education and caregiving, Andrew So continues to inspire and empower his students at CCA. His journey — from being a music educator and café owner to caregiver instructor — reflects his adaptability and passion for teaching. Whether he is guiding students in caregiving, or mentoring youth in coffee brewing, Andrew’s impact extends far beyond the classroom, changing lives one lesson at a time.

Andrew So was recently recognized by CCA leadership for his teaching contributions to the CCA training programs, with a promotion to Lead Instructor.

Aida’s Leap: How an Apprenticeship Transformed a Single Mom’s Life

A Dream Rooted in Healthcare

Aida Rustemova Bonfiglio, a single mother and immigrant from Kazakhstan, had always dreamed of working in the medical field. She never imagined that a paid apprenticeship would make that dream a reality. Inspired by her family’s deep roots in healthcare—her grandmother was a nurse who became a surgeon, and her mother was a doctor—Aida grew up with a strong desire to care for others. But heeding her mother’s advice not to follow in their footsteps because of the demanding work and long hours in the medical field, she earned a bachelor’s degree in international relations and a master’s in international law in Kazakhstan. However, as a newcomer to the United States, Aida faced a range of challenges: language barriers, financial instability, and the daunting task of supporting her young daughter as a single parent.

Despite her background as an attorney with a bachelor’s degree in international relations and a master’s in international law, Aida’s credentials were not recognized in the U.S. Instead of pursuing a career in law, she found herself drawn to the healthcare field—a dream that, for a while, seemed out of reach.

The Game-Changer: CCA’s CNA Registered Apprenticeship Program

Aida’s life changed when she heard about a Certified Nursing Assistant (CNA) registered apprenticeship program offered by the Center for Caregiver Advancement. The program promised more than just training—it provided a holistic support system, including paid tuition, financial stipends, and mentorship, giving Aida the opportunity to continue her studies without incurring debt. “It felt like someone always had my back,” Aida shared, reflecting on her experience.

“The financial support allowed me to focus on my studies and care for my daughter at the same time. I didn’t have to choose between my family and my education.”

Support Every Step of the Way

The apprenticeship program was a game-changer for Aida. As a single mother who doesn’t receive child support, she long struggled to make ends meet. The apprenticeship paid for her time in class, making it possible for her to support her family while gaining the education and experience she needed to enter an allied health profession. The program also covered tuition and stipends for food and gas, relieving the stress of living paycheck to paycheck.

What Aida appreciated most about the program, however, was the mentorship. “It wasn’t just about the training. It was about the people who supported me every step of the way,” she explained. From her initial interview with her program coordinator, Martha, to ongoing guidance from a dedicated mentor once she started working as a CNA, Aida felt encouraged and empowered throughout her journey

A Career Transformed: Thriving as a CNA

Today, Aida is thriving in her career as a CNA, with a renewed sense of purpose and a growing passion for caregiving. 

“This program changed my life. I’ve always wanted to help others, and now I’m living my dream.”

But Aida’s ambitions don’t end there. She dreams of becoming a Licensed Vocational Nurse, a goal she is actively working toward to make an even greater impact on the lives of her patients.

Advice for Aspiring Apprentices: Go for It

Aida’s story is a powerful example of resilience and determination. It highlights how apprenticeship programs not only provide individuals with the skills and training needed for a successful career but also offer essential support during times of personal struggle. For Aida, the apprenticeship program was more than just a job opportunity—it was a life-changing experience that gave her the tools to build a better future for herself and her daughter. When asked what advice she would give someone considering the apprenticeship program, Aida’s answer is simple yet profound.

“Go for it. CCA’s program offers you everything you need to succeed—training, financial support, and the chance to build a career without experience. It changed my life, and it can change yours too.”

As we celebrate National Apprenticeship Week this November, Aida’s journey is a testament to the power of opportunity and the importance of support in overcoming obstacles. CCA’s CNA Registered Apprenticeship Program provided her with both and helped Aida realize a lifelong dream.

Cassandra Parker: Learning to Balance The Roles of Caregiver and Daughter

For Cassandra Parker, becoming a full-time caregiver wasn’t something she expected, but when her family faced crisis after crisis, it became a role she embraced with grace and determination. Her story is one of resilience, love, and learning—both as caregiver and daughter.

In 2021, Cassandra’s life took a turn when her father was diagnosed with stage four kidney cancer during the COVID-19 pandemic, making it difficult for him to get the surgery he needed. This came just after she had lost her mother to stage four pancreatic cancer. With her sister preoccupied with a newborn, Cassandra took on the responsibility of caring for her father. “The baton was passed to me,” she explains.

Despite her limited knowledge of caregiving systems like IHSS (In-Home Supportive Services) at the time, Cassandra quickly stepped into her role, beginning her journey as a full-time caregiver for her father. 

Navigating Dual Roles: Caregiver and Daughter

One of the hardest parts of Cassandra’s journey has been finding a balance between being a caregiver and a daughter. “Asking for help has been crucial,” she shares. “When you’re a caregiver, your focus is on making sure your consumer is properly taken care of, but as a daughter, especially after losing my mother, it’s tough. You need that emotional support.”

Cassandra found solace and structure in CCA’s courses, which provided her with tools to manage the dual roles.

“Participating in CCA’s course gave me permission to be a daughter again.”

The courses not only allowed her to take a step back from the constant demands of caregiving but also gave her the knowledge and skills to better support her father.

For Cassandra, caregiving is more than just tasks—it’s about preserving her father’s independence and humanity. “You want them to feel like they can still take care of themselves. We don’t want them to feel like they’re less than,” she explains.

The Power of a Community and Lifelong Learning

According to Cassandra, one of the most valuable aspects of CCA’s courses is the peace of mind they provide. She learned critical skills, like managing medications and navigating healthcare, but also discovered something even more powerful: the importance of self-care. “You can’t take care of anyone else unless you take care of yourself,” she stresses.

Cassandra first learned about the courses through her involvement with SEIU Local 2015. “I came across Rodney, one of the field assistants. He told me about the free course—worth $9,000—and I thought, ‘I have to take this.’ It wasn’t just about the stipend; it was about gaining the knowledge I needed to take care of my father.” For Cassandra, the course was transformative. “I got so much more than I expected. It wasn’t about the money; it was about making sure I was doing everything I could for my father.”

A Message for New Caregivers

To those considering caregiving, Cassandra’s advice is clear: “You can do it. It’s not going to be easy, but you’re not perfect, and that’s okay. It’s important to take care of yourself mentally and emotionally before you can take care of your consumer.”

Cassandra’s journey has taught her the importance of community. Through the courses, she found a support system that helped her care for her father and herself. “You’re not on your own,” she reminds others. “You’ve got this.” As she continues to care for her father, Cassandra is thankful for the resources and community CCA has provided. 

“Being a caregiver is the most rewarding thing. CCA really cares about their caregivers, and I’ve learned that you have a community—you’re not in this alone.”

Research: CCA Training May Reduce ER Visits, Health Care Costs

A research article appearing in the March/April 2024 edition of the peer-reviewed journal Professional Case Management suggests that high-quality caregiver training provided by the Center for Caregiver Advancement (CCA) contributes to reduced emergency room visits for the consumers in their care. The study also suggests that receiving care from a CCA-trained caregiver appears to reduce healthcare costs for these consumers.

The study led by co-authors Susan A. Chapman, Melinda T. Neri, and Robert J. Newcomer, followed caregivers who completed 16 weeks of in-person In-Home Supportive Services (IHSS) training through CCA. The researchers compared the caregivers who received CCA training to a group of caregivers who did not take the IHSS caregiver essentials skill-building course. The research team tracked each group of caregivers for three years.

The caregiver skill-building program was developed by CCA with support from a Center for Medicare and Medicaid Services Innovation Grant, established by the Affordable Care Act.

Summary of the Impact Study

The purpose of this study was to evaluate whether training a California In-Home Supportive Services (IHSS) home care worker impacted the health care utilization of the IHSS consumers. Home-based personal care services are provided through California’s IHSS program. The research team used a quasi-experimental design involving a group of IHSS consumers whose IHSS (home care) workers completed 16 weeks of in-person home care worker training from the Center for Caregiver Advancement (CCA).

Researchers also used a comparison group of IHSS consumers whose IHSS workers had not received this training. Both groups were members of the same health plan and were enrolled in the IHSS program at the time of enrollment into the study. The training effect was evaluated over three years, comparing emergency room (ER) use and inpatient (IP) hospital stays: 12 months prior to IHSS worker training, 12 months after training, and 13–24 months after training. Researchers collected demographic information on the workers and post-training perceptions.

CCA Training for Caregivers Delivers Positive Results for Consumers and Healthcare Systems

  • Reduction in Hospitalizations: 30% reduction in hospital readmissions for consumers who received care from trained home care workers compared to those who did not receive training.
  • Emergency Room Visits: There was a reported 25% decrease in emergency room visits among consumers cared for by trained caregivers.
  • Healthcare Cost Savings: These reductions in utilization led to an average savings of $1,500 per consumer annually.

Impact of CCA Training: Skilled Caregivers Are Key

Training through CCA was associated with several other factors that impact quality of life. For consumers who receive care from trained caregivers, researchers saw:

  • 20% fewer complications for consumers with chronic illness
  • 35% increase in adherence to care plans
  • 40% increase in consumer satisfaction with their care

CCA was founded in 2000. Over the years, CCA has established itself as California’s most experienced provider of free, accessible training that focuses on a supportive, experience-based learning environment. CCA believes in building a workforce of highly trained caregivers that many Californians can’t live without.

It is estimated that 20% of Californians (1 in 5) will be 65 or older by 2030. California is in a care crisis, with high demand for trained caregivers — a demand that will increase over time as the population in California ages. Research studies that investigate the impact of CCA training have helped to advance policy initiatives that are designed to develop more career pathway opportunities and build professionalization for long-term care workers.

The findings from this research study were published in Professional Case Management. For details, please read the original article here.

Source Citation: Professional Case Management, Volume 29(2):81-87, March/April 2024. DOI: 10.1097/NCM.0000000000000711
For a summary of the study findings at-a-glance, view CCA’s infographic here.

Report: The Impact of Offering IHSS Training in Multiple Languages

As California’s largest provider of free and accessible caregiver training, the Center for Caregiver Advancement (CCA) makes sure our programs are understandable to as many as possible. By offering our courses in many languages, we strive to create spaces where all caregivers can learn, regardless of background.

Offering Caregiver Training in Multiple Languages

Accordingly, CCA offers In-Home Supportive Services (IHSS) training in multiple languages. For the state’s IHSS Career Pathways Program, CCA teaches the courses in seven languages in addition to English: Spanish, Korean, Mandarin, Armenian, Cantonese, Russian, and Vietnamese.

The majority of caregivers who completed the CPP took the training in a language other than English.   

Quality of care should not be limited by language barriers for immigrant communities. Offering IHSS training in multiple languages means that more of California’s immigrant populations and immigrant families have access to caregiver education. 

An Immigrant Caregiver Appreciates Developing Skills in Mandarin, Her Native Language

Fei Tian is a part-time Chinese language teacher and part-time IHSS provider for her parents. Her weeks are spent divided between time with her father and mother who live in different towns and each have their own unique needs.

Finding Caregiver Skills Training Offered in Her Language Was a Game-Changer

Fei is a Career Pathways Program student who takes courses in her first language, Mandarin. “Having the training in my first language is very important,” Fei said, “It is so beneficial because [in Mandarin] I understand everything and I’m more ready and able to learn.” 

Living in the United States as immigrants from China, Fei and her parents often face language barriers. For example, Fei has had to accompany her father to his appointments. Sometimes he has needed an interpreter to understand his condition.

Having the choice to take the training in Mandarin made a huge difference for Fei and her parents. After taking the CCA class, she now understands their needs better, and can give them a higher quality of care. 

“I came from China, but there are people from Russia, Japan, and Korea. They all want to learn in their own language, where they can readily benefit from [the training]. We are very happy that we have this kind of opportunity,” Fei said.

Fei Tian

Bill Zhang, who also took CCA’s multi-week IHSS training program in Mandarin, shares Fei’s opinion. “I think the fact that the training is offered [in other languages] is extremely important,” he said. Bill and his classmates all agreed that they were able to learn so much new material thanks to it being taught in Mandarin, the language in which they are the most comfortable.

Spanish is the second most widely spoken language in California and is the most popular language among all non-English courses provided by CCA. Many of our state’s caregivers can take advantage of free IHSS training in Spanish, just like Elka Ventura Escobar.

She took the multi-week IHSS Essentials course. Elka is her mother’s caregiver and said the lessons helped improve their relationship. 

Elka’s mother was a lawyer in their home country and the decline in her health and cognitive abilities has been challenging for Elka to navigate. The course offered in Spanish meant that her mother was able to follow along with her. They both learned valuable lessons that improved the quality of Elka’s care and their overall relationship. “Both of us listened to the classes together. So sometimes she’d say, ‘Did you hear that? Did you see? You do things that are not right,’” Elka said.  This created an environment of trust and mutual respect.  

Material that might otherwise be lost in translation is now captured in the right context, preserving the quality of instruction and care. “[My mother] and I both recognize our [prior] mistakes. I heard a lot of what we needed to do and now we don’t argue as much,” Elka said. 

Language Barriers Should Not Compromise Quality of Care

Maricela Serrano is a Spanish language CPP student whose typical day in her role as her mother’s IHSS caregiver never truly ends. Maricela draws upon what she learned in her courses throughout her daily caregiving tasks. When describing the positive impact of these lessons, she said, “It’s like a blindfold has been lifted from my eyes.” 

Maricela and her mother

Prior to her participation in the Career Pathways Program, Maricela felt very stressed and did not understand her mother’s condition and why she reacted in certain ways. She learned many things in the CPP, such as how to read medicine labels, and how to tell if emergency services are needed or not.

Maricela said her instructors were excellent and added, “I hope that [the program] receives more funding because this is a big blessing for every one of us who will take care of our family members and other people.” 

Maricela does not speak English. Without the option to take courses in Spanish, she could not benefit from the free training. Maricela compares her situation before this training as being a soldier without weapons. After training, she now feels equipped with the proper knowledge necessary to give her mother the highest quality of care she can. 

Many IHSS providers also benefit from CCA’s Armenian and Russian language CPP courses such as Ruzan Samvelyan, who moved from Europe to the United States seven years ago. With a lifelong dedication to education, Ruzan previously worked as a supervisor for 160 schools in Yerevan, Armenia.

After moving to California, her educational journey traveled a different path. She became a caregiver when her husband was diagnosed with cancer.

Ruzan naturally wanted to learn as much as she could to provide the best care possible in her new caregiving role. Fluent in Armenian and Russian, she took courses in both languages. Speaking of fellow caregivers in her Armenian community in California, Ruzan says, “A lot of people who moved from Armenia to the United States don’t know English. It’s really hard to learn English, but they need to have this knowledge because it helps. It helps a lot.”

Personal Fulfillment and Job Satisfaction

When caregivers are equipped with training in their native languages, they can navigate caregiving scenarios with greater ease.  This fosters a sense of professional fulfillment and job satisfaction and helps them better meet the needs of their consumers. 

“For me, there was a lot of useful and necessary information, not only for my work but also for me, personally,” said caregiver Anna Nadejda. Anna took CCA’s CPP courses on traumatic brain injuries, cardiovascular disease, and autism spectrum disorder in Russian. “The most important thing is that it is easier to understand this amazing material provided by [CCA] in my native language,” she said.

Related Reading:
CCA Training May Reduce ER Visits, Healthcare Costs

IHSS Caregivers Are a Lifeline for Californians

Reflective Listening

If your client or consumer is experiencing trauma, it is important to support them by practicing reflective listening (also known as active listening). Reflective listening focuses on understanding the speaker, rather than giving your reaction or opinion on what was said. This communication strategy involves two key steps:

  1. Seeking to understand a speaker’s idea
  2. Offering the idea back to the speaker to confirm the idea has been understood correctly by you

This helps caregivers provide support to the consumers in their care when they are experiencing trauma. Active listening can be particularly helpful in emergencies. It focuses on the meaning and emotions behind the speaker’s words, to ensure the speaker feels listened to and understood. This listening technique has numerous observable benefits such as the following: 

  • It prevents miscommunication and wrong assumptions
  • It makes people feel they are being heard and understood
  • It encourages people to hear and reflect on their own statements
  • It builds and deepens the conversation

How Can You Practice Reflective Listening?

A key component of this communication technique is where the listener restates and reflects back the speaker’s message. By restating the speaker’s message, the listener confirms understanding and helps to ensure that the speaker feels heard.

It’s a more focused form of active listening. It goes beyond simply acknowledging the speaker. It is a way to actively validate their message.

To accurately practice reflective listening, it is also imperative to avoid the following:

  • Asking a series of questions to get information from someone
  • Giving unsolicited advice
  • Minimizing the person’s concern

Report: Advancing Opportunities for Caregivers Empowers Women 

In California, around one in three women are currently providing long-term care for a family member or friend, according to the 2024 annual Report on the Status of Women and Girls in California. Caregiving, a field predominantly consisting of female workers, is a vital role many Americans depend on. Yet, it often remains an “invisible workforce;” despite the value it brings to the economy and healthcare system, the workforce is not given the compensation or recognition that it deserves. 

Societal Structures and Institutions Are Built Without Women in Mind

“The idea of the selfless woman who puts everyone else first is ingrained in our culture and even our communities. It is even reflected in our institutions and structures that were built without women in mind, increasing barriers for women and limiting our economic opportunity,” said Holly Martinez, Executive Director of the California Commission on the Status of Women and Girls, during the Report’s public release event on March 22.

An Estimated 90% of Caregivers or Home Care Workers Are Female

As California’s largest provider of free and accessible training for caregivers, the Center for Caregiver Advancement (CCA) is a staunch advocate for dismantling barriers and promoting equity for long-term care workers. One of CCA’s core organizational beliefs is that caregiving is a profession deserving of respect and recognition. Around 90 percent of CCA-trained homecare workers are women.

Similarly, 89 percent of skilled nursing workers who were trained at CCA are women. The highest percentage of both homecare and skilled nursing workers were in their 50s. Also among CCA-trained home care workers, 70 percent report they take care of a family member.

These statistics directly align with the data presented at this year’s Report on the Status of Women and Girls in California, which suggests that “the average caregiver is a 58-year-old woman caring for an 81-year-old parent.”

CCA Training Empowers Caregivers By Giving Them Specialized Skills for Professional Growth

CCA’s training makes it possible for hard-working caregivers to step out of invisibility as a workforce by acquiring specialized skills and knowledge that establish them as professionals. This was our mission since the beginning as our organization’s founders, a group of resilient female caregivers, fought to provide long-term care workers with three crucial things that had been previously lacking: livable wages, benefits, and training. 

Since 2000, CCA has trained over 42,000 of California’s paid caregivers. One of the key goals of our organization is to inspire system-change conversations around specialized skills and translate those into higher wages for caregivers. Those who participate in our programs are paid for their time in training, with some programs offering stipends upon completion. This is a step in the right direction towards breaking long-established barriers and recognizing the profession of caregiving for the noble and respectable role that it is. 

Although significant improvements have been made in recent decades regarding advancing women’s roles in the workforce, progress remains as we strive to build a more equitable world. For example, according to the Report, “women still take on more unpaid caregiving duties than men.” 

Building a More Equitable Future in the Caregiving Workforce and Beyond

An important aspect of our vision at CCA is centering our work on race and health equity, acknowledging that progress for women is not truly achieved unless that includes all women – regardless of their background. 

The inequities in society are multifaceted and go beyond gender. For example, as shared in the Report, to make as much in her lifetime as a 65-year-old white male, a White or Asian-American woman would need to work until she is 75 years old. However, a Black woman would need to work until she is 95 and a Latina until she is 115 years old. 

According to the Pew Research Center, “differences in factors such as education, hours, experience and occupations significantly affect the overall earnings between different groups of women.” Building a more equitable workforce entails removing barriers that limit access to these crucial factors. 

Immigrant women of color comprise the majority of the caregiving workforce. In 2022, 61 percent of CCA-trained homecare workers identified as Hispanic or Latino, 19 percent identified as Black or African American, 13 percent were Asian, and four percent White.

Among the skilled nursing workers trained that same year, 58 percent were Hispanic or Latino, 22 percent identified as Black or African American, 15 percent as Asian, and four percent as White.

Access to education is a barrier that CCA is actively working to remove. All of our training programs are completely free of charge, removing the financial burden of funding an education.

Additionally, we offer training in several different languages in addition to English, including Spanish, Korean, Mandarin, Armenian, Cantonese, Russian, and Vietnamese. 

While data reporting gender and race-based inequities can be sobering, it is an important step to acknowledge these truths. These statistics help guide further progressive action as we strive to build a more equitable workforce where everyone, regardless of their gender, race, or wealth, has an equal chance at success.

Pioneering Research on IHSS Training

CCA Partners with J-PAL North America at MIT for Groundbreaking IHSS Training Evaluation

In collaboration with the Center for Caregiver Advancement (CCA), the Abdul Latif Jameel Poverty Action Lab (J-PAL) North America at MIT will conduct the nation’s first randomized controlled trial (RCT) to evaluate the impact of CCA’s training on In-Home Supportive Services (IHSS) workers. This pioneering study aims to delve into both the caregiving and healthcare outcomes of the training, marking a significant step forward in workforce development and healthcare research.

The RCT is part of CCA’s “Upskilling IHSS Providers in San Bernardino” project, funded by the California Workforce Development Board’s High Road Training Partnership (HRTP). It will evaluate data from CCA’s 35-hour IHSS Essentials course, which equips caregivers with critical skills and knowledge in areas such as infection control, medication safety, activities of daily living, mandated documentation, self-care, and more.

“We are proud to work with the J-PAL team on this groundbreaking randomized evaluation on IHSS training,” said Corinne Eldridge, CCA President and CEO. “This joint project validates the critical role that home care workers play in keeping older adults and people with disabilities out of institutional care. We know that access to high-quality training programs not only contributes to increased worker retention but also facilitates recruitment in a field facing a care crisis.” 

This study addresses a critical gap in research as no prior RCTs have been conducted on IHSS training or any home care training programs, according to Matt Notowidigdo, PhD, Professor of Economics at the University of Chicago Booth School of Business and Co-Scientific Director of J-PAL North America.

In an era where job training initiatives predominantly focus on reskilling workers in fields like technology and IT, this project underscores the importance of evaluating training programs within the healthcare sector.

“Healthcare is just as important, especially direct care, as it is very much the future of work. It means we, as academic researchers, have an obligation to evaluate different kinds of training programs to study their impact on healthcare workers and the people they care for,” said Notowidigdo. “CCA is the perfect partner for this as they are pioneers in this space.”

The randomized controlled trial will operate on a cohort basis, with participants selected at random for the IHSS training, while others will be part of a control group. Each cohort will serve as a sub-study, and participants will be followed for a full year post-training. This comprehensive approach includes surveys, administrative data from the state of California, and access to Medicare and Medicaid data of the individuals receiving care.

The primary goal is to observe the impact of training on both IHSS workers and the individuals they care for. The evaluation will assess healthcare utilization, costs, and outcomes on the IHSS consumer side, including factors such as hospitalization rates and preventable incidents like accidents and falls. On the caregiver side, the RCT will examine worker attachment to the job, duration of employment, job satisfaction, confidence, and various aspects of mental health such as stress and anxiety.

“There are reasons to think training helps caregivers feel better about the job, more confident, and more comfortable which helps them stay in their job longer,” said Notowidigdo.

CCA’s work with other university-based research institutes shows that caregivers report post-training confidence in their ability to do their jobs. CCA regularly evaluates the value of its training programs on the workforce and the quality of care through impact studies in partnership with academic institutions and research organizations. UC San Francisco’s Institute on Health and Aging studies CCA’s caregiver training on Alzheimer’s disease and related dementia. Vital Research analyzed data for the Caregiver Resiliency Teams Impact Study and is doing the same for the Career Pathways Program.

CCA’s curriculum and program design relies on evidence-informed practice, using results from these impact studies, qualitative research, and subject matter expert opinion, to guide the training framework. The findings from the RCT, combined with CCA’s existing body of research, will move the evidence base into actionable strategies and policy that will advance workforce development for long-term care workers.

For Notowidigdo and his research team, the rarity of the intersection between labor and healthcare research makes this project even more significant. The study not only explores the impact of the training on healthcare outcomes but also considers its influence on the labor market.

“(California’s) IHSS program and the innovative training provided by the Center for Caregiver Advancement represent promising models for other states around the country that are considering new programs to support in-home caregiving,” said Notowidigdo.

Related Reading: IHSS Providers Are a Caregiving Lifeline for Californians

Dementia Training for Family Caregivers

UC Irvine and the Center for Caregiver Advancement launch dementia training courses to address future demand for skilled caregivers.

Diagnosis of Alzheimer’s Disease in California to Increase 20% by 2025

LOS ANGELES, CA – February 9, 2024 – To meet the anticipated growing number of dementia and Alzheimer’s cases in California, the University of California, Irvine (UC Irvine), the Center for Caregiver Advancement (CCA), and Alzheimer’s Orange County have announced the launch of a free eight-module virtual training course for caregivers of those diagnosed with dementia in southern California. A 2023 report from the Alzheimer’s Association predicts cases of Alzheimer’s disease in California will increase by more than 20% between 2020 and 2025.

To meet the increasing anticipated needs of populations diagnosed with Alzheimer’s disease and other dementias, the number of caregivers must grow significantly. Currently, more than 11 million Americans provide unpaid care for a family member or friend with dementia, according to the Alzheimer’s Association.

In California, more than 1 million Alzheimer’s caregivers provide 1.8 billion hours of unpaid care. Caregiving can have a profound impact on the health of the individual providing the care, associated with higher levels of depression, anxiety, medication use, compromised immune function, and vulnerability to elder abuse.

CCA’s multi-week, virtual evidence-based caregiver training, was developed in collaboration with UCI Health geriatricians, Alzheimer’s Orange County, and funded by a California Department of Public Health grant. The live training will be offered via Zoom and participants can enroll now through March 2024. To qualify for the free training, participants must be either an unpaid caregiver for persons with dementia or a family member designated as the caregiver for persons with dementia (paid or unpaid) living in Southern California.

The program will train caregivers on effective communication strategies to support activities of daily living (ADLs), safety, and the management of symptoms and distress for those diagnosed with ADRD (Alzheimer’s Disease and Related Dementias). Caregivers will learn how to prevent caregiver burnout and stress mitigation. Caregivers will also learn proactive strategies to prevent challenging situations and reduce caregiving stress.

The course is specifically designed for family (or unpaid) caregivers of individuals with Alzheimer’s disease and related dementias (ADRD).

CCA, with its expertise in curriculum development and caregiver training programs, will deliver the training in English and Spanish. CCA’s ADRD program for In-Home Supportive Services (IHSS) providers has proven to impact those who completed the training: 96% say they learned new skills and 94% say their communication with the person they’re caring for improved.

UC Irvine will conduct an educational assessment of the family caregiver training program, comparing caregiver health and stress levels before and after training, as well as skills and knowledge competency. The assessment will also evaluate caregiver behavior change to measure the impact of the training on the person receiving care.

About the Center for Caregiver Advancement

The Center for Caregiver Advancement (CCA), is the largest provider of training for caregivers in California and has trained more than 42,000 nursing home workers and in-home caregivers. advancecaregivers.org The CCA is committed to improving care and building better lives for caregivers in California and the people they serve. We measure our impact through improved wages and career development for caregivers, the quality of care for their consumers, and reducing the stress on California’s over-burdened healthcare system.

About the University of California, Irvine Division of Geriatrics and Gerontology

The Division of Geriatric Medicine & Gerontology at the UCI School of Medicine is made up of an interdisciplinary group of professionals whose mission is to address the changing health needs of older adults and those who love them. We are committed to delivering high-quality, comprehensive care in a variety of settings and to providing leadership in geriatric education, research, advocacy, and community outreach. The skill and dedication of our physicians to elder care has led to UCI Medical Center being named repeatedly as one of the nation’s best hospitals for geriatric care by U.S. News & World Report.

Moving the work of advancing caregivers

2023 was a year of remarkable growth for our organization and for the long-term care workforce. The state’s extension of the Career Pathways Program, funding of the CNA Registered Apprenticeship Program, and continued investment in specialized caregiver training show the growing recognition of the value of training caregivers. All of these align with our commitment to advancing the professionalization of long-term care work. 

As we look ahead to 2024, we remain committed to setting the standard for caregiver training and building a workforce of highly trained caregivers that many Californians can’t live without. 

2023 HIGHLIGHTS:

Language equity: We continue to address the need for equitable access to training by providing our programs in multiple languages. We increased our language offerings to eight: English, Spanish, Armenian, Korean, Mandarin, Cantonese, Russian and Vietnamese. This ensures training and continuing education courses are accessible for IHSS workers who are most comfortable learning in a language other than English.

Nationally recognized curriculum: Our training programs are evidence-based, refined through worker feedback, and backed by our impact studies. Our specialized curriculum has been licensed by organizations outside California, utilizing our experience and expertise to support sister training funds and union workers across the country. 

Condition-specific training: We offer condition-specific training courses to equip caregivers with the skills and knowledge they need to provide quality care. IHSS providers can enroll in courses that teach them essential skills, basic health and safety, emergency preparedness, as well as condition-specific knowledge (Alzheimer’s and related dementia, autism, diabetes, heart disease, traumatic brain injury). 

SNF industry solutions: Since the launch of the CNA Registered Apprenticeship Program earlier this year, we have trained and placed Certified Nurse Assistants at skilled nursing facilities across the state. We also now run our own CDPH-approved NATP as a hybrid offering to alleviate some of the barriers workers face, such as demanding schedules and transportation needs. 

Climate-resilient workforce: We released our Impact Report and hosted an Impact Study Briefing about the outcomes of our pioneering Caregiver Resiliency Teams project, underscoring the importance of investing in caregiver workforce training to build a climate-resilient California. cca.fyi/crtimpact  

Stipends for specialized skills: Part of our long-term goal of linking specialized skills to increased wages for caregivers, stipends are a hallmark of our training programs. 

  • IHSS providers: Paid the hourly wage rate of their hours in training
  • CNA Registered Apprenticeship Program participants: Receive stipends for child care, transportation and grocery expenses, as well as retention bonuses.  

LOOKING AHEAD: WHAT’S IN STORE FOR 2024

Groundbreaking research: We are partnering with the renowned J-PAL North America at MIT, which will conduct a randomized control trial on our IHSS Essentials training program in San Bernardino County. This will be the first RCT across the nation on IHSS training. The RCT, along with the impact study from UC San Francisco on the ADRD training, will lay the foundation for policy change that will recognize worker specializations, improve worker retention, create advancement within the home care workforce, and secure long-term funding for caregiver training. 

Upskilling the IHSS workforce: We will deliver IHSS Essentials, Alzheimer’s Disease and Related Dementia care, and Caregiver Resiliency training to IHSS providers in San Bernardino County, addressing the need for highly trained caregivers in under-invested communities. Access to this specialized Alzheimer’s training is especially important to support the caregivers caring for those with ADRD in San Bernardino. Given the extreme heat the region experienced in 2023, the Caregiver Resiliency training will give IHSS providers an increased understanding of climate change impact and the skills they need to address climate-related emergencies. 

Training for unpaid family caregivers: We are excited to start providing Alzheimer’s and dementia care training for unpaid family caregivers in the Inland Empire. This project is in partnership with CDPH and UC Irvine, which will research the impact and value of the training program. Classes begin in February.

Impact studies: We will continue to measure the impact of our training programs through knowledge checks and pre- and post-training surveys. Through our relationships with academic institutions and research organizations such as UC San Francisco and UC Irvine, we can demonstrate how our customized training programs advance quality care, improve retention, and reframe the value of care work.

Elevating care: Now on the seventh year of our partnership with L.A. Care, we continue to elevate the quality of care the health plan’s members receive from their IHSS providers. L.A. Care’s utilization studies of the training’s impact have consistently shown a decrease in emergency department visits and inpatient utilization among members whose caregivers completed our training.

Sign-up to be added to our mailing list!

By providing your email and phone number, you agree to receive emails and text messages from CCA. Message and data rates may apply. Message frequency varies.
This field is for validation purposes and should be left unchanged.