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From Pilot to Caregiver

Former Airman and Engineer Shares the Value of Proper Training

When Carlos Martinez flew Boeing 767s as a commercial pilot years ago, he was responsible for the lives of more than a hundred passengers at a time. Before that, he ferried friends and family on a Cessna plane to all points across California. Later, as an aeronautics manufacturing engineer, he built critical parts for aircrafts, fighter jets, and space missions. But those days are long behind him. In his retirement, he now faces what he said is the most daunting job he’s ever had: being a caregiver.

“As a pilot, you train for every emergency. And as an engineer, you have checklists, procedures, simulations. Your whole career is preparing for that emergency situation, ok?,” Carlos said. “But as a caregiver? I had no training for that!”

Carlos is one of California’s more than 600,000 In-Home Supportive Services (IHSS) providers caring for the state’s aging population and people with disabilities. He is the caregiver for two people in his family: his adult son, who has a chronic illness, and his mother, who is showing signs of Alzheimer’s disease and Parkinson’s disease.

He said being responsible for the life of two loved ones is proving to be more stressful and more intimidating than his time in the cockpit. All because there is no formal training required of caregivers. And until he heard of the Center for Caregiver Advancement’s free training, he didn’t even know there were any available for people like him.

Before enrolling in CCA’s training program, “I thought I knew what to do when I took over caregiving for my son. My wife showed me how to do it, and you know, some of it I thought was basic common sense when you’re taking care of somebody. Most of the time you’re doing things by routine,” he said.

But things changed when he started learning about topics like proper body mechanics, medication adherence, and assistance with daily living activities. Something clicked. “Why do you hold his head like that, why do you lift his body that way … Knowing ‘why’ you have to do things a certain way, it makes a lot of sense,” he said.

“You don’t know it was wrong the way you were doing it, until an instructor teaches you the right way.”

The training program he completed in December was a life-changer, he said. His son is an L.A. Care Health member, which made Carlos eligible for the IHSS+ Home Care Integration training program run by CCA in partnership with L.A. Care. The 10-week training reinforced some of the skills he already knew as a parent of a son whose childhood was marked by a chronic illness. But as a former pilot and aeronautics manufacturing engineer, he soaked in the lessons focusing on procedures and case scenarios. Each module included activities that invited the caregivers to discuss how to handle certain scenarios – such as knowing when to go to urgent care vs. the emergency room.

He is determined to participate in as many CCA courses as possible. Right now, he is enrolled in several of the classes offered by CCA through California’s IHSS Career Pathways Program. He has signed up for all the courses under the Alzheimer’s care learning pathway, so he can be better equipped as his mother’s caregiver.

“Every profession has a checklist. With Alzheimer’s, there must be a procedure. I want to learn that procedure: what to expect (as the disease progresses), how to talk to her, what to do … all of that,” he said.

He urges all caregivers, whether they are caring for family or consumers as an IHSS provider, to sign up for training. “It’s great that the state is now funding training for caregivers,” he said. “I’m taking advantage of as many opportunities as I can to learn.”

CCA to present at 2023 On Aging conference

The Center for Caregiver Advancement is proud to be one of the presenters at the American Society on Aging’s 2023 On Aging conference on March 27-29 in Atlanta, Georgia. This is the nation’s largest multidisciplinary conference on aging and brings together experts on issues affecting the elderly population.

CCA will host the session “Caregiver Resiliency: Training Long-Term Care Workers to Prepare for, Respond to, and Recover from Climate-Related Emergencies,” focusing on how we are training caregivers on climate-change emergency preparedness and community resilience. This session will discuss CCA’s Caregiver Resiliency Project, and the unique training program designed to increase emergency response knowledge with a focus on climate change-related situations.

The panelists for this session will discuss how partnerships developed through the project will lay the foundation necessary for system change conversations around recognizing worker specializations and translating those skills into higher wages. The panelists will include Corinne Eldridge, CCA President & CEO; Moraima Castañeda, CCA Director of Home Care Programs; Syuzanna Petrosyan, CCA Senior Director of Nursing Home Programs; Greg Thompson, Executive Director, PASC-LA; and Dereck Smith, Executive Vice President, SEIU Local 2015.

CCA will also participate with UC San Francisco in “The IHSS+ ADRD Training Project: Bolstering California’s Caregiver Workforce” session spotlighting the evaluation study being conducted by our research partner UCSF’s Institute on Aging on the impact of Alzheimer’s care training on caregivers.

Thousands sign up for Alzheimer’s care courses in Career Pathways Program

FOR IMMEDIATE RELEASE

Center for Caregiver Advancement Addresses Urgent Need for Caregiver Training Through Career Pathways Program

Thousands sign up for free training, offered in eight languages;
Alzheimer’s care courses are the most in-demand

Los Angeles, CA – Responding to the urgent need for a highly trained workforce that will take care of California’s aging and disabled population, caregivers are signing up by the thousands for the free training offered by the Center for Caregiver Advancement (CCA) through the In-Home Supportive Services (IHSS) Career Pathways Program. The program is part of the state’s Master Plan for Aging roadmap, which includes evidence-based, specialized caregiver training as one of its top priorities in the next two years.

CCA is the only organization utilizing evidence-based curriculum that has already been tested and delivered to more than 10,000 caregivers in California. The curriculum for the Career Pathways Program is based on CCA’s existing training on Alzheimer’s and dementia care (IHSS+ ADRD), emergency preparedness and community resilience (Caregiver Resiliency Teams), and basic skills (IHSS+). CCA has also developed new training content for diabetes, traumatic brain injury, and autism care.

“With California’s population aged 65+ expected to grow to 10.8 million by 2030, the need for training caregivers has never been more urgent,” says Corinne Eldridge, CCA President and CEO. “CCA has been a pioneer of an equity-driven movement for quality training for over two decades. We are proud to partner with the California Department of Social Services in making training accessible to paid caregivers in the state. The Career Pathways Program will bring advancement opportunities to the workforce, which will help attract and retain workers.”

CULTURAL DIVERSITY: TRAINING OFFERED IN MULTIPLE LANGUAGES

Recognizing the cultural and linguistic diversity of this workforce, CCA’s classes for the state initiative are offered in eight languages (English, Spanish, Korean, Cantonese, Mandarin, Vietnamese, Armenian and Russian). CCA is the only training provider offering courses in this many languages.

“The majority of caregivers are women of color and immigrants who are fluent in languages other than English. We ensure that they can take our training in the language that they will be most successful in,” says Eldridge. “We know from our long history in the field and studies of our impact that our training can lead to higher retention, skills gain and higher quality care because caregivers have the knowledge and confidence to be successful in their jobs, leading to better health outcomes for consumers.”

MOST IN-DEMAND LEARNING PATHWAY: ALZHEIMER’S CARE

CCA’s classes for the Career Pathways Programfilled within days of opening registration. The most popular courses were part of the Alzheimer’s disease and related dementia (ADRD) learning pathway, with more than 3,000 IHSS providers signing up for the ADRD courses and joining the waitlist in January.

IHSS provider Carlos Martinez registered for multiple classes in the ADRD learning pathway because he wants to know what to expect as his mother goes through the stages of Alzheimer’s. “I want to understand the ‘why’ of many of the things we do as caregivers. Most of the time you think you know what to do because it’s routine, or you watched somebody do it. But it’s different when an instructor teaches you the right way,” he says. “It’s great that the state is now involved with funding training for caregivers.”

Long an advocate for caregiver advancement, CCA worked with SEIU Local 2015 to advance a statewide workforce development initiative for long-term care workers. That advocacy work led to the inclusion of $200 million in California’s Senate Bill 172 for the IHSS Career Pathways Program. The initiative is part of a historic $2.5 billion investment in the direct care workforce under California’s Master Plan for Aging.

ABOUT CCA: The Center for Caregiver Advancement is the largest provider of training for caregivers in California and has trained more than 20,000 nursing home workers and in-home caregivers. Founded in 2000 by the long-term care workers who are now members of SEIU Local 2015, CCA provides quality educational opportunities including free classes for in-home caregivers and nursing home workers to help them build better lives for themselves and the people they serve. advancecaregivers.org

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Contact:
Pia Orense
213.544.7260
piao@advancecaregivers.org

Taking care of the care workers

When your job is to care for others, it is especially important to prioritize your own health and well-being. Developing self-care practices can prevent burnout and improve your physical and emotional well-being. That is why our partner organization, HCAP, is offering a free workshop all about self-care for caregivers.

This 1.5 hour workshop is completely online and will cover the following topics: 

  • What is self-care?
  • Practical ways to deal with stress and challenges
  • Cost-effective tips, ideas, and exercises to try at home

The course will be taught in English with interpretation in seven (7) other languages. See below for the 2023 workshop dates: 

English with Interpretation in Spanish, Polish, and Russian

  • Saturday, Feb. 4, 10 am 
  • Wednesday, March 22, 4 pm 
  • Tuesday, April 25, 4 pm

English with Interpretation in Spanish, Vietnamese, and Korean:

  • Thursday, Feb. 23, 10 am
  • Friday, April 7, 10 am

English with Interpretation in Spanish, Mandarin, and Cantonese: 

  • Friday, March 3, 10 am
  • Thursday, April 20, 4 pm 

Celebrating the work of advancing caregivers

Since the inception of CCA in 2000, advancing caregivers as a respected and recognized workforce has always been our goal. With California’s population aged 65+ expected to grow 18% or by 1.25 million adults, the need to both attract people to this work and offer career advancement opportunities through high-quality caregiver training has never been more urgent.

Last year, we pioneered more training programs that address this need: the Caregiver Resiliency Teams Project, the first of its kind in the nation, and the CNA Registered Apprenticeship Program, which will impact California’s nursing home industry by providing a pipeline of highly trained CNAs to unionized skilled nursing facilities.

Infographic of 2022 accomplishments

CCA has expanded our reach and impact to thousands of workers across the state with our launch of 120 hours of original curriculum and training programs that are worker-centered and honor the consumer-directed model of care. As a team that pushes for validation of the caregiving workforce and the immigrant women of color who do this work, we work hard and at a fast pace. We know that what we do will advance lives. CCA is meeting the moment we have been working to create for over two decades – through organizational growth, program expansion, and the continuing evolution and development of our 2023-2025 Strategic Plan. This lays the roadmap for our continuing journey on delivering person-centered and linguistically and culturally competent training to California’s long-term care workers.

We are excited about what the next three years will bring as we continue to advance caregivers and build the workforce of highly trained caregivers that many Californians can’t live without.

Sincerely,
Corinne Eldridge
President and CEO

Journal publishes research on ADRD training

CCA’s work with UCSF Institute on Health and Aging on our IHSS+ ADRD Training Project was published in the Journal of Applied Gerontology. Using pre-and post-training surveys, the research team, led by Assistant Professor Jarmin Yeh, measured increases in the participating caregivers’ knowledge and self-efficacy, as well as distress and depression among the caregivers. Co-authored by CCA team members, this paper adds to existing literature that new educational training models that use online and remote strategies can enhance IHSS caregivers’ dementia knowledge and skills to work with consumers living with ADRD.

The research team found “promising signs that online training can bolster the capacity of IHSS caregivers to better support their consumers living with ADRD or cognitive impairment. Dementia knowledge and self-efficacy significantly increased at post-training, with trends suggesting retention at 3-month follow-up.”

Read the full paper: “​​Enhancing Dementia Knowledge and Self-Efficacy of In-Home Supportive Services Caregivers Through Online Training.”

A test of resiliency and preparedness

Caregiver Amber Peña knew what she faced was familiar, but no less threatening to the life and health of the people she was responsible for keeping safe. An hours-long power outage during California’s prolonged heat wave this summer meant the home care worker needed to stay calm and focused on herself and her mother and aunt.

There was no light, no refrigerator, no microwave, and no air conditioning. But Peña did have one source of power: her knowledge and experience.

Peña, and other graduates of the Caregiver Resiliency Project from the Center of Caregiver Advancement (CCA), are now armed with expertise gained from the first-of-its-kind training program. The project offers a specialized six-week curriculum focused on emergency preparedness through the lens of climate change. It is made possible by a $1.07 million grant from the California Workforce Development Board’s High Road Training Partnership.

Graduates learn how to respond to, prepare for, and recover from climate-related disasters such as extreme heat, wildfires, and power outages. The record-breaking heat wave that blanketed California in August and September of 2022 challenged caregivers to step up as first responders as well as essential workers.

Certified Nursing Assistant Jasmine Drake of City View Post Acute in Northern California said she took the class to fill the gap between what she knew from experience and formal training.

“I think it’s valuable because more lives can be saved if you understand how to do things in an emergency,” she said. “And if the residents know you’re dependable, they’ll feel safer. The likelihood of (a climate change emergency) happening is higher now, with fires and earthquakes. I learned helpful tools that help me know what to expect, like having an evacuation plan. Now, I’m more aware. I feel I won’t panic and I can be useful.”

Drake remembers only too well how she endured a heat wave in San Francisco, working in a sweltering nursing home and caring for stressed residents.

“It was an old building, and it was either very cold or very hot, and when it rained, it leaked,” the nursing home worker remembered. “All we could do was give our residents water and ice cream. In the October 2021 wildfire, we couldn’t see the sky even though it was daytime. People were panicking and we closed the windows because the smoke was too much.”

CNA Frida S. Gonzalez said her work at Sun Mar Nursing Center in Anaheim teaches her compassion and sparks a joy from helping others. Her Caregiver Resiliency training taught her the value of preparation, such as knowing the signs of heat-related conditions and how to assemble an emergency kit.

“I also wasn’t aware of social and cultural aspects of climate change issues, for example, how access to healthcare changes among different groups or how poorer neighborhoods don’t have an abundance of trees like other more affluent areas,” Gonzalez said. “I learned how to use active listening and (that skill) deepened my concern and understanding for my patients. It’s useful information and much needed.”

Photo of worker with a quote

Home care worker Peña said before enrolling in the class, she didn’t know to safely prepare for disasters.

“I knew I could stay calm and focused, but I wanted to further my education and knowledge of emergency preparedness, to be able to help my family and friends,” she said.

Peña said the value of her training extends from herself to the people she serves through the state’s IHSS program and the community at large.

“We need this type of training,” she said. “I feel more prepared and educated on how to safely and properly handle multiple emergency situations such as floods, earthquakes, and fires.”

Peña said one lesson she will remember is how climate change can cause trauma during – and a long time after – a related disaster.

“(I learned) how people can be affected by trauma, such as during a fire, and all that comes into play while you’re going through it, but once the fire is out, coming back and seeing you have nothing, to be affected by that, to be scared of the what ifs, and thinking of the next time. This training taught me to react to that and help,” she said.

Most of all, Peña said her mother and her aunt, her care recipients, now know what to do in an emergency – from where to meet, to whom to call if they get separated. She herself is empowered to advocate for vulnerable communities and an equally beleaguered planet.

“Climate change has affected multicultural communities in multiple ways, such as lack of knowledge and lack of resources,” Peña said. “Without knowledge, there is no power nor understanding about changes going all around you. As a culture, we need to hold ourselves accountable for the damage we’ve caused. Now let’s learn from this and fix the problem ahead for the future.”

Specialized Alzheimer’s care training, Year 3 report

In 2019, UCSF was awarded a five-year, $3.2 million California Department of Public Health Alzheimer’s Research Award to study the impact of IHSS+ Alzheimer’s care training in partnership with the Center for Caregiver Advancement (formerly CLTCEC) and Alameda Alliance for Health (AAH). Under the agreement, training will be provided to 600 IHSS providers over five years.

IHSS+ Alzheimer’s is a voluntary 10-week training course where In-Home Supportive Services (IHSS) providers learn practical skills to help care for people experiencing symptoms of Alzheimer’s disease and related dementias. A comprehensive, competency-based training program, IHSS+ Alzheimer’s is designed to enhance the skills and knowledge of these caregivers who play a crucial role in maintaining the health and well-being of the older adult consumers they serve and keeping them healthy at home as opposed to in institutions.

CCA launches CNA & LVN Registered Apprenticeship Program

PRESS RELEASE

The Center for Caregiver Advancement receives a $14 million grant from the California Workforce Development Board to launch a statewide CNA & LVN Registered Apprenticeship Program

CCA’s apprenticeship program is a significant part of the solution to the skilled nursing industry’s workforce challenges. Program is free for workers, who will get paid for their hours in the classroom and in training.

LOS ANGELES, CA – Sept. 15, 2022 – The Center for Caregiver Advancement (CCA) received a $14 million grant from the California Workforce Development Board (CWDB) to launch a statewide Certified Nurse Assistant (CNA) Registered Apprenticeship Program and to pilot a CNA to Licensed Vocational Nurse (LVN) registered apprenticeship program. This earn-and-learn apprenticeship model is a significant part of the solution to the skilled nursing industry’s challenges of reducing employee turnover and addressing nursing staff shortages.

The grant is part of the High Road Training Partnerships (HRTP) Resilient Workforce Fund Initiative. CCA will train 500 people to become CNAs, and 12 CNAs to become LVNs by the end of the three-year funding period, offering career growth for incumbent nursing home workers and other community members. The training is free to eligible participants, with CCA covering the costs of tuition, books, and any costs related to certification. Aside from the free training, participants also receive robust wrap-around services and support for the cost of childcare, groceries, and transportation. CCA will also reimburse participating facilities the wages of the participants who earn CNA certification during their first four weeks of employment.

The program is available to unionized skilled nursing facilities that are in the Education Fund, a training fund for members of SEIU Local 2015. As the only Labor Management Partnership in California, SEIU Local 2015 and nursing home employers are collaborating with CCA in implementing a framework that advances economic, occupational, gender, and racial equity efforts while providing a pathway to fixing an industry crisis.

“This apprenticeship program will enable employers to focus resources on quality of care by increasing the number of highly trained CNAs in our facilities,” says John Bowen, Vice President of Operations at Sun Mar Healthcare and a member of CCA Board of Trustees. “Through on-the-job training and mentorship, the participants quickly learn their facilities’ policies, procedures and expectations, which help create a seamless transition into their new roles as critical members of our team.”

Participants will work as nursing aides at participating facilities while they are in the program. They will also receive mentorship support from an experienced CNA or LVN who will help them acclimate to their new roles. Participants are guaranteed a wage increase upon obtaining their state certification and being promoted to CNAs.

“This is a true collaboration between labor and management. The industry-specific, targeted approach of CCA’s apprenticeship program will create upward mobility for our members and help ease the strain on our burdened long-term care system,” says Arnulfo de la Cruz, Executive Vice President of SEIU Local 2015 and a member of CCA’s Board of Trustees.

Long-term care workers at skilled nursing facilities in California provide critical care and health support for the state’s most vulnerable communities. But employee turnover and retention pose massive challenges for the industry, with CNA turnover rates reaching nearly 100%. CCA’s Registered Apprenticeship Program will help participating facilities meet staffing requirements with the acquisition of highly trained CNAs, with a worker-centered training program.

“The apprenticeship program will answer the call for qualified caregivers with on-the-job training, building experience while overcoming the barriers that prevent people from being able to participate in traditional licensing programs,” says Corinne Eldridge, CCA President and CEO. “We are proud to provide a solution for our employer partners who are in critical need of a highly trained workforce and help them reduce turnover and increase employee retention.”

ABOUT THE CENTER FOR CAREGIVER ADVANCEMENT

The Center for Caregiver Advancement is the largest provider of training for caregivers in California and has trained over 18,000 nursing home workers and In-Home Supportive Services (IHSS) caregivers. Founded in 2000 by the long-term care workers who are now members of SEIU Local 2015, CCA provides quality educational opportunities including free classes for in-home caregivers and nursing home workers to help them build better lives for themselves and the people they serve.

Advancecaregivers.org

ABOUT THE HRTP RESILIENT WORKFORCE FUND

For more information about the High Road Training Partnership: Resilient Workforce Fund, please visit the CWDB website at https://cwdb.ca.gov/hrtp-rwf_program/.

The emotional realities of Alzheimer’s caregiving

In his mind, Carlos Corona has two mothers. One is of the past, the mother who was vibrant and energetic and could do everything. The other sits across from him today, unable to recognize her oldest son.

“Once in a while, you look out of the corner of your eye, and think, those two pictures don’t go together,” he said. “And then you have to come back (to reality). Now it’s easier and faster for me to come back from those brief moments.”

For that skill, Carlos credits the training he received from the IHSS+ Alzheimer’s training for caregivers taking care of those showing signs of Alzheimer’s disease and related dementia. The program is offered by the Center for Caregiver Advancement (CCA) in partnership with the California Department of Public Health, UC San Francisco, and Alameda Alliance for Health.

As an In-Home Supportive Services (IHSS) provider, Carlos already had been taking care of his mother for 10 years before he discovered the training. He had taken her into his home after she started exhibiting symptoms of Alzheimer’s in her late 50s. She is now 76.  

“I took my mother to live with me not knowing what I was up against,” Carlos said. “In the beginning, she was able to do everything. She could go to the fridge and get lettuce and tomatoes. Now she doesn’t recognize what a fridge is, what a tomato is, so I have to work through that process.”

Even though he had a lot of experience being a caregiver by the time he completed the training, Carlos said the program was still useful.

During the 10-week, 35-hour program, participants learn more about the progression of Alzheimer’s disease and dementia, how to manage hallucinations and repetitive behaviors, assist with personal hygiene, prevent wandering, reduce caregiver stress and avoid burnout. Caregivers also undergo CPR certification training and receive a stipend at the end of the program.

“One thing that impacted me which I never thought about until I took this course is (that) my elderly mother remembers me in the past and not in the present,” Carlos said. “Because I am with her on a daily basis, I took it for granted that she knew who I was. But she only recognizes the son she had 10, 15 years ago and she doesn’t recognize my face today, and that never occurred to me. She doesn’t recognize my face. That’s the thing that impacts me the most.”

That realization prompts him to be more patient today, and not insist on doing things his way, Carlos said.

“With the training, I had come to more acceptance, that my mother doesn’t have the capacity anymore,” he said. “I can be more tolerant, or I can utilize different approaches to actually help her accomplish the same thing (like when she eats) because everything is regulated around her well-being.”

In the past, Carlos said he would walk away and leave his mother when she got agitated. Now, he stays and redirects the conversation from anger and hostility to calm and peace.

“I talk to her about her life before dementia and she kind of gets engaged in that,” he said.

It is bittersweet that as the disease progresses, his mother only remembers life from about the 1950s to 2000.

“I have to go back in time,” he said. “Everything beyond that is cut off.”

He will repeat instructions and questions, hoping something will make sense for his mother. She is still mobile and able to walk. But Alzheimer’s has brought her panic attacks and anxiety, which is now managed with medication.

Carlos said caring for someone struggling with Alzheimer’s is like trying to fit a key into a keyhole in the dark.

“You keep trying,” he said. “Before she goes to sleep, I gotta take her to the bathroom. She says, “Yes, I do want to go to the bathroom.” But once we get to the bathroom, she forgets. So we come out again. And we do that about three or four times and one of those times, she’ll remember. So we have to keep doing it, hoping that one of those times, it will click.”

The pandemic put a stop to the activities that got mother and son out of the house, and Carlos said he has learned to do more exercises with her.

“If my mother didn’t have Alzheimer’s she would probably outlive us all,” he said. “She doesn’t have high cholesterol, she has no diabetes, none of that. She doesn’t need any medication for her lungs or heart or kidneys. It’s just the brain, you know. Right now, she has a hard time trying to pull up the words when she’s willing to communicate with me.”

But her son does find words to describe his life and role as a caregiver. He said it is a choice and a commitment.

“Being a caregiver is a very noble profession,” he said. “I don’t think we quite grasp it, how much good we do. You need to be proud that you’re doing what you’re doing because not everyone is willing to do it. That’s how you give back to humanity, this is how you make a difference.”

Carlos said he gets help from one of his three siblings, one weekend out of the month. Otherwise, it is up to him to give his mother compassionate and dignified care.

“The best part of my day is when my mother is comfortable,” he said. “When you can see that she’s happy. You know that she ate well, she slept well. She’s clean. She took her shower, or she let me give her a shower without any resistance. And we’re on the couch and she’s watching TV, and she’s kind of engaging the TV. You don’t see any anxiety on her face. No panic. That’s probably my daily reward. I think that would be the best time.”

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