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In the world of caregiving, being able to properly help seniors and people with disabilities with simple activities of daily living can make a world of difference. For caregiver Jennifer Davis, it means giving the people you’re caring for “a lifestyle that allows them to feel like they have a life worth living.”

Davis was one of more than 300 In-Home Support Services (IHSS) providers who recently completed CLTCEC’s IHSS+ caregiver training program. The training’s curriculum covers essential caregiving skills such as nutrition, safety, medication, and personal care.

 Davis said that one of the most important sections of the training revolved around navigating activities that typically require manual dexterity. The module turned out to be critical information she needed to care for her partner, who is quadriplegic. “I learned how to properly assist with her medication. It was important to the two of us – being able to help her handle the meds in her hands and help her put it in her own mouth,” Davis said.

For Annie Gibson, who has been a caregiver for 20 years, the training opened her eyes to other things she could do to make life more comfortable for the people under her care. In the module dedicated to nutrition and diet, she learned about assistive devices that can help a person eat.

 “It was instrumental for me to learn how to use the modified utensils for eating, especially for my client who is in hospice,” Gibson said. She also made sure her client’s family knew how to use the tools to continue the standard of care when she’s not around. “I showed her son how to use the plate, spoon, and the attachment to the plate to help them push the food around.”

Training like this is “absolutely important so caregivers know the proper tools and techniques to do their jobs,” said Davis. “It provides uniformity for all providers so we can say to our clients, ‘This is how we were properly trained. We work with you and work for you.’ That’s important for them to recognize.”

It’s easy to see why Team Caceres thrives. Sergio and Emerita Caceres, both Certified Nursing Assistants (CNAs) at Los Angeles Rehabilitation and Wellness Centre – Pursue Health, push each other to do better, dream bigger, and provide better quality of care.

Sergio is the strong, quieter one. Born and raised in Peru, he came to America in his 20s, learned English and went to school while working in restaurants. His family boasts four CNAs, and the career path not only transformed Sergio’s future. It led him to his wife, Emerita.

The two met at work more than 20 years ago. Emerita, also from Peru, is the lively, sociable one of the couple, able to coax smiles out of patients and co-workers. Always on the go, she whirls from task to task with efficiency and cheer.

“If I have to pick the hardest part of the job, I can’t think of anything really, because we work as a team,” Sergio said. 

Aside from raising their two children, one of whom is USC-bound, the couple have also made time to enroll in most of the classes offered by the SEIU 2015 Education Fund. Sergio and Emerita have completed classes and received certifications on CPR, Computer, Dementia, in-person Continuing Education Units (CEUs), as well as cell phone-based classes that focus on Vocational English and skills building.

“The great thing about Emerita and Sergio is that they have a really good work ethic,” said Jennifer Sierra, former Director of Staff Development (DSD) and current Infection Preventionist at Los Angeles Rehabilitation and Wellness Centre – Pursue Health. “It is very important for a supervisor or DSD to acknowledge their efforts in going above and beyond, trying to make sure that they’re educated and knowledgeable and that they’re aware of everything that’s going on at work. That’s a big step: taking initiative to further your education and your knowledge in order to fully do your job to the best of your ability.”

The decision to enroll in so many classes was easy, Emerita said. 

“We always want to help our patients, and when we improve, we do that,” she said. “It was hard to make time, but we did it together. And we learned so much, especially about Alzheimer’s patients and patients with Dementia. The training helped us understand them.”

Sergio said the classes have definitely enhanced their skills as caregivers.

“We are better for knowing more, for understanding more, and us learning more is better for all,” he said, adding that he most enjoys the practice they receive from the classes.

“We are 20 years on the job and we still love most caring for the patients, and being compassionate with them,” he said.

SEIU Local 2015 representative Karen Rodriguez admires the couple’s dedication to their jobs and to their patients. “It just shows that they are always willing to continue that quality care for their patients,” she said. “They know that the more educated you are the more skilled you are. They already have the compassion, the care factor there, so anything above that is just amazing.” 

For Emerita, every day is a chance to make her work count, to uplift those who are suffering and make the world a better place. Working side by side with her husband is a happy bonus.

“We treat our patients like family, and you take care of family,” she said.

CNA program means career advancement, better life for two former home care workers

For Laura Garcia and Elizabeth Sanchez, moving mountains is a matter of will.

The two nursing home workers are being recognized for completing all of the requirements of the SEIU 2015 Education Fund’s Certified Nursing Assistant (CNA) program. They accomplished this while working one full time, or two part-time jobs, as well as going to class during weekends for several months.

The Education Fund — through funding from the Employment Training Panel (ETP) — paid for their training toward certification. Garcia and Sanchez just finished the required 500 work hours at their current facility, Huntington Park Nursing Center – Covenant Care.

Certified Nursing Assistants Elizabeth Sanchez and Laura Garcia at Huntington Park Nursing Center – Covenant Care.

“I worked many hours and had to give up plenty of time with my family, but it paid off,” said Laura Garcia, a former In-Home Supportive Services (IHSS) home care worker. “I wanted a better career and better life for my family and this has helped me prepare for my future.”

The Education Fund established the CNA program to address a statewide shortage and retention of CNAs at nursing homes. The Fund is a joint effort between employers and SEIU Local 2015 to provide additional training and career pathways to workers through building skills and earning industry-recognized certificates. Aside from a reimbursable down payment, the CNA program is completely free for students.

Marthen Lumingkewas, Executive Director at Huntington Park Nursing Center – Covenant Care, said the Education Fund’s training is a critical part of setting a high standard for both patient care and CNA job satisfaction.

“Being a caregiver is not an easy job,” said Lumingkewas, whose own parents worked as nursing assistants and would often bring their child to work. “It’s more of a calling. You have to have compassionate care, be patient, listen, be a therapist, be an advocate. A program like this is critical because it could be a mirror, something people could see that could be duplicated.”

Their training is already making a difference, according to Lumingkewas. “I’ve only heard good things (about Laura and Elizabeth). They’re confident in their job ability and duties,” he said. “If you want staff competency, retention and confidence in their ability to do their job, I think programs such as this are very critical. It’s a blessing not just for one person, it can affect others, too.””

Most workers who have participated in the Education Fund’s CNA program previously worked in nursing homes as kitchen aides, in housekeeping or in activities, or — like Garcia and Sanchez — as home care workers. They undergo several months of intensive training, then have to pass the state exam. After they get their certification, students need to complete 500 hours working as a CNA at their current facility as part of the program requirements.

The expectation around the Fund’s CNA program is for SEIU 2015 bargaining unit members to “graduate and be hired, preferably by the facility where they work. But this is also an avenue for them to grow and to improve their lives,” said Ericka Ochoa, SEIU 2015 Region 1 Coordinator for Huntington Park Nursing Center – Covenant Care. “With quality training, we can make sure that CNAs are respected by society and their employers.”

Garcia and Sanchez have done it all. Both say it wasn’t easy, but the support they received from the union and the Education Fund staff have made a difference.

“I always like to see the glass half-full than half-empty and it helps me see that I’m almost to the end,” Garcia said. “The classes made me more aware and gave me more knowledge on how to treat my patients.”

The struggle to complete training and certification fuels both women’s dreams. For Garcia, it is to continue giving 100 percent effort to help her patients. She is also driven to inspire her four children.

“What I love most about my job is when patients tell me I’m doing great,” Garcia said. “The most challenging part is thinking I won’t complete my assignment for the day.”

Both women said they are grateful the Ed Fund helped empower them. The Fund and its team pushed them to work even harder to make their piece of the American dream a matter of fact.

“This was a terrific program and changed my life for the better,” Garcia said.

A study of CLTCEC’s training program concludes that “training IHSS caregivers in California is an important step in ensuring the long-term well-being of older adults with ADRD.” The paper, “Competency-based training for in-home supportive services providers of consumers with ADRD,” was published in the Gerontology & Geriatrics Education journal in 2019. 

“We see a positive difference in provider’s knowledge and confidence levels in caring for adults with Alzheimer’s and dementia after completing the training. This translates into better care for the clients, as the providers are more skilled in managing this condition,” said Lourdes Guerrero, adjunct assistant professor of medicine at the UCLA David Geffen School of Medicine. 

Guerrero co-authored the paper with Corinne Eldridge, President and CEO of CLTCEC, and Zaldy S. Tan, medical director of the UCLA Alzheimer’s and Dementia Care Program.

The paper studied the impact of CLTCEC’s IHSS+ Alzheimer’s training course, which was initially developed in partnership with the UCLA Geriatrics Workforce Enhancement Program (GWEP) in 2017. It analyzed the program’s effect on the participant’s knowledge and/ skills gains, and their well-being, and how the training can transform the quality of care for older adult IHSS consumers.

 CLTCEC’s IHSS+ Alzheimer’s training program is a comprehensive, competency-based, 10-week course designed to enhance the skills and knowledge of caregivers who play a crucial role in maintaining the health and well-being of the seniors they serve. The modules cover essential caregiving skills such as communicating effectively, reducing caregiver stress, managing repetitive behaviors, and assisting with personal hygiene and activities of daily living. The curriculum uses CLTCEC’s original IHSS+ training modules, with a special focus on teaching ADRD-specific caregiving skills. At the end of the program, participants earn First Aid and CPR Certification as part of their training.

“The most impactful elements of the training were the gains in providers’ confidence levels regarding safety concerns, communication issues, and managing Alzheimer’s and dementia-related behaviors. Equipping providers with knowledge and skills in these areas will greatly improve the quality of care the consumers receive and, I hope, will lead to more satisfying care relationships,” said Guerrero.

The study found statistically significant gains in the participants’ overall confidence in caring for a person with dementia or Alzheimer’s. Participants reported that, after the training, they felt more confident performing specific tasks like how to ensure the person’s safety at home and how to keep a person with dementia or Alzheimer’s from wandering. Participants also noted significantly improved confidence in managing their caregiver tasks and in their ability to calm themselves down, thus improving their own overall well-being.

CLTCEC’s curriculum and training model will be the subject of a research study to be conducted by UC San Francisco (UCSF). In 2019, the California Department of Public Health awarded a five-year, $3.2 million Alzheimer’s Research Award to UCSF in partnership with CLTCEC and Alameda Alliance for Health. 

 CLTCEC will provide the training to 600 IHSS providers over five years in Alameda County, with the first cohort starting in September. 

“Our training program builds skills so caregivers can deliver higher quality care and better health outcomes for the people they serve,” says Corinne Eldridge, president and CEO of CLTCEC. “ADRD now affects over 650,000 adults in California. With the increasing number of older adults, the growth of individuals living with Alzheimer’s disease or related dementia will increase. Caregivers play — and will continue to play — a crucial role in maintaining the health and well-being of these older adults.” 

In her hands, Cecilia Rodriguez held a bag.

“In my dream, I grab a bag and in it, I place all my dreams and the pain of having left my children,” she said. She was 33 and a young mother in 1986 Honduras. Her youngest child was only 7. Still, she had to leave.

Rodriguez, now 66, found work trimming clothes in Chinatown. Then she began making tamales to sell. Eventually, she was able to send for her six children.

“Thanks to God, I have all my children living legally in the United States,” she said.

One of them has a disability, and he is the reason she came to the doorstep of the California Long-Term Care Education Center (CLTCEC). “I have always liked challenges, and I like to learn more,” Rodriguez said. 

CLTCEC is the largest provider of long-term care training in California. Its IHSS+ training program is a 10-week course that educates and empowers caregivers who provide services to seniors and persons with disabilities. In these classes, caregivers learn skills such as assisting in activities of daily living (bathing, dressing, etc), infection control, medication adherence, nutrition, communication, home safety, CPR, and personal care.

Before the pandemic, classes were held in person in multiple languages across Los Angeles County. 

During her IHSS+ training, Rodriguez gained valuable skills and knowledge on how to better care for her son. But what she most enjoyed during class was interacting with fellow caregivers and sharing experiences. She missed that camaraderie when the coronavirus outbreak forced CLTCEC to pause in-person classes in March. 

“I felt bad (when classes stopped),” she said.

Classes resumed two weeks later but it was in a format that caused her to worry. 

“I’ve never enjoyed meetings via technology, because I felt I wasn’t prepared. But I learned to enjoy the challenge.”

Rodriguez said her field representative, Isabel Menjivar, talked her through using her phone to access Zoom meetings, persevering until both of them felt confident in her newfound skills.

“Now I’m really good,” Rodriguez said. “I’m much more prepared.”

Dr. Antonio Borras, CLTCEC instructor, said his students panicked and were hesitant at first, but quickly grew in confidence and enthusiasm once online classes began.

“It was an unforgettable experience to see my students face a new challenge, something they would have not thought about and overcome all difficulties,” he said.

Rodriguez is using her training not only to protect and nurture her son, but also to keep herself healthy and strong. She is fastidious about hand-washing, and she has learned how to carefully and properly assist her son with dressing, bathing, and moving.

“My day is happy when my son wakes up and hugs and kisses me,” Rodriguez said. “We have breakfast together and we exercise. I bathe him and I thank God that he has given me this angel who is never in a bad mood.”

Rodriguez said overcoming her fear of technology, especially since English is not her first language, brought back memories of when she first arrived in the United States.

“I received my strength when I stepped out of Honduras in 1986,” she said. “I defeated (my fears) and triumphed. I got all my dreams and what I wanted with faith in God.”

It is something she tells her son, and all her children: “Dream and practice fighting for what you want. Fighting and dreaming is how goals are achieved.”

The transition from her initial job preparing meals for nursing home residents to becoming part of their care team as a Certified Nursing Assistant (CNA) was an easy one for Alba Marroquin.

“Everything is going awesome with the residents because I kind of know what they like and what they don’t,” she says. “I am so comfortable working as a CNA now. I loved working as a Dietary Aide too, but this is what I really wanted to do.”

Marroquin graduated in December 2019 from the CNA certification program offered by the Education Fund. Her cohort, which included nursing home workers from participating facilities and a few In-Home Supportive Services (IHSS) workers, took classes through the American Medical Career College in Pomona. A new cohort has already started in the first quarter of 2020.

After passing her state exam, Marroquin was hired immediately as a CNA at Laurel Wellness (Longwood facility) where she had been working as a Dietary Aide since June 2019. For  workers in dietary, housekeeping and other non-clinical positions at skilled nursing facilities, the certification sets them on a new career path.

“I never thought I might be able to achieve this goal, but now I feel more secure than before,” she says. “I am truly grateful for this opportunity that the Education Fund has given me.”

The Education Fund offers the CNA program to eligible workers employed at nursing home facilities participating in a labor-management partnership with SEIU Local 2015. The program provides a solution to the severe staffing shortage in California’s nursing homes, which need an estimated 1,700 to 2,400 additional nursing assistants ^[1] as an industry to help meet state staffing requirements. It also helps reduce employee turnover by increasing staff morale and job satisfaction.

To help nursing homes retain and strengthen their nursing staff, the Education Fund also offers a 30-week mentoring program with employer and union collaboration that matches longtime CNAs with those who, like Marroquin, are just starting out. Additionally, eligible CNAs can earn a Restorative Nursing Assistant (RNA) certification through the Fund.

While she was undergoing the CNA training, Marroquin gained a new appreciation for the work of nursing assistants and the patients under their care. “I learned to have more respect for elderly people and for all CNAs.”

Marroquin has her sights on advancing her career through more training programs such as the ones the Education Fund offers. “I want to go for Licensed Vocational Nurse or a Registered Nurse,” she says. “I want to continue studying because now I’m confident I can do everything that I put my mind to. This (CNA course) gave me that confidence.”

^[1]https://lao.ca.gov/Publications/Report/3815