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CNA apprenticeships offer career pathways

The Center for Caregiver Advancement, in partnership with EmpRes and SEIU Local 2015, has launched the Certified Nursing Assistant (CNA) Apprenticeship Program, which is meant to provide career pathways for nursing home workers and address a critical staffing shortage at skilled nursing facilities. The program is sponsored by Healthcare Career Advancement Program (H-CAP), a national labor-management organization, and is registered with the U.S. Department of Labor.

The apprenticeship is offered through CCA’s nursing home program (the Education Fund) and provides workers the opportunity to get paid as nursing aides while they pursue training to become CNAs. The training is provided at no cost to the worker, and all program-related fees and materials are covered by the program as well. For those who need childcare or transportation, they will receive a stipend to help offset those expenses.

“This program is an investment in the nursing home workforce as a whole, and in the individual lives that provide essential care for vulnerable residents. Apprentices will earn as they learn, and they can look forward to a wage increase once they receive their CNA certification. This will open up opportunities for economic and social mobility for them,” said Arnulfo De La Cruz, Executive Vice President, SEIU Local 2015.

Currently, the program is available to workers at EmpRes facilities in Salinas and Vallejo, with a few slots open to IHSS caregivers in the area.

“We believe it is a unique opportunity to provide a career pathway for individuals interested in entering into the Certified Nursing Assistant occupation,” said Cindy Cour, Vice President of Human Resources at EmpRes and a member of the CCA board of trustees governing the Education Fund. “Not only does the program provide on-the-job learning and related instruction for the apprentice to master the competencies and become certified, it provides additional support through assigned mentors to ensure success throughout the program and beyond,” said Cour.

A recent study of the nursing home workforce shows that the turnover rate for CNAs can be as high as 129%. One of the goals of CCA’s training programs, especially the CNA certification and apprenticeship programs, is to help skilled nursing facilities address the industry’s staffing shortage and high turnover rate.

“We believe partnerships such as these will improve employee retention and satisfaction, which in turn improves residents’ quality of care. It also provides an avenue for these workers to learn new skills and hopefully open up opportunities that lead to continued career growth in long-term care,” said Cour.

Breaking down language barriers

When Byeoung Dutt has questions for her care recipient’s doctor, she first turns to Google Translate to help her write down her thoughts in Korean, then English. 

“If there is an abnormal condition in his blood sugar, blood pressure or overall health, I report his condition by emailing or calling doctors and nurses,” says Dutt. If her report is too complicated or if her question involves more technical terms, she asks for an interpreter to help her translate the conversation. But there is a difference now in how she communicates with the care team. Thanks to CCA’s training offered in her native language, “I have gained confidence in my job.”

Byeoung Dutt

Dutt recently completed CCA’s 10-week training for In-Home Supportive Services (IHSS) providers in Los Angeles County. The course covers essential caregiving skills, including medication adherence, assisting with daily activities such as dressing and bathing, proper nutrition, and CPR. It is taught in several languages: English, Spanish, Armenian, Cantonese, Mandarin, and Korean.

More than a million of direct care workers, or roughly one in four, in the nation are immigrants. In California, almost a quarter of the home care workforce is Asian/Pacific Islander.

“Getting training in my native language allowed me not only to understand 100% of all this training, but also to see the connection between what I learned last week and what I will learn this week” Dutt says.

She cites the modules on safety and on durable medical equipment (DME) as an example. “I understood the connection that the medical equipment is necessary to prevent the consumer from falling. I made a connection to the learning before and after, so I understood more quickly and easily.”

Because of what she learned during her IHSS+ training, she keeps a daily record of her care recipient’s vitals, medications, and general observations about his health and any unusual behaviors so she can communicate any changes and concerns with his care team.

Training helps change the perception of what caregivers do, she says. “This kind of training is indispensable for a caregiver to be treated as someone responsible for the health and safety of another person, not just a housekeeper.”

Her diligence and professionalism have not gone unnoticed. The pharmacists, primary doctors, and medical staff she talks to have told her that the person she is caring for “is very lucky.”

“Because I am taking care of him in a better way for his health and his quality of life based on that training, I am filled with pride,” she says.

The Center for Caregiver Advancement’s IHSS+ Home Care Integration training program is offered in partnership with L.A. Care and SEIU Local 2015.

Turning experience into a lasting legacy

CCA board member Joyce Hayashi knows full well the struggles that long-term care workers face every day. She lived it as the caregiver for her mother after she suffered a severe stroke, then later for her sister, Doreen, when she became disabled by muscular dystrophy.

“Many of my contemporaries would not have stopped their careers to care for their family full time,” says Joyce, who quit her job as the operational vice president of a production company to devote her time to caregiving. “But as an Asian American, it’s part of my culture to care for your parents. And as the elder child, there’s an expectation that you would take charge as needed.”

Becoming a homecare worker was not something Joyce had envisioned, a situation she acknowledges as something most family caregivers have in common. “It was daunting. I had no idea what caregiving entailed. It was something I didn’t know anything about, I had no training. It was unimaginably difficult,” she recalls of those earlier days.

Joyce turned her experience into an opportunity to help others facing the same challenges. She joined the union and quickly became one of its most active members. Alongside fellow care workers, she fought for better wages and benefits and advocated for access to training that would lead to improved skills and career pathways.

A few years after attending her first union meeting, Joyce was elected to the executive board as a divisional vice president. She served on the SEIU 2015 Executive Board from 1992 until 2018, and on the SEIU State Council Board of Directors from 2013 to 2016.

Her advocacy for homecare workers continues to this day. Aside from her work with SEIU L2015, she has been one of CCA’s stalwart supporters as a board member since 2013.

Joyce currently serves as a member volunteer for the Venice Pioneer Club, providing community support for Westside Japanese seniors. She is also on the executive board for the West Los Angeles Buddhist Temple. She takes pride in her work with the Buddhist Women’s Association as co-chair of its membership committee, in addition to her role as program consultant for Bay Street Arts, the Downtown Los Angeles Artist Space Cooperative.

Since she started becoming involved with L2015, she has seen the union’s membership grow not just in numbers but also in diversity.

“At the time I first joined, there were not many Asian Americans who were caregivers in the union. But today it has changed, we have different cultural backgrounds and many different ethnicities,” she says. “It gives a great deal of energy to our movement. That all these different voices can contribute to the cause, to influence others. We’ve learned from each other. We’ve learned to work with each other.”

Finding creative ways to give care

Lynda Jackson

Watching one of the people she cares for show signs of dementia breaks Lynda Jackson’s heart just a little. The biggest struggle was dealing with the memory loss – they would argue over trivial things, like forgetting where a shirt went or that a question had already been asked and answered.

So Jackson enrolled in the Center for Caregiver Advancement’s training program focusing on caring for people with Alzheimer’s and dementia. For Jackson, the turning point of the training was the module on how each stage of the disease affects the brain. “To me, understanding the physical aspect of what’s happening in the brain … and learning and understanding the various phases that they go through … that for me was important,” she says.

Aside from covering the essential skills of caregiving, CCA’s IHSS+ Alzheimer’s training program in Alameda County introduces caregivers to the symptoms and stages of Alzheimer’s and dementia, which differ from the signs of aging. They learn strategies for responding to common behaviors associated with the disease, such as aggressive language and repetitive questioning, and ways to lessen agitation and anxiety. They learn to recognize wandering, sundowning and hallucinations.

Armed with a new understanding of the disease, Jackson also listened to her fellow caregivers share their experiences with their care recipient’s symptoms and the different ways they responded. The training helped her get more creative with how she provided care for 70-year-old Grace (name changed for privacy).

“The training program helped me get inventive on how to make their care better, making me more aware of their needs,” Jackson says.

When Grace started forgetting little things, Jackson encouraged Grace to write down her requests either on a tablet or a piece of paper. Now they rely on those notes, clearly written by Grace, to avoid arguments. They do crossword puzzles, read books, go for walks. Grace likes music from the 1970s, so Jackson will sometimes look up artists from that decade and play their songs from her phone. On good days, Grace sings along. On bad days, they will get in Jackson’s car and drive around Berkeley, wondering about each house’s history and the people who live there.

Since her IHSS+ Alzheimer’s training ended in December, Jackson says she wants to keep reading about the disease itself and learning more about the way the brain works. She encourages other caregivers to take the training. “The curriculum is good. It was encouraging and informative. Now I’ve got the knowledge that I can apply to my caregiving,” she says

Grace is like family and seeing her struggle “hurts my heart just a little,” Jackson says.

But her heart is full every day she walks in Grace’s door. “When I come in, she comes and hugs me first thing! I don’t even get to take off my coat. And I think, ‘that’s good, that’s good.’ And I want to hold on to that as long as I can.”

Persevering despite the pandemic

Juggling two jobs and school pays off for a nursing home worker

Starting a new career can be overwhelming for anybody, but doing it as a new nursing assistant in the middle of a pandemic presents its own challenges. For Martha Espinosa-Silva, trying to answer the questions from the people she takes care of are the toughest.

“They’re always asking, ‘When can I go out? Can my family come and see me?,’” she says. “They’re asking me these questions and I don’t really have an answer.”

Espinosa-Silva is a Restorative Nursing Assistant (RNA) at Centinela Skilled Nursing & Wellness Centre (West) in Inglewood, where she helps residents with rehabilitation and therapy so they can improve their quality of life.

The coronavirus has devastated nursing homes across the nation. In California alone, more than 154,400 cases and 12,998 deaths have been reported at facilities across the state.

“It’s very tough. We’re there (in the facility) regardless of whatever’s going on. And it’s a lot of things that you have to think about. You got to take care of yourself, your residents and the people around you. And we have families that we go home to, so you make sure that you’re taking the proper steps to take care of them, too. So it’s been tough, but it’s getting better,” she says.

Espinosa-Silva had been working as a kitchen aide before she enrolled last summer in the Certified Nursing Assistant (CNA) and RNA certification courses offered by the Center for Caregiver Advancement (through the Education Fund).

She initially was uncertain if Centinela’s’s staffing schedule would be able to accommodate the days she needed to attend classes. Also, she was already working two jobs, one full time and another part time stint at another facility.

But with support from her supervisor and her Education Fund coordinator, she started her training. For three months, she did not have a day off: She attended her classes on weekends, in between shifts at the two facilities where she worked.

“It was a little bit hard,” she admits about juggling work, her studies and her personal life. “But I was determined that I was going to do the program, that I was going to finish it.”

And she did. She passed her state certification exam and, in August 2020, started working as a CNA.

Receiving her license was a reward for all her hard work and she was ready for her new job. However, she didn’t expect a struggle on her first day: She was so overwhelmed she almost walked away. She was used to staying behind the scenes, prepping meals in the kitchen, and not being on the floor with the residents. But she persevered.

“Everywhere you go, there’s something that challenges you as a person and it’s going to make you grow in many ways,” she says.

She found the work of a nursing assistant so meaningful that a few months later she enrolled in the Fund’s Restorative Nursing Assistant (RNA) program to move one more step forward in her career path.

“The certification that I have now, it means a lot. It’s something that is pushing me forward to either being an LVN or speech therapist. I’m holding on to this dream, for my future because I want to stay in the medical field.”

Climate-disaster training for caregivers

Training caregivers to be first responders in climate-related disasters will play a critical role in protecting California’s seniors and people with disabilities and helping them recover and build resiliency. The Center for Caregiver Advancement (CCA) will address this need for specialized training, thanks to a grant from the California Workforce Development Board (CWDB).

CWDB recently announced that CCA, formerly the California Long-Term Care Education Center, is one of the recipients of its latest round of High Road Training Partnership (HRTP) grant awards. The grants, totaling $8.9 million, fund sector-based workforce development projects in several industries and areas that are critical to the state’s strategy for a just recovery from the COVID-19 pandemic and economic crisis while addressing climate change and community resilience. 

“The COVID-19 pandemic, on top of increasingly dangerous wildfires, extreme heat, and power shutoffs, has emphasized the essential role that caregivers play each and every day, taking care of our loved ones and providing critical services that many Californians can’t live without. This HRTP grant will give us the resources to prepare hundreds of in-home supportive services (IHSS) and nursing home workers to respond to health and climate related emergencies,” said Corinne Eldridge, CCA President and CEO.

CCA will receive a little more than $1 million for its Caregiver Resiliency Project, which will train 500 caregivers in the next two years on how to prepare for, respond to, and recover from adverse climate change impacts, most notably fires, power outages, extreme weather, and pandemics. By increasing the long-term care industry’s ability to plan for climate disasters on behalf of California’s most vulnerable communities, CCA’s project will positively impact the region’s climate resilience and contribute to reduced carbon emissions, transportation emissions, and water use. The project will train In-Home Supportive Services (IHSS) providers and nursing home workers, which may include CNAs and dietary, housekeeper and laundry staff.

“We are excited to support these partnership projects that are leading the nation in showing how workers, employers, and communities can and must work together to build an equitable, inclusive clean energy economy. We have an opportunity to advance quality jobs and accessible pathways for underserved communities,” said Dr. Angelo Farooq, CWDB Board Chair. “This productive infrastructure enables California’s high road employers to compete and flourish.”

This round of grant awards funds 11 innovative projects in transportation electrification, building decarbonization, offshore wind, tribal forest restoration, long-term care, and other industries. The projects are located throughout California in Los Angeles, the San Francisco Bay Area, Sacramento, San Luis Obispo, Kern County, rural communities in Fresno County, and the Greater Sierra Nevada region in rural Northern California. 

The selection of these projects reflects the state’s priorities in mitigating and adapting to climate change through technology and innovation as well as nature-based ecological solutions. They also highlight the importance of healthcare workers and caregivers in supporting community health and resilience, especially as climate-related threats and disasters increase and become more severe.  

ABOUT THE PROJECT

The Center for Caregiver Advancement’s Caregiver Resiliency Project is part of the California Workforce Development Board’s High Road Training Partnership, which is funded through California Climate Investments, a statewide initiative that puts billions of Cap-and-Trade dollars to work reducing greenhouse gas emissions, strengthening the economy, and improving public health, and the environment — particularly in disadvantaged communities.

www.cwdb.ca.gov

ABOUT CCA

The Center for Caregiver Advancement is the largest provider of training for long-term care workers in California. Our mission is to build the workforce of highly trained caregivers that many Californians can’t live without. Founded in 2000 by the long-term care workers who are now members of Service Employees International Union (SEIU) Local 2015, CCA provides quality educational opportunities to long-term care workers so they can build better lives for themselves and the consumers they serve. CCA serves two specific groups of workers: In-Home Supportive Services caregivers and nursing home workers in residential care and skilled nursing facilities.

www.ccaorg.wpengine.com

Training builds trust

IN HER OWN WORDS: Okesha Reese, IHSS provider

“(After training), I began to look at the consumer differently. Now if I’m helping them eat or use the bathroom, I try to be respectful and do everything in my power to preserve their dignity. The value of this is more than something you feel in your heart. It also builds trust and allows for better communication among the team… What I learned with CLTCEC training and on the job is to find ways to take initiative. I don’t show up at my shift like a robot and go through the same motions. I’ll ask my stepmother if there’s something she’d like to do differently today. Do more than what’s on paper, you might say. Like we’ll sit on the porch or go outside a few steps if she’s feeling up to it. It might not sound like much, getting some sun and fresh air. But you should see the light in her eyes.”

Sandra Owens-Taylor

Sandra is proof that it’s never too late to look for a new calling.

She was raised in Pomona, where her family had a successful garment business. Following in her father’s footsteps, Sandra worked as an executive in the garment industry for over thirty years before seeking out what she wanted next in life.

When Sandra retired, she began tutoring and giving in-home care. And what she found was so much more than a new calling. She found a way to help and uplift others while working as a caregiver— a way to spread joy. And a way to receive it as well.

“What I enjoy most is when I can see that it’s effective and that I’m making an impact on someone else’s life. I’m bringing joy. I’m bringing light. I’m supporting their independence.”

Sandra said the caregiver training she received from the Center for Caregiver Advancement had empowered her in her role. It not only helps her give better care but also better value herself and the generous work she does. 

“We really have to understand that we are important, number one, in the work that we do. And number two, we don’t know it all. We must stay abreast, and we must continue to educate ourselves. We can feel positive about what we’re doing because we know we’re doing it correctly,” she said.

This new path, and the caregiver training she has received, have brought new meaning and happiness to Sandra’s life. And those around her are taking notice.

“The joy that I carry is contagious. I’m active in my church as well. [They] have defined me as director of health and safety. So it definitely plunged me into a broader perspective, just even in my life, period.”

Lorena Sandoval

Lorena Sandoval was born in Mexico and grew up in Long Beach, California. She’s had to overcome a number of hurdles from an early age. At 16, she left home and was homeless before being taken in by a relative. At 18, she had her first child before welcoming another three along.

She worked in the kitchen in nursing homes and then worked as a housekeeper before taking the leap to become  the leap a Certified Nursing Assistant (CNA).

“I thought it’s now or never. It was really hard because I didn’t have much schooling, but I didn’t want to let my kids down, and I wasn’t going to let myself down.” Lorena said.

The Education Fund and Local SEIU 2015 representatives wouldn’t give up on Lorena either. They kept encouraging her to take the CNA training program and continue building her skill set as a caregiver.

“They kept telling us, ‘Don’t give up.’ It’s almost like it was personal to them that we reach our goals,” she said. “I’m so grateful.” Lorena learned not just how to become a CNA but to believe in herself again.

“Everything I learn, I hold on to it like the most precious thing I have,” Lorena said.

While building up her experience as a CNA, she challenged herself to keep learning. First, enrolling in the Restorative Nursing Assistant certification class, then taking advantage of the mental health and wellness workshops. Now, not only can she take better care of her patients, but she’s also able to take better care of herself.

“I love what I do with all my heart. I love working in nursing homes with the elderly. I love making them and my co-workers laugh,” she said.

Through the caregiver training she’s received from the Center for Caregiver Advancement and the Ed Fund, Lorena has built a better life for her family and proven to herself that she can achieve so much more than she imagined.

“As for dreams, I would love to do home health and become an LVN. I want to take advantage of life and what is given to me,” she said. “I want to prove to myself that I can do better.

Making Daily Life Easier

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.”

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