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IN HER OWN WORDS:

“After caregiver training, I began to look at my consumer and the issue of trust 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 care team… What I learned with CCA caregiver training and on the job is to find ways to take initiative and build trust. I don’t show up at my shift like a robot and go through the same motions. I’ll ask my stepmother (my consumer) if there’s something she’d like to do differently today. Do more than what’s on the schedule, 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.” — Okesha Reese, IHSS provider

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 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.

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, quiet 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 CNA training and other health classes offered by the SEIU 2015 Education Fund. Sergio and Emerita have completed classes and received certifications in 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 as CNAs 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 to be better CNAs 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 CNAs 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 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 and a better life for two 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 through CCA. 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 the Center for Caregiver Advancement (CCA)’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 related 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 CCA’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 translate to better care for older adult IHSS consumers.

 CCA’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 CCA’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 aimed at providing better care.

“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 and qualified to provide better care. They cited greater skill and confidence in 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.

CCA’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 CCA and Alameda Alliance for Health. 

 CCA 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 CCA, formerly 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.”