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Crisis averted: Learning to act in an emergency

When Tracy Mills Jones arrived at her brother’s house, the floor was covered in blood. A caregiver for over 30 years, Tracy had dealt with many emergencies but this was one of the gravest. Her brother, who was hemorrhaging from a diabetes-related complication, was nearly unconscious. Although the situation was frightening, Tracy didn’t panic. Because of the free In-Home Supportive Services (IHSS) training she had received from the Center for Caregiver Advancement (CCA), she knew what to do.

After attempting to stop the bleeding by applying pressure, she determined that the wound would need a tourniquet to avoid fatal blood loss. “I learned that the body has 14 pints of blood,” Tracy says. “My brother had lost 7.”

When the paramedics arrived, they were surprised to see Tracy’s skillful application of first aid. Not many people know how to deal with a hemorrhaging artery. “Who taught you to do that?,” asked one of the paramedics. Tracy replied proudly, “I took a caregiving class. They taught me how to deal with emergency situations. Every home care provider should take this class.” The paramedic was quick to agree.

Through her CCA training, Tracy learned about first aid, body mechanics, infection control, nutrition, medication adherence, and much more. One of the modules that became a critical source of information on that fateful day focused on knowing which situations necessitated a trip to the urgent care or the emergency room. “I learned so many different things,” Tracy says. “Because of this training, I was able to save my brother’s life.”

Unlike other healthcare workers, IHSS providers and family caregivers do not get formal training. The Center for Caregiver Advancement is working to change that. CCA and SEIU Local 2015 proposed and advocated for state legislation that would build career pathways for in-home caregivers through training. In October, Gov. Newsom signed SB 172, which includes over $200 million for the IHSS Career Pathways Program to incentivize, support, and fund training opportunities for career advancement in the home care and health care industries. Under this program, training is voluntary and offered at no cost to IHSS providers. Participants will be compensated for each hour of their coursework and they will be eligible for incentive payments after successfully completing certain milestones.

Although there are currently no federal or state training requirements for in-home caregivers, the impact on client outcomes is clear. To date, CCA has trained over 16,000 caregivers in California: this has helped reduce emergency visits by 42% and hospitalizations by 60% among in-home care recipients, according to an analysis conducted by L.A. Care, the nation’s largest publicly operated health plan serving more than 2 million members in California and funder of one of CCAs programs.

Tracy wishes she had received training earlier in her caregiving career. Her first experience in the field was caring for her mother. Looking back, she realizes how unprepared she was for the task. With no knowledge of caregiving and no resources to help her, Tracy did the best she could, but some of the mistakes she made are still impacting her. “I have back problems now,” says Tracy, who was lifting her mother without knowing proper body mechanics. “I wish I had learned how to lift properly back then.”

Because of CCA’s training, which emphasizes dignity, respect and safety for both the caregiver and the person receiving care,Tracy now has the knowledge and resources she needs to practice her profession without sacrificing her wellbeing. “If you’re taking care of people, you should be mandated to take [IHSS training],” she says.

CCA’s classes also provided a venue for Tracy to meet her peers. There are few opportunities for caregivers to share information about their profession and learn from each other. Meeting her peers in this training environment proved very impactful for Tracy. From them, she was able to share her struggles and learn strategies—such as recording doctors’ visits to better help her clients understand medical instructions they are given—that have improved her caregiving.

As part of the training, caregivers learn how to perform CPR and receive an American Red Cross CPR/AED certification. Because of how common heart attacks are, Tracy recognizes that CPR is important for her to learn, both for her clients’ safety and her family’s. Of the 356,000 out-of-hospital cardiac arrests that occur in the U.S. each year, 75% happen at home. CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival. Though Tracy hopes she will never again encounter an emergency situation like the one she faced with her brother, she knows that with the training she has received she can face a crisis with confidence.

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