Dale Russakoff wrote an interesting article online at The New York Times blog called The New Old Age. He discusses how he chose a nursing home for his mother including talking to CNAs who provide the vast majority of care in nursing homes. "After all, these were the women — and they were all women — who would spend the most time with my mother, who would notice small changes that raised big questions, who would make her feel cared for. Or not." Most nursing homes would not allow him to talk to the CNAs.
High turnover rate is a major problem. More than 70 percent of nurses’ aides, or certified nursing assistants, change jobs in a given year. The reasons for the high turnover rate among nurses’ aides are the same as they were then: low wages ($10.48 an hour on average), poor benefits, high injury rates and lack of respect on the job. Researchers have found that high turnover in a facility corresponds with poor quality of care — more bedsores and more use of restraints, catheters and mood-altering drugs. That is, more reliance on medicine and technology, less on relationships.
“Cycling in aides who don’t know you is very disorienting and upsetting, and the resident is the one who suffers on the quality end,” said Peggy Powell, a senior staffer at PHI, formerly known as the Paraprofessional Healthcare Institute, a nonprofit group focused on improving the front-line work force in long-term care.
In nursing homes with high turnover rates, certified nursing assistants tend to leave within three months, often because of inadequate training and support to juggle multiple frail, ailing residents at a time, according to Robyn Stone, senior vice president for research at the American Association of Homes and Services for the Aging. Once aides leave, everyone else must pick up their caseloads, and the stress of the job rises.He decided on the facility where they allowed him to talk to the CNAs. "These women used the word “we” when talking about the nursing home, making clear that they felt a sense of ownership. And it seemed significant that the marketing director asked their permission before allowing me to impose on their break time. Moreover, he trusted them enough to leave me alone with them in the break room."