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As the American demographic ages, the nation confronts a dilemma in its long-term care system — a deficit of certified nursing assistants.

A recent research from the University of Georgia College of Public Health indicates that a deficiency of resources and upward mobility opportunities may be worsening the issue.

CNAs constitute approximately one-third of all personnel in nursing homes. Yet, they deliver nearly 90% of direct care, encompassing assistance with eating, bathing, and mobility as well as offering companionship and monitoring for symptoms of illness.

“I believe that most individuals are unaware of the daily responsibilities of a CNA, and how frequently they are truly the primary support for nursing home residents,” stated Curt Harris, co-author of the research and director of the UGA College of Public Health’s Institute for Disaster Management.

Moreover, the count of CNAs is diminishing.

The shortage of manpower is not a recent issue, the researchers noted. However, it was exacerbated by the COVID-19 pandemic, during which nursing homes lost over 220,000 employees, many of whom were CNAs. This resulted in a decline in care quality for residents, increased stress for the remaining workforce, and a growing cycle of burnout and turnover.

“The crisis continues to perpetuate itself and expand indefinitely,” commented Austin Dobbs, co-author of the study and emergency preparedness manager in the Institute for Disaster Management. “A change is imperative. It cannot persist in its current state as the system cannot endure.”

Lack of awareness and financial impediments also contribute to CNA deficit

The research pinpointed issues in remuneration, recruitment, and retention as pivotal elements in the deficit.

Providing direct care can impose a physical and emotional burden, Harris stated, and CNAs frequently lack access to mental health support.

“The volume of care they deliver and the emotional toll they carry home leads to notable turnover,” Harris remarked.

Obstacles to training, a general unawareness of the profession, financial limitations, and the accessibility of certification examinations all contribute to a lower retention rate of CNAs.

Furthermore, this situation doesn’t resolve once a CNA joins the workforce.

Insufficient opportunities for career advancement, alongside unprofessional treatment from peers and residents, hinder retention in this sector, as indicated by the study.

Advocacy and enhanced training access are crucial for resolving the CNA shortage

According to the researchers, advocating for CNAs and other staff within long-term care facilities is essential. Promoting improved access to training, establishing pathways for career developments, and endorsing initiatives aimed at increasing wages and funding support are a few suggested actions, Dobbs stated.

Additional potential solutions encompass enhancing grant-funded efforts such as the Georgia CNA Career Pathway Initiative, which tackled initial barriers to entering the workforce. This initiative also led to the CNA Virtual Skills Evaluation program, designed to assist CNAs in overcoming testing challenges. As a result of this initiative, over 6,000 Georgia CNAs completed their skills evaluations online, increasing accessibility to the profession.

“You don’t require a degree to be an advocate. You just need to care.” —Curt Harris, College of Public Health

“What is preventing disaster from occurring is the remarkable individuals currently working in the field: from CNAs on the ground, students training to become CNAs, to those instructing them in training programs across Georgia and beyond in the United States,” Dobbs explained. “They are the true heroes in this narrative. However, they require support. Be an advocate for those who provide care to your family members.”

“You don’t need a degree to be an advocate,” Harris noted. “You just need to care.”

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