A decade ago, a landmark Institute of Medicine report, Retooling for an Aging America: Building the Health Care Workforce (2008), underscored that the nation’s health care workforce was unprepared to meet the health and long-term care needs of the growing number of older adults. The report called for new initiatives to boost recruitment and retention of the paid care workforce – from geriatric specialists to health care aides. Findings recognized that more training at all levels was needed and that in order to attract and retain providers of high quality care, new workforce and payment models may be needed.

Older adults with Alzheimer’s disease and related dementias - numbering close to 4 million today and projected to exceed 6 million in the next 15 years (Brookmeyer et al., 2018) – constitute a disproportionate share of long-term care consumers. Although most dementia care is provided by family or unpaid caregivers, approximately 45 percent of older adults with dementia receive assistance with daily activities from a paid care worker either in the community, residential care, or nursing home setting (Kasper et al., 2015). People with dementia have unique care needs that change over the course of the disease, and the current long-term care workforce is underprepared for these care needs. In early phases, there may be changes in memory, judgment and emotional reactivity along with increased reliance on others to maintain functioning. As the disease progresses, the ability to drive, manage finances and keep track of medications may be lost. Eventually individuals lose the ability to bathe, dress, and eat without assistance and may not recognize care providers. Behaviors that make care more challenging, such as agitation, paranoia, wandering, and difficulty communicating or resisting care, are not uncommon, even early in the course of dementia. Given the growing numbers of older adults living with dementia, and recent changes in care setting and delivery models, preparing the long-term care workforce to address dementia care needs – referred to here as the “dementia care workforce” – is an important priority.

The goal of this half-day seminar is to review recent research on gaps in the dementia care workforce across various settings. Presenters have been asked to provide background in three broad areas: (1) current and future gaps in the paid dementia care workforce; (2) defining and understanding the implications of creating high quality jobs for direct care and other paid workers; and (3) dementia care workforce issues for at-risk populations (e.g., rural areas, those serving dually eligible for Medicaid or groups with low socioeconomic status, those transitioning from hospital to post-acute and home settings, and people with dementia for whom English is not their primary language). Discussion will focus on research and data needs.

This half-day seminar is part of the semi-annual meeting of the Committee of Population (CPOP), supported by the National Institute on Aging.