The Listening Sessions each used the same seven questions to frame the facilitated discussions at each Session, and note takers at each location recorded the Session discussions. For this Report, the notes taken during all of the Listening Sessions were compiled, and a content analysis was conducted to systematically identify key words and phrases used at each Session to determine important structures and themes. The results are based on ratings provided by three independent raters who identified and tallied themes discussed at each of the Listening Sessions.
The independent raters used a coding frame and a frequency for each topic was tallied for each Session. The researcher compiled the results from the independent raters and a comprehensive list of key topics discussed along with the frequency rating for each topic was tallied. A total frequency and percent of discussion associated with each key topic was determined for each of the seven major discussion questions that framed the Listening Sessions.
There were consistent themes that emerged across the urban, rural and suburban Session sites. These findings are presented in this section. The results are broken down by question and are as follows:
Question 1: Do you see a need for more education about aging for staff in your organization?
In response to the question about the need for more education about aging for staff within organizations, there were 13 topics discussed at the meetings. The overarching theme of "more training is needed" highlights the fact that at this time, there are no specific education requirements for jobs working with older adults. Some professionals may receive training, notably nurses, social workers, and therapists; however, paraprofessionals, such as home care aides, receive very little and only basic skills training. The only experience a person often has to show is that they have had prior work experience with older adults. The breakdown of the key points of the discussions is as follows:
Most of the discussion (50 percent) focused on the need for more/expanded training for aides, which needs to be provided at the level of their comprehension, and should include incorporating education about gerontology. Aides receive only the mandated basic training opportunities, whereas training opportunities are often afforded to nurses and social workers (although, this was described as too limited at least once). This limitation was identified multiple times at three sites (upstate and downstate). Discussion also focused on barriers to education (8.7 percent) and that job requirements do not stipulate the need for education/training in gerontology (13 percent), primary experience required for a job is simply having worked with the elderly (6.5 percent), and civil service requirements rarely require training (2 percent). Discussion focused on several additional issues that were brought up twice (each 4 percent): housekeepers and other facility staff would benefit from training, the need for minimum competencies, training for HIV/AIDS, and the usefulness of needs assessments. Finally, training in emergency preparedness was brought up once (2 percent).
TABLE 1.
| Need for more education about aging for staff in organizations working with older adults | ||
|---|---|---|
| More training needed for aides, which needs to be at the level of their comprehension | 9 | 19.6% |
| Job requirements do not stipulate need for training in gerontology | 6 | 13% |
| Gerontology needs to be incorporated into CNA training | 6 | 13% |
| Aides would benefit from expanded training | 5 | 10.9% |
| Barriers to education | 4 | 8.7% |
| Primary experience requirement is working with the elderly | 3 | 6.5% |
| Nurses and social workers have many training opportunities, but aides receive only the mandated basics | 3 | 6.5% |
| Housekeepers and other staff would benefit from training | 2 | 4.3% |
| Needs assessment | 2 | 4.3% |
| Need basic level education/minimum competencies | 2 | 4.3% |
| Training for HIV/AIDS | 2 | 4.3% |
| Civil service requirements rarely include need for training | 1 | 2.2% |
| Emergency preparedness | 1 | 2.2% |
| Total | 46 | 100% |
Question 2: On what topics would you like to see more education?
There were 33 topics recommended at the Listening Sessions about which more education was described as needed. The topics were quite varied, and at the same time, highlight the overwhelming need to provide education across the board to include aging studies, and to provide positive information on aging in educational settings. The most frequently discussed topics by Sessions participants for which they suggested more education was for positive aging and human development, and relatedly, to address ageism (12.5 percent), followed by the topic of disabilities and developmental disabilities (9 percent). The topics of elder abuse, caring for individuals with Alzheimer's Disease and other Dementias, cultural issues, and family, each accounted for 5.7 percent of the discussion. Next, legal issues and sensory deficits (4.5 percent) were followed by psychosocial and physiological changes, chronic illness, career mapping, long term care insurance, and communication issues, each at 3 percent. In descending order in the discussion were hoarding, gender issues, consumer-directed care, and wellness/leisure, loss/grieving, and ageism at 2 percent, and finally, topics discussed once, or about 1 percent were: acute care, self neglect, emergency preparedness, computer skills, palliative care, values and ethics, assessment skills, entitlements, Medicare, teamwork, stress management, caregivers, working with an older workforce, and independent living.
TABLE 2
| Aging-related topics about which Session participants would like to see more education | ||
|---|---|---|
| Positive information about aging, human development; address ageism | 11 | 12.5% |
| Disabilities and developmental disabilities and aging | 8 | 9.1% |
| Elder Abuse | 5 | 5.7% |
| Caring for individuals with Alzheimer's Disease and other Dementias | 5 | 5.7% |
| Cultural issues | 5 | 5.7% |
| Family | 5 | 5.7% |
| Legal Issues | 4 | 4.5% |
| Sensory Deficits | 4 | 4.5% |
| Psychosocial as well as physiological changes | 3 | 3.4% |
| Chronic illness | 3 | 3.4% |
| Career mapping | 3 | 3.4% |
| LTC insurance | 3 | 3.4% |
| Communication issues | 3 | 3.4% |
| Hoarding | 2 | 2.3% |
| Gender Issues | 2 | 2.3% |
| Consumer Directed Care | 2 | 2.3% |
| Wellness/Leisure | 2 | 2.3% |
| Loss/grieving | 2 | 2.3% |
| Ageism | 2 | 2.3% |
| Acute Care | 1 | 1.1% |
| Self-neglect | 1 | 1.1% |
| Emergency preparedness | 1 | 1.1% |
| Computer skills | 1 | 1.1% |
| Palliative Care | 1 | 1.1% |
| Values/Ethics | 1 | 1.1% |
| Assessment Skills | 1 | 1.1% |
| Entitlements | 1 | 1.1% |
| Medicare/health care providers | 1 | 1.1% |
| Teamwork | 1 | 1.1% |
| Stress Management | 1 | 1.1% |
| Caregivers | 1 | 1.1% |
| Working with an older workforce | 1 | 1.1% |
| Independent living | 1 | 1.1% |
| Total | 88 | 100% |
Question 3: How should training and educational opportunities be presented?
There were 18 topics recommended at the Listening Sessions. While the topics were varied, the most frequently discussed topic was the need for online training and education (24 percent) followed by work-site training/mentoring and face-to-face training at 17 percent. Next, classroom (10 percent) and incorporating all of them (8 percent) were followed by video conferences (5 per cent) and audio conferences (3 percent). Work study programs and booklets were brought up twice each (2 percent) and the following were each a focus of 1 percent of the discussion: in-service training, correspondence course, credit for life experience, college courses, intensive program training, community forums, mobile teams of educators, modular programs, and evening programs.
TABLE 3.
| How should training and educational opportunities be presented | ||
|---|---|---|
| Online(with good modules) | 21 | 24.1% |
| Work-site training and mentoring | 15 | 17.2% |
| Face-to-face training | 15 | 17.2% |
| Classroom | 9 | 10.3% |
| Incorporating all of them | 7 | 8.0% |
| Video conferences | 4 | 4.6% |
| Audio conferences | 3 | 3.4% |
| Work study programs | 2 | 2.3% |
| Booklets | 2 | 2.3% |
| In-service training | 1 | 1.1% |
| Correspondence course | 1 | 1.1% |
| Credit for life experience | 1 | 1.1% |
| College courses | 1 | 1.1% |
| Intensive program training | 1 | 1.1% |
| Community forums | 1 | 1.1% |
| Mobile teams of educators | 1 | 1.1% |
| Modular programs | 1 | 1.1% |
| Evening programs | 1 | 1.1% |
| Total | 87 | 100% |
Question 4: What credentialing and certification should be considered?
From this question, there were 14 topics discussed at the Listening Sessions. Most frequently discussed was the topic of "no incentives" (25.4 percent) are in place for credentialing or certification for selected disciplines where service is provided to older adults. This was followed by the thought that some staff would want to pursue a certificate, but some would be intimidated and that funding is limited, and many people cannot take time out of their working schedule to participate in such a program (14 percent). Approximately 10 percent of the discussion focused on the idea that people need to be certified, but there was still a question as to the incentives for staff to obtain a certificate/degree. Participants (5.6 percent) also raised each of the following issues: not everyone wants to further their education; a certificate is not always the answer; and more intergenerational gatherings are needed. Nearly 3 percent of the discussion focused on the question of whether selected workshops could be bundled for a certificate. And finally, discussion topics brought up once (about 1 percent) were: certificate programs "die on the vine," certificate programs are good, minimum competencies, and both training and Continuing Education Units (CEUs) are more important than certification.
TABLE 4.
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Question 5: Should gerontology be infused into college curricula? Across disciplines?
Question 5 led to five (5) topics that were raised at the Listening Sessions. Overwhelmingly, rather than focusing on infusing gerontology into college curricular or to include it across disciplines, most of the discussion focused on the idea that understanding about aging needs to start with young (grade school-age) children (71 percent). Following this, several topics were discussed once each (7 percent): bridge public health and aging, guidance counseling needs to provide information about aging services fields, gerontology is not a respected field, and gerontology should be added to college curriculum.
TABLE 5
| Should gerontology be infused into college curricula, and/or should it be infused across disciplines | ||
|---|---|---|
| Understanding aging needs to start with school children - it should be incorporated into grade school curriculum | 10 | 71.4% |
| Bridge public health and aging | 1 | 7.1% |
| Guidance counseling (provide information about aging services fields) | 1 | 7.1% |
| Gerontology is not a respected field | 1 | 7.1% |
| College curriculum (add gerontology) | 1 | 7.1% |
| Total | 14 | 100% |
Question 6: What is the ability of organizations to support education/training for employees?
There were 3 topics discussed at the Listening Sessions as part of the question about the ability of individual organizations to support education and training for employees. Discussion was focused as follows: the need for funding for advanced education (42 percent), payment for scholarships and pay increases (38 percent), and time off for education/training (21 percent).
TABLE 6.
| What is the ability of organizations to support education/training for employees? | ||
|---|---|---|
| Need the funding for advanced education | 10 | 41.7% |
| Payment for and scholarships/pay increases | 9 | 37.5% |
| Time off | 5 | 20.8% |
| Total | 24 | 100% |
Question 7: Other comments
At the end of each Session, participants were provided the opportunity to add any additional comments about this subject that they wished to raise. There were 12 additional comments raised at the Listening Sessions including: the disconnect between employers and academic institutions (17.5 percent); the separation between state government and providers, the need for federal/state/county incentives for training, and work force training fragmentation (12.5 percent each); the need for facilities to build training expenses into their budgets, the need to build career ladders to help paraprofessional aides work toward an LPN/RN degree, and the major shortage of workers in aging services (10 percent each). The next most cited concern was a lack of funding given to educate individuals working with older adults, even though there is a lot of funding given to those working with children (5 percent).
Each of the following topics held 2.5 percent of the discussion: Specific rules apply to long-term care insurance regarding paid caregivers, and thus, training requirements may need to be developed, there is a lack of geriatric curriculum in medical school, and there is a major nursing shortage. Finally, the role of the social worker in health care and social service organizations is diverse (i.e., they conduct hospital discharge planning, counseling, establish programs and services, determine eligibility for programs, provide education), which requires education and training in many areas.
Table 7
| Other Comments | ||
|---|---|---|
| There is a disconnect between employers and academic institutions | 7 | 17.5% |
| There is a disconnect between state government and providers | 5 | 12.5% |
| Federal/state/county incentives are needed for training | 5 | 12.5% |
| Work force training is very fragmented. There needs to be a comprehensive approach to aging education | 5 | 12.5% |
| Facilities need to build training expenses into their budgets | 4 | 10% |
| There is a need to build career ladders to help Aides work toward LPN/RN | 4 | 10% |
| Major shortage of workers in aging services | 4 | 10% |
| There is a lot of funding to educate individuals working with children, but not for individuals working with older adults | 2 | 5% |
| LTC insurance have specific rules regarding paid care givers - training requirements may be developed | 1 | 2.5% |
| Lack of geriatrics curriculum in medical school | 1 | 2.5% |
| Major nursing shortage | 1 | 2.5% |
| Diversity in social work roles | 1 | 2.5% |
| Total | 40 | 100% |
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