Surgeon General Vivek Murthy, MD, sounded an urgent alarm to the healthcare industry last spring as the COVID-19 pandemic was ebbing. Burnout, he said, had become a crisis among overworked, stressed-out healthcare workers. And that could exacerbate the direct caregiver crisis.
“We have a moral obligation to address the long-standing crisis of burnout, exhaustion and moral distress across the health community,” Murthy said at the time. “We owe health workers far more than our gratitude. We owe them an urgent debt of action.”
Burnout is defined as a state of emotional, physical and mental exhaustion caused by excessive and prolonged stress. A shortage of direct care workers contributed to caregiver burnout during the pandemic. Now, burnout threatens to make the caregiver shortage even worse. In a survey of 2,500 nurses earlier this year, more than one-third of respondents said they planned to leave their jobs by the end of 2022, citing burnout as a leading contributor.
That statistic comes as no surprise to Sheria Robinson-Lane, RN, PhD, assistant professor at the University of Michigan School of Nursing.
“When you are a professional caregiver, you are giving of yourself in order to support other individuals and you’re with people at the worst times of their lives and have to put your best face forward,” Robinson-Lane told McKnight’s Home Care Daily Pulse.
Burnout can manifest itself in a variety of ways and affect people differently. Some may feel depressed or worthless, while others may experience physical symptoms such as fatigue, headaches and insomnia.
Employee assistance
Home care providers can mitigate burnout among staff in a number of ways, according to Robinson-Lane. Employee assistance programs are a good start. Many programs offer mental health services that provide assessments and counseling to help workers address burnout. Agencies also should ensure that workers in the field have time to decompress between work assignments. That might include taking a walk or eating a snack between their patient visits.
Robinson-Lane said it is imperative that agencies create a culture of belonging. That is central to mitigating burnout, especially for home care workers who often feel disconnected from co-workers or managers because they rarely come into the office.
“One of the things that really good managers do is build in time for relationship-building into the week,” Robinson-Lane explained. “That might be having coffee or tea with the administrator and having them come in and having a little snack. They rotate in various staff to really get to know individuals and talk about their challenges and what their personal goals are.”
Enhanced training and career advancement are also ways of keeping burnout at bay by keeping direct care workers engaged and satisfied in their jobs.
Pandemic effect
Andrew Dubler, co-founder of Home to Stay Health Solutions in Cherry Hill, NJ, noticed burnout escalating among his 155 caregivers during the pandemic, especially among those who worked with the cognitively impaired. Those patients sometimes can be combative or exhibit unusual behaviors, adding stress to a caregiver’s day.
Home to Stay provides caregivers 12 hours of dementia training, but Dubler concedes caregivers can forget what they learned if they don’t regularly encounter certain problems. So Home to Stay developed a series of micro-lessons that can be sent to caregivers’ smartphones to reeducate them on ways to deal with various patient situations.
“What that did is it brought it back to them and it reinforced it with a quiz,” Dubler told McKnight’s Home Care Daily Pulse. “That micro-learning session might only be three to eight minutes, but it’s enough to kind of bring it back, reinforce and give them the confidence to go into the home and have a successful engagement.”
The sessions have been so successful with Home to Stay staff that Dubler and his partner will be licensing the tutorials to other home care firms in 2023 through an app.
Other home care agencies have creative solutions. Woburn, MA-based HouseWorks is mitigating burnout among its 1,000 caregivers in the Boston area by offering career advancement with the potential to earn more money.
“Someone can come in as a companion and then they can become a homemaker and a home health aide,” HouseWorks co-founder Andrea Cohen told McKnight’s Home Care Daily Pulse. “It’s a couple of dollars difference between each level.”
To help caregivers advance within the organization, HouseWorks recently applied for a $550,000 workforce training grant through the state of Massachusetts. The company hopes to use the funding to develop simulation programs that will help caregivers get certifications for healthcare jobs.
Signs of hope
Although the COVID-19 pandemic is now in its fourth year, there are signs it is beginning to ease its grip on the home care industry. Senior care solutions firm Activated Insights has been tracking burnout among home care workers throughout the pandemic. The firm’s burnout index increased 10% in the second half of 2021 compared to the same period in 2020. But in the second half of 2022, the index fell 14% compared to the previous year. The company attributed the drop partly to an improvement in staffing levels.
While that is encouraging, Activated Insights CEO Jacquelyn Kung told McKnight’s Home Care Daily Pulse it doesn’t signal a turning point in the home care industry’s most pressing problem.
“The larger issue of caregiver shortages remains,” Kung said. “We don’t have as many caregivers as we need for the aging population especially as the early tail of baby boomers age into their late 70s and more personal care needs arise.
Up Thursday: Hear a podcast with Sheria Robinson-Lane, RN, PhD, about how to identify who is at risk of burnout.
Editor’s note: In terms of labor problems, there has never been a time like today. In this series, McKnight’s Home Care is exploring the various facets of the workforce shortage, how home care is responding to it and the innovation that is propelling the field forward with new and sometimes unconventional solutions. Read all the installments this year.
