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Career ladders and lattices can provide career advancement and specialization for senior living and care employees. But aging services thought leaders admit more work needs to be done to integrate programs into provider organizations.

Experts from LeadingAge, PHI and the LTSS Center @UMass Boston were part of a panel discussion Wednesday on the importance of formal advancement opportunities for direct care workers.

Career ladders help workers pursue careers in other fields or categories, whereas lattices deepen expertise within an existing role, said session moderator and LeadingAge Director of Workforce Strategy and Development Jenna Kellerman.

“We need a mix of near-term and long-term solutions to build out recruitment and retention of staff in the field,” Kellerman said. Career ladders and lattices are an important way to address existing and forthcoming workforce shortages, she added. “We need to be strategic and systematic and clear in helping staff progress in their careers in a meaningful way.”

PHI Senior Director of Policy Research Kezia Scales shared examples of career lattice programs — senior aides, peer mentors, condition specialists, transition specialists and trainers — that can be implemented at the employer level without going against scope of practice regulations.

In terms of career ladders, Scales said practices that build skills, augment job responsibilities and increase worker compensation improve retention in the long term. Just this week, PHI released a guide on steps to implementing a care integration senior aide, focused on elevating trained home care aides. She also shared information on a care connections senior aide program to provide coaching and support for home care workers and family caregivers.

Alternative job paths possible

In many cases, the only professional development available to direct care workers is in nursing, said Natasha Bryant, senior director of workforce research and development for the LTSS Center @UMass Boston. She advocated for finding alternatives to clinical pathways for workers to develop skill sets in other roles.

Schedulers, social workers, service coordinators, activity specialists and behavioral health specialists are examples of job opportunities that can build on the skills of the direct care workforce and keep them within the industry.

“It allows for a career endpoint for those who don’t want to pursue a four-year nursing degree,” Bryant pointed out.

Peer mentoring endorsed

Scales said peer mentor programs have proven one of the best interventions for reducing turnover within long-term care. 

“Peer mentors play a role in interrupting the cycle of turnover that frequently repeats within the first 90 days of hire, providing support and validation for new hires from their first moment on the job when they might otherwise feel overwhelmed, uncertain, unseen and unsupported,” Scales said.

Peer mentorship programs also strengthen organizational culture, reinforcing a provider’s commitment to the needs and wellbeing of the workforce, she said.

Programs face implementation barriers

The challenge to implementing many of these programs, the panelists agreed, is funding. 

Bryant said that most career lattice programs are grant-funded pilot programs. Although those programs provide supportive data on addressing workforce recruitment and retention, she said many aren’t continued once the funding runs out.

“One thing is how do we get beyond just a grant-funded program and integrate these into provider organizations,” Bryant said, adding that rigorous evaluation of the impact on direct care workforce, care quality and cost is needed.

Scales said innovation is happening across the field, but it is impossible to quantify, and most programs operate under the radar. 

“I agree we need to foster innovation and measure it, capture the impacts and build continuously — innovation by innovation — the evidence base that supports replication and scalability of these roles,” Scales said.