America's Direct Care Workforce Needs Better Training.
As the baby boomers age, the need for high quality senior care will continue to grow. While more than half of adults over 65 will need some type of long term care services in their lifetimes, nearly 90% of seniors want to age in place. That older adults would want to remain in their homes makes complete sense, but what happens when their homes do not necessarily fit as they once did? This can lead to challenges as physical, emotional, and cognitive changes associated with normal aging begin to emerge.
Our collective goal, then, should be not only to provide the necessary assistance for aging in place, but also to enable older adults to “thrive in motion” — as AARP’s Chief Medical Officer, Dr. Charlotte Yeh, has often described — regardless of setting or place.
More than two million home care workers across the United States serve a critical role in providing personal assistance and health care support to older adults in home- and community-based settings. This workforce — comprised of home health aides, personal aides and nursing assistants — helps mitigate some of the challenges associated with normal aging by assisting adults with daily tasks from eating to personal hygiene to medication adherence.
The home care workforce has doubled over the past ten years and is projected to add more jobs than any other single occupation over the next decade. Despite the significant growth in demand for home care workers, the pool of likely applicants will be considerably smaller over the same period.
Given the demanding nature of their work, both mentally and physically, and the important roles they can play in preventing common causes of injury in the home setting, the need for high quality, readily-available training for this workforce cannot be overstated.
To be productive, home care workers must receive high-quality education and training on the skills needed to mitigate some of the challenges associated with normal aging. For example, home care workers need training on how to keep seniors safe from falls. This includes known methods and tips for fall-proofing the home, as well as safe techniques for lifting and protected walking. Home care workers also need training on the effects of mood swings and depression on well-being, diet and exercise. These workers need to understand the memory-related changes associated with normal aging and how to identify the signs of sundowning. Critically, home care workers need to know how to address the less common, but potentially dangerous situations that can arise when a senior is confused, frustrated, or on the verge of acting out.
Not only does high-quality education and training for home care workers provide them with the tools that they need to be effective and satisfied in their job, this also increases satisfaction and reduces stress in seniors. Dissatisfaction and stress in seniors reduces the likelihood of successful aging in place and the senior’s survival rate.
Unfortunately, the quality of education and training for home care workers is highly variable. Education and training usually involve reading text or perhaps watching videos. Text and video predominantly engage the cognitive learning systems in the brain that are highly susceptible to forgetting and rely on working memory and attention that are limited resources. Supervised practical training is much better because it involves experiential learning, which is more effective than learning by reading text or watching videos. Experiential learning engages multiple learning and memory systems in the brain (e.g., sensory, behavioral, emotional and cognitive) in synchrony leading to multiple, highly contextualized, interconnected memory traces. Unfortunately, supervised practical training is resource intensive and is not scalable.
This is where virtual reality (VR) solutions shine. VR trains through experience, but is not time or labor-intensive. VR provides home care workers with a first-person immersive experience. When combined with interactive storytelling the lines between real and virtual immersive experience blur to the point that the learner has a sense of “presence” and feel like they have “landed” somewhere else. VR experiences can be repeated thus reducing the problem of forgetting. VR is also scalable and provides the same consistent, high-quality education and training to all home care workers. Finally, VR offers a number of seamless data analytics and reporting tools. Not only can completion rates be stored, but subjective survey, and objective test questions can be administered within the VR headset to provide immediate insights on home care workers confidence and satisfaction, as well as their knowledge of the trained material.
Imagine training home care workers with VR by transporting them into multiple common yet challenging situations. In one case, they might be transported into the home of a senior and can shadow a skilled home care worker interacting with a depressed patient while providing useful tips and demonstrating useful tricks for improving their mood. The trainee might then be transported into the home of a senior that was just “fall proofed”. The senior can provide a tour of their home highlighting the changes and safety features. Finally, they might be transported into a confrontational situation where they can observe a skilled home care worker deescalate the situation while describing to the trainee the methods that they are using.
VR is especially useful for training empathy in home care workers by allowing them to “walk a mile in a senior’s shoes”. Imagine a VR experience in which the home care worker is transported into the body of a senior who is experiencing the disorientation and frustration associated with poor memory functioning, visual impairments, or sundowning. Imagine having the trainee experience first-hand the senior’s frustration when a worker states that they will “only be a minute”, but don’t return for ten to twenty minutes, or a situation in which the senior is speaking but is receiving no response. “Walking a mile in someone else’s shoes” engages emotional learning centers in the brain that quickly and effectively build empathy. This will enhance communication and understanding that are critical in senior care. These advantages are unique to VR and these skills are critical to high-quality in-home health care.
Seniors overwhelmingly want to age in place. This has its challenges, but those challenges can be met by a highly trained home care workforce who can enable older adults to “thrive in motion.” We finally have access to a technology that can at once connect and prepare these two groups for the road ahead, together. Virtual reality provides high-quality education and training that these workers need in a cost effective and scalable manner — one experience at a time.