While much has been said about the need for more health-care workers as the U.S. population ages, the greatest need for such workers isnt among the ranks of doctors and nurses. Rather, its for entry-level workers who provide basic health care, those in the industry say.


Less than 5 percent of senior citizens really need care outside of their home, says Polly McMahon, director of gerontology at Spokane Falls Community College. There is a huge demand for basic-level providers. Nearly every family is touched by the need to get a caregiver into their life.


Theres already big demand for such workers, who have skills in such areas as first aid and basic mental health and wellness, McMahon says. A prospective caregiver who passes an about 100-hour course and becomes what is known as a NAC, nursing assistant certified, will easily find a job, she says.


One hundred percent of NACs who want work get placed, McMahon says.


Pay for a NAC is low, about $8 to $9 an hour, and the work is hard, says Karen Burgerson, manager at Maplewood Gardens, a Spokane retirement center that provides part of the training necessary to become a NAC.


Retirement facilities and schools alike are taking steps to address the growing need for gerontology caregivers, but not enough is being done, says McMahon.


In the community, people are lined up to employ these front-line workers, but as far as training, we are in denial to meet their educational needs, she says.


Thats partly because of the sheer volume of the need.


Alice Dupler, assistant dean for advancement at the Washington State University Intercollegiate College of Nursing here, says 12.5 percent of the U.S. population is over the age of 65 now, but thats expected to jump to 20 percent by 2030.


Educational opportunities


Another elder-care job that requires at least some education is the certified caregiver. McMahon says the biggest difference between a certified caregiver and a NAC is in where the where is employed. While certified caregivers often work in assisted-living facilities and in independent-living situations where seniors live on their own, NACs usually work in nursing homes and hospitals and receive higher pay than certified caregivers, she says.


Other trained providers are licensed practical nurses, who can perform many nursing duties involving elderly care, but cant administer intravenous or chemotherapy, start blood work on a patient, or assume an administrative nursing role. Registered nurses can perform those additional duties.


SFCC offers the only gerontology degree in the Spokane area, a two-year gerontology paraprofessional degree, which is an Applied Associate of Science degree, says McMahon. It also offers a class to train certified caregivers, and refers some students to its sister school, Spokane Community College, which offers NAC training.


SCC offers NAC training for about 20 students each spring and fall. Students who take the course must pass a national exam to receive their NAC certification. Several retirement facilities here also offer NAC training or a part of the training.


McMahon says a federally funded program offered by SFCC trains disadvantaged individuals to become caregivers or, if they continue their training at SCC, NACs. Referred by caseworkers to attend the free program, those students are taught for five weeks at SFCC about personal life skills, including language if thats a barrier to employment, as well as basic health care for the elderly.


If they go no further in their studies, they can become a certified caregiver. If they choose to attend SCC for another five weeks of schooling, they can become a NAC, she says. The students in the program for disadvantaged individuals are taught separately at SCC from other NAC students.


Both certified caregiver classes and NAC classes generally include such skills as bathing the elderly, providing oral care, and transferring them such as from a bed to a chair, as well as learning the warning signs that would trigger a caregiver to call a nurse for help, says McMahon.


Says WSUs Dupler, Most of our students want to work with kids or pregnant moms, but regardless of what setting they end up in, or where they go, the majority of them will end up working with older adults.


Spokane Community College also has a nursing program. Carol Nelson, nursing program director at SCC, says nurses often are reluctant to pursue careers in elder care because the pay is significantly less than in other fields of nursing, and because there often is a heavier patient load than in elder care.


Education opportunities


Dupler says the WSU Intercollegiate College of Nursing doesnt offer a gerontology nursing degree, but is helping to meet the demand for additional elder-care workers by placing a greater emphasis on aging through integrating more special curriculum into our nursing program.


In addition to teaching some classes on aging, the college now is instituting outreach programs and giving specialty workshops to health-care professionals and older adults. The programs and workshops focus on both good and bad behaviors that impact the quality of aging.


About 65 students graduate from the SFCC gerontology program each year, and about 60 percent of those graduates continue their education for two more years at schools such as Whitworth College and Eastern Washington University, McMahon says. Some become nurses, she says.


Nelson says that SCC currently has 175 students in the first year of its nursing program. Students can become licensed practical nurses after four quarters of study, or registered nurses after seven quarters of study.


Much of a nursing students first quarter at SCC is spent working in a hands-on experience at one or more of the Spokane areas long-term care facilities, she says. Many nursing students who remain through the seventh quarter spend much of that final quarter working in extended-care facilities to learn an RNs role in that environment, Nelson says.


Washington State University at Spokane doesnt offer a gerontology degree at its campus at the Riverpoint Higher Education Park here, but addresses such educational needs through another venue, says Bettie Rundlett, program manager of the schools Area Health Education Center here. That center just finished offering a 10-week, statewide telehealth gerontology health course, aired from Deaconess Medical Center, for physicians, nurses, health administrators, NACs, and other elder health-care staff, she says.


McMahon says, Getting a nurses aide certificate can either be a steppingstone to becoming a nurse, or a vocation unto itself.


Nelson says many first-year nursing students help fill the local demand for NACs by taking the National Nurse Aide Assessment Program Exam, passing it, then working in a NAC position in a hospital or retirement home here while attending school.


Maplewoods Burgerson says the state mandates that every caregiver be trained in such areas as dementia care, mental illness, human immunodeficiency virus (HIV), and developmental disabilities. Employees who arent certified in those areas must become so within a certain period after theyre hired.


Sandy Davidson, administrator at Brighton Court, an assisted-living facility in Spokane Valley, says the market for entry-level workers is very tight in elder care.


In many cases, they can go to McDonalds or Burger King and get about the same amount of pay with a lot less responsibility or the need for additional training, he says.


He asserts, however, that the rewards in caring for the elderly are greater than from flipping a burger.


Contact Rocky Wilson at (509) 344-1264 or via e-mail at rockyw@spokanejournal.com.