The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Retooling for an Aging America: Building the Health Care Workforce
TABLE 5-2 Characteristics of Direct-Care Workers, 1999
Nursing Home Aides
Gender (% female)
Average age (years)
White, non-Hispanic (%)
Hispanic or Latino (%)
U.S., native-born (%)
Marital status (% married)
Education—less than high school (%)
Year-round, full-time employment (%)
Part-year, part-time employment (%)
SOURCE: Montgomery et al., 2005.
A recent study found notable differences between female direct-care workers and the female workforce overall (Table 5-3) (Smith and Baughman, 2007). Black women, for example, make up a disproportionately large percentage of the female direct-care workforce relative to their presence in the female workforce overall (29 percent versus 13 percent). A second difference is that female direct-care workers are more likely to be single mothers than are female workers in general (24 percent versus 14 percent); of those who are single parents, 35 percent to 40 percent are below the poverty line (GAO, 2001b).
EDUCATION AND TRAINING REQUIREMENTS
The education and training of the direct-care workforce is insufficient to prepare these workers to provide quality care to older adults. Although there are a number of state and federal requirements for the education and training of nurse aides, home health aides, and personal- and home-care aides, these requirements are minimal (Table 5-4). Many direct-care workers have no more than a high school education, and some have even less (Montgomery et al., 2005; Smith and Baugham, 2007). Minimum training requirements for these workers are often inadequate or non-existent, and they vary across occupational categories and settings of care as well as among states. A number of other training-program characteristics vary among states as well, including the specific qualifications that instructors are expected to have, maximum student/instructor ratios, and the required program approval and oversight processes (AARP, 2006).