Training Incentives

The Issue

From opening doors and navigating elevators to taking showers and playing with the kids, there’s a lot we take for granted with healthy, fully functioning bodies. But for Americans with disabilities, the mental and physical demands of everyday life pose severe challenges. Across the U.S., nearly 26% of adults—61 million people—have disabilities that affect their day-to-day lives. Disabilities can impact individuals’ hearing, vision, mobility, cognition, and level of independence. Even with laws and policies protecting those with disabilities against discrimination, many still face prejudice, unemployment, and economic instability. 

They also face the high costs of medical bills and caregiving. Coupled with limited opportunities for gainful, consistent employment—only 33% of people living with disabilities are employed, compared with 75% of adults without disabilities—these costs place them at greater risk of falling into poverty. Today, half of Americans who live with disabilities have annual household incomes of less than $35,000, and a quarter live in poverty. 

Disability is also an issue of gender and race. Women are more likely to develop disabilities, and Black people are disproportionately burdened with both disabilities and poverty. Nearly 14% of working-age Black people have a disability, compared with 11% of whites and 8% of Latinos. Of those with disabilities, 40% of Black people live in poverty, compared with 24% of whites, 29% of Latinos, and 19% of Asians.

Whether paid at-home caregivers or family members and friends, people living with disabilities often rely on the assistance of others. The National Alliance for Caregiving reports that nearly 53 million Americans today provide unpaid care to someone with a disability, most of whom are relatives. In 2018, the Bureau of Labor Statistics reported that there were 3,253,000 paid in-home caregivers across the U.S. With Baby Boomers aging, and with older adults at a higher risk of developing a disability, the job market for caregivers is projected to grow by 36%. This means the demand for caregivers may soon exceed the supply—increasing the vulnerability and disadvantage of those with disabilities. 

Today, we need more caregivers. And we need more high-skilled caregivers who are better equipped to tackle the demands of the profession. The Bureau of Labor Statistics finds that the majority of home-health aids enter their jobs with only a high school diploma. Because those with disabilities often need specific medical treatments, the lack of training of home-health workers is concerning. Especially because a lack of skills may lead to repeat hospital visits, which bear high private and public costs. When home-health workers lack the skills and training they need to adequately care for their clients, those with disabilities are put at increased risk of injury, failing health, and poverty.

Training solutions that encourage the skills development of caretakers may be a cost-effective way to improve both the health outcomes of people with disabilities and the professional experience of caregivers. But we need to know more about how best to support caregivers and those they serve. Because for millions, they’re a lifeline out of poverty. And a step closer to independence. For many, they’re a face of hope.

The Intervention

To help avoid institutional care, Helping Restore Ability (HRA) provides in-home attendant care services to Texans living with disabilities. To improve the skills, confidence, and service of caregivers, HRA is launching a new online training program with two informative and interactive courses. The first teaches caregivers how to recognize and responsibly report signs of abuse, neglect, and vulnerability of their clients. The second course focuses on basic infection prevention and control.

Research Question

What is the best way to engage at-home caregivers in training designed to improve their clients’ health outcomes?

Research Study Design

Since its launch in 1977, Helping Restore Ability has remained true to its mission of enabling people with disabilities to lead full, independent lives. To best serve caregivers and their clients, HRA is committed to cost-effectiveness—good stewardship of their funding is a top priority. Today, 95% of the funding HRA receives goes directly to caregivers. But in addition to stewarding their funds, HRA believes that their ability to use their resources well hinges on a deeper understanding of their programs. 

To better engage caregivers and improve the opportunities of those living with disabilities, HRA needs to know what works. HRA’s Department of Research and Informatics has joined forces with LEO to do just that. Across the state of Texas, HRA supports 1,500 caregivers who dedicate their lives to selfless service. Here at LEO, we look forward to continuing our partnership with HRA and building evidence around what works to develop the skills and confidence of HRA caregivers. Our partnership is built on the belief that caregivers have the potential to make a difference in the lives of millions of Americans with disabilities who are ready to thrive.

Update: You can learn more about the research results from this study here.

(Photo Credit: Helping Restore Ability)

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