Cape Cod's population is aging, at the same time the region has fewer and fewer working professionals to take care of the elderly. That shortage has been a factor in a number of nursing homes closing on the Cape and South Coast earlier this year.
A large part of the nursing home workforce is made up of Certified Nursing Assistants – also known as CNAs. Often paid minimum wage, these workers are the first line of caretakers for the elderly.
At the Cape Cod Nursing Home in Buzzards Bay, Claire Jevnik was taking part in a training program for certified nursing assistants. On this day, she was assisting a resident to get dressed. Jevnik was one of a cohort of 9 or so trainees who were learning how to do a job that’s in high demand on the Cape, but one that not many people want to do.
As a CNA, she'll help nursing home patients do things their own family members may not want to help with – like changing clothes, bathing, and feeding.
"That's what I thought I was going to be the most uncomfortable with, just getting in somebody's personal space," Jevnik said. "You're so used to doing it by yourself. Having to do it for somebody else is very odd."
Heather Meier, the training coordinator for the program at Cape Cod Nursing Home, said nursing assistants are critical members of the staff, especially for the residents.
"Many times, we are the only people they see in a day," Meier said. "We're their pseudo-grandchildren. We help them get through their day and make their day an enjoyable one."
A typical nursing assistant position pays minimum wage, currently $12 an hour for Massachusetts. Nursing homes say this is because of low MassHealth and Medicare reimbursement rates. In an expensive place like the Cape, the wage makes it especially difficult to retain employees.
"Honestly, you can't drive by a facility without seeing a 'CNAs needed' placard out front," Meier said.
The Cape isn't the only place in the state that's experiencing a shortage in these critical workers, but it is one of the hardest hit areas.
"Across the Commonwealth, we are facing severe shortages of certified nursing assistants working in nursing facilities," said Tara Gregorio, head of the Massachusetts Senior Care Association, an industry group that represents nursing homes across the state. "But it's particularly severe in Barnstable County, Cape Cod."
According to Gregorio, Barnstable County has the highest rate of vacant CNA positions in the state, with about 200 vacant positions at any given time, or just over a 20% vacancy rate.
"The demographic of younger people who can fill these positions is declining on Cape Cod, so we really need to be creative," Gregorio said.
That creative approach means recruiting nursing assistants with free in-house training programs that offer a job afterward, like the program at the Cape Cod Nursing Home.
Bill Bogdanovich, the director of Broad Reach Health nursing homes in Chatham, said that especially on the Cape, openings for nursing assistants are often in direct competition with better paying seasonal jobs.
"The availability of seasonal jobs where pay can be quite an enticement makes it harder here than in other parts of the state," Bogdanovich said. "In addition, housing is probably the single biggest differentiator."
Broad Reach, like Cape Cod Nursing Home, runs its own in-house training program. But it's been taking things a step further. Bogdanovich has been recruiting candidates from Puerto Rico to supplement the workforce, and Broad Reach also has about 20 affordable housing units it offers to nursing assistants.
Every little bit helps to attract candidates. But in the end, the job is still tough.
Kevin Lima was another nursing assistant in training at Cape Cod Nursing Home. He said at first he was nervous, but he’s been getting the hang of it. He was in his final day of training today.
"The hardest part for me, I would say, is showering," Lima said. "Because some residents could get aggressive. Some residents think they could take their own showers, so they will just refuse me."
But he said he’s ready to get started, and that he loves taking care of people.
"I just have a lot of energy and I can do it," he said.
Lima is a senior this year at Dennis Yarmouth high school. He plans to pick up evening shifts from 3 to 11 at night, after school.
This is part one of a two-part series looking at Certified Nursing Assistants on Cape Cod, and how this workforce shortage impacts the region. Part two is here.