Why Aren’t Caregivers Receiving Training?

CW: Death

Camran Hayes became a caregiver around five years ago and immediately discovered that the eight hours of job training his company supplied him was insufficient. At one point, he saw around a dozen people every week in and around Madison, Wisconsin driving 20 miles in the city and to outlying towns and accruing mileage in the process.

Sometimes he’d work with nurses, who utilized medical terminology in care plans for his clients. This baffled him. He’d seek advice from more experienced colleagues when he was afraid of making a mistake.

Mistakes in healthcare can be fatal. Marion Wilson, 64, died in 2019, after Fikirte T. Aseged accidentally gave her cleaning vinegar instead of colonoscopy prep medication. According to the investigation, Aseged thought the bottle of vinegar was the bottle of GoLYTELY solution when she and another caregiver woke Wilson at 3 a.m. to take the second half of her medication.

Wilson began having difficulty breathing the next morning at her colonoscopy appointment. She was brought to a local emergency room, where she died. An autopsy revealed that the cleaning-strength vinegar had irritated and destroyed the tissue in Wilson’s esophagus, stomach, and small bowel, resulting in her death.

The demand for caregivers is growing. The field is predicted to have approximately eight million job openings by 2026, propelled by the growing ranks of persons over the age of 65, who would number nearly 90 million in the United States by 2050. The majority of those people will choose to age at home and will require assistance from home care workers who are already in limited supply.

Although Hayes was not measuring vital signs or assisting with medical equipment, he was frequently placed in situations that required medical expertise and an understanding of not only how to deliver care, but also where to seek help.

When caregivers lack sufficient training, advocates warn, they are more likely to feel unsupported and make mistakes that might harm clients.

A few states have established training mandates, which advocates see as a first step in creating a uniform standard that would professionalize the workforce and create a system that could support future demand.

The typical personal care worker makes $10 an hour, works irregular and part-time hours, and relies on public benefits to remain financially secure, according to PHI.

Training requirements vary by state and depend on factors such as whether the aide works in assisted living or in private homes, what type of care is being provided and who is paying for that care.

According to KFF, Medicaid is the largest payer for long-term care services. Despite the fact that Medicaid is a state-federal collaboration, funding for home and community-based care is set at the state level.

More than a dozen states have training requirements. Personal care aides in New York and Washington must have 40 and 75 hours of training, respectively, and verification of particular skills to work in any Medicaid program or at an agency.

Meanwhile, Oregon has established a Home Care Commission, which offers training and certification options, as well as a public registry of enrolled caregivers. Personal care aide training is not required in seven states: Connecticut, Indiana, Nebraska, Kansas, Tennessee, Texas, and Vermont.

Caregivers allow disabled and elderly Americans to live their lives. More must be done to ensure that disabled people and the elderly receive the services and support they need.


Jenkins, Austin. “Judge Acquits Caregiver in 2019 Vinegar Death in Spokane.” KUOW, 8 July 2022, http://www.kuow.org/stories/judge-acquits-caregiver-in-2019-vinegar-death-in-spokane.

Rodriguez, Katie. “As Worker Shortages Loom, Some States Move to Train Paid Caregivers.” The Washington Post, 29 July 2023, http://www.washingtonpost.com/dc-md-va/2023/07/28/caregiving-workers-training-aging/.

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