Working in long-term care settings for older people with dementia: nurses' aides

This paper reports a study exploring the reasons for continuing to work among nurse aides who cared for older people with dementia in long-term care settings in Taiwan.

High nurse aide turnover has been a major problem for many managers of long-tem care facilities in Taiwan. Most studies on nurse aide turnover have focused on the factors on why they left, but little is known about their reasons for continuing to work in long-term care settings in Taiwan.

A qualitative research design was used. Sixteen nurse aides were interviewed individually using a semi-structured interview guide and content analysis was used to identify the major themes in the data.

Five major themes emerged from interview data: monetary needs, relationships with residents, working environment, training opportunities and gratification (listed in order of frequency of occurrence).

Nurse aides face challenges in caring for the increased number of older people with cognitive impairment and it is important to assess their perspectives towards their work in the changing environment. The findings suggest that it is essential for nursing managers to assess nurse aides' needs to increase job retention and to improve the quality of resident care in long-term care settings.

Careful appraisal of prospective nurse aides' attitudes, regular training programmes in dementia care, adequate staffing and equipment, performance-based pay rises and subsidized training are practical retention strategies for these nurse aides.