One of the causes of the ongoing scandals of elder abuse in nursing homes and assisted living facilities has not had a great deal of discussion – but it is very much part of the problem.

It is quite understandable that nursing home workers are often vilified, as these workers are often (though not always) the perpetrators. However, because these cases receive so much attention in the media, it is too easy to forget that most nursing home workers are well-trained, competent, and caring.

They are also struggling. Case in point – Nicole Jefferson, a certified nursing assistant. In a recent guest column she wrote for the Hartford Courant, she stated:

It’s hard, tough demanding work, but I love my job. I genuinely love taking care of people. . . . I have been a nursing home worker for three years and I make only $12.35 per hour. I spend all day taking care of other people’s family members and, at the end of the day, I can’t even provide for my own.

She points out that most nursing home employees wind up on public assistance – much like many employees of big-box stores and fast food chains.  Although nobody who works a full-time job should have to live in poverty, there is a difference: caregivers such as Ms. Jefferson must have training and education beyond high school. Even at a two-year community college, this comes at a cost, and usually involves incurring student loan debt.

Given that these people work such long hours, doing such difficult work for so little, it should not be surprising that elder care facilities have difficulty attracting competent, high-quality employees. As a result, it should come as no surprise that many nursing homes hire whomever they can get – and screening is often spotty, if done at all. Although forty-three states require background checks for prospective employees (there is no federal statute governing this), the Office of Inspector General of the federal Department of Health and Human Services found that over 90% had at least one employee with a prior criminal record. Forty-four percent of these were for property crimes, such as theft (disappearance of personal items and unexplained depletion of funds are a common problem at nursing homes). Sixteen percent were drug-related, while just over 13% involved crimes against persons, such as rape and assault.

Would higher wages and better working conditions make a difference?  Ms. Jefferson, who is among the nursing home employees currently lobbying the state of Connecticut for higher pay, seems to think so. She says: “a budget is a moral document…an expression of what a society values and thinks is important.”

Matt Schultz, an elder abuse attorney with Levin Papantonio, said: “society needs to place much more value on the health and well-being of our elders. We must be willing to pay to protect the mothers, fathers and grandparents who raised us, and make certain they receive the best care from workers who aren’t distracted by how they will pay next month’s bills and feed their own families.”

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K.J. McElrath is a former history and social studies teacher who has long maintained a keen interest in legal and social issues.