
Improving dementia care: New training requirements under Colorado’s Senate Bill 22-079
As the number of older adults in the U.S. increases, so does the need for a workforce skilled in caring for those with age-related conditions, such as Alzheimer’s disease and related dementias. In response, Colorado’s Senate Bill 22-079 introduces enhanced training requirements for care providers in assisted living and nursing facilities. Since January 2024, staff at these facilities have been required to participate in this new training. Adult day centers began implementing their training earlier, as of July 1, 2023.
The bill highlights the growing demand for a skilled dementia care workforce, the need to reduce turnover in professional care settings, and the pivotal role direct care workers play in the health outcomes of those with dementia.
An increasing dementia population
According to the Alzheimer’s Association 2024 Facts and Figures Report, nearly 7 million people over age 65 are living with Alzheimer’s disease. Of those 85 and older, 33.4% have Alzheimer’s dementia. In Colorado, an estimated 90,800 residents who are 65 or older have Alzheimer’s.
In turn, the proportion of residents with dementia living in care communities, such as assisted living, memory care units and skilled nursing facilities, is rising dramatically. When SB22-079 was passed in 2022, nearly half of Colorado nursing facility residents and 42% of those in residential care facilities had dementia. These statistics served as key drivers for the bill, which aims to ensure that residents can receive specialized care tailored to their needs, primarily delivered by the direct care workforce.
The role of direct care workers
Direct care workers are pivotal in providing daily care for individuals living with dementia. As highlighted in the Alzheimer’s Association report, “direct care workers deliver the majority of day-to-day care to patients, clients or residents living with Alzheimer’s disease and other forms of dementia.”
These professionals include nursing aides, personal care aides, companions and others in the health care industry who assist older adults with personal care needs. In addition to helping with functional abilities and socialization, direct care workers offer emotional support and help alleviate distress among residents in care facilities.
Training topics under SB22-079
To address the growing need for specialized dementia care, the bill requires direct care workers to complete at least four hours of initial dementia training, followed by two hours of training every two years. Importantly, the training must be offered at no cost to employees.
Topics covered in the training include:
- Dementia diseases and related disabilities.
- Person-centered care.
- Care planning and activities of daily living.
- Dementia related behaviors and communication.
Staff turnover and burnout
By requiring care provider education, the bill aims to combat significant challenges in the dementia care workforce: staff burnout and high turnover rates. Advocates of SB22-079 believe that specialized training can better prepare direct care staff for the demands of their jobs, potentially reducing stress and preventing burnout.
Stress has long been recognized as the biggest contributor to staff burnout. Turnover in residential care settings is also a persistent problem, with rates ranging from 19% to 55% in assisted living and memory care communities. In skilled nursing facilities, turnover rates reach as high as 99%. These rates are often attributed to the demanding workload, low wages, and the emotional stress of caring for individuals with intensive needs.
A recent Cornell University study, published in the Journal of the Post Acute and Long-Term Care Medical Association, noted that turnover and staff shortages significantly contribute to job stress and reduced care quality in long-term care communities.
However, person-centered care approaches have been shown to improve interactions with residents, promoting well-being for both individuals with dementia and their caregivers. Direct care workers who spend more time and build connections with patients often experience less stress. By focusing on these care techniques, SB22-079 seeks to improve workforce retention and care quality.
The importance of Senate Bill 22-079
Increased workforce preparation for dementia care is essential as the aging population continues to grow. Senate Bill 22-079 is a significant step toward addressing the challenges faced by both care workers and individuals with dementia.
Coral Cosway, Senior Director of Public Policy at the Alzheimer’s Association of Colorado, a key sponsor of this bill, emphasizes the importance of this legislation.
“The Alzheimer’s Association actively supported SB22-079 to help improve the quality of care in settings where a large portion of the residents or program participants are living with Alzheimer’s and related dementias. We believe that begins with direct care staff who understand the unique needs of these vulnerable individuals.”
Senate Bill 22-079 was supported by several organizations, including:
- Alzheimer’s Association of Colorado – A key sponsor, advocating for better care and support for individuals with dementia and Alzheimer’s disease.
- LeadingAge Colorado – A non-profit organization representing senior living and care providers, supporting workforce development and care standards.
- Colorado Assisted Living Association – Representing assisted living facilities, helping to improve training and care for dementia patients.
- Colorado Health Care Association – Advocates for skilled nursing care providers who supported the bill to improve the competency of caregivers in dementia care.
These organizations worked together to ensure high-quality care and training for staff working with people living with dementia, aligning with the bill’s goal to enhance workforce well-being and improve care quality for residents.
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ABOUT THE AUTHOR
Reece Abbott is a junior studying sociology at Colorado State University.