The workforce crisis in elder care is no secret: Nursing homes care for a population that has more acute clinical needs than in the past, and nursing staff is overworked and stretched thin.

As such, often there is less time for staff to help their most frail and elderly residents with life’s most essential tasks: eating and drinking.

To combat the incidence of dehydration and weight loss in nursing homes, I introduced H2345 — nutrition; feeding assistants; training programs.

The bill, which passed both chambers and is now headed to the governor, will enable a new paid position to be created in nursing homes, within the parameters of federal guidelines: a nutrition and hydration assistant (NHA).

These assistants will ease the workloads of registered nurses, licensed practical nurses, and certified nursing assistants (CNAs) and work to reverse the morally unacceptable trend of residents not getting the help they need to eat well and drink adequately.

Indeed, according to the Alzheimer’s Association, 54 per cent of residents in long-term care settings have low food intake. Incidence of low fluid intake appeared in 51 per cent of residents.

The groundwork for the bill was a bipartisan initiative, launched by the Centers for Medicare and Medicaid Services (CMS) in Washington, to help facilities in every state address a chronic caregiver shortage. The bill authorizes the Arizona Department of Health Services to develop a program via the rule-making process.

The initiative has received overwhelmingly positive responses from the public, caregivers across the nation, and state and federal public policymakers. Similar programs have worked successfully for years in several states. A few facts about the program:

• NHAs must work under the supervision of a nurse

• Training programs must be at least 8 hours in length and meet minimum curriculum criteria set by CMS

• The NHA plan does not alter in any way the standard set by Congress and implemented via CMS regulations, that nursing facilities “must provide each resident with care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being”

• Patients for whom the NHAs may care cannot have “complicated feeding problems” such as difficulty swallowing, recurrent lung aspiration and tube or parenteral/IV feeding

• CMS received more than 6,000 public comments on the proposed plan, and around 99 per cent were supportive.

The bill was not without controversy. But opponents’ primary claim — that nutrition and hydration assistants will displace certified nursing assistants — is fallacious. There would be no need for this program if there were a sufficient number of certified nursing assistants in the first place. Nutrition and hydration assistants will supplement certified nutrition assistants, not supplant them. Moreover, it is difficult to fathom how a program designed specifically to relieve a staffing crisis would exacerbate it.

Opponents, such as the Southern Arizona Nurses Coalition, maintain that nursing homes should “employ people as feeding assistants who meet the 75-hour nurse aide training….requirements.” This disregard for a sensible division of labor and staffers’ wide variety of training is analogous to requiring House pages to have the training of the House clerk.

Nutrition and hydration are, needless to say, issues of life and death for our frail elderly. I am personally committed — the long-term care community is committed — to melding innovation, intelligence and vigilance in addressing this challenge. To that end, we will make every effort, and we will work with all parties, to ensure the success of this program and to maintain the safety and dignity of residents.

Arizonans “well stricken in years” deserve no less. That their final hours can be caregivers’ finest hour is my hope.

Mr. Stump, R-9, is vice chair of the House Health Committee and serves on the Interagency Council on Long Term Care. —