Exploring Barriers and Opportunities in Direct Care Careers
Choose your player
Roll the dice!
Instructions
Start
Tuition & Credentialing Barriers Moving up in the care field often means paying for training or new licenses that workers can’t afford. Some states don’t accept credentials earned elsewhere, so even experienced aides may have to start over when they move.
CNA → LPN → RN Pathway Many workers advance through formal education — earning nursing credentials that expand their responsibilities and pay. Each step from CNA to LPN to RN builds confidence, expertise, and long-term stability in the field.
Entrepreneurship Some seasoned caregivers take what they’ve learned and start their own home care agencies, cooperatives, or training programs. It’s a way to create better jobs and help others succeed while continuing to make an impact in their communities.
Low Wages & Benefits Cliffs Many direct care workers earn so little that even full-time hours keep them below a living wage. If they take on extra shifts or get a small raise, they can lose access to public benefits like Medicaid or childcare — a “benefits cliff” that discourages advancement.
Peer Mentor / Trainer Experienced aides can step into mentorship or training roles that recognize their skills and leadership. These positions let them grow professionally while supporting newer workers and improving the overall quality of care.
Burnout & Trauma Caring for others is demanding, and constant understaffing or crisis situations take an emotional toll. Many workers feel drained, unseen, or labeled as “low-skill,” which makes it hard to find the time or motivation to pursue growth.
Climb
Slide
INSTRUCTIONS
Move through your career journey! Each player starts as a Direct Care Worker. Roll the die and move your token along the board. If you land on a Climb, you’ve found an opportunity — move up! If you land on a Slide, you’ve hit a barrier — move down. Your goal: Reach the top and discover all six “climbs.”
If the player falls on the bottom of a climb, they move up to the top square where the ladder ends.
If the player lands on a square where the tail of a slide starts, they go down to a lower square where the headis located.
Slide
Climb
You’ve completed your journey!
Every “slide” represents a real barrier that direct care workers face — from low wages to limited career support. Every “climb” represents a real pathway forward — through mentorship, education, and entrepreneurship. Together, we can make more climbs possible and fewer slides inevitable. Learn more on ncoa.org
Direct Care Workforce Proof of Concept
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Created on October 24, 2025
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Transcript
Exploring Barriers and Opportunities in Direct Care Careers
Choose your player
Roll the dice!
Instructions
Start
Tuition & Credentialing Barriers Moving up in the care field often means paying for training or new licenses that workers can’t afford. Some states don’t accept credentials earned elsewhere, so even experienced aides may have to start over when they move.
CNA → LPN → RN Pathway Many workers advance through formal education — earning nursing credentials that expand their responsibilities and pay. Each step from CNA to LPN to RN builds confidence, expertise, and long-term stability in the field.
Entrepreneurship Some seasoned caregivers take what they’ve learned and start their own home care agencies, cooperatives, or training programs. It’s a way to create better jobs and help others succeed while continuing to make an impact in their communities.
Low Wages & Benefits Cliffs Many direct care workers earn so little that even full-time hours keep them below a living wage. If they take on extra shifts or get a small raise, they can lose access to public benefits like Medicaid or childcare — a “benefits cliff” that discourages advancement.
Peer Mentor / Trainer Experienced aides can step into mentorship or training roles that recognize their skills and leadership. These positions let them grow professionally while supporting newer workers and improving the overall quality of care.
Burnout & Trauma Caring for others is demanding, and constant understaffing or crisis situations take an emotional toll. Many workers feel drained, unseen, or labeled as “low-skill,” which makes it hard to find the time or motivation to pursue growth.
Climb
Slide
INSTRUCTIONS
Move through your career journey! Each player starts as a Direct Care Worker. Roll the die and move your token along the board. If you land on a Climb, you’ve found an opportunity — move up! If you land on a Slide, you’ve hit a barrier — move down. Your goal: Reach the top and discover all six “climbs.”
If the player falls on the bottom of a climb, they move up to the top square where the ladder ends.
If the player lands on a square where the tail of a slide starts, they go down to a lower square where the headis located.
Slide
Climb
You’ve completed your journey!
Every “slide” represents a real barrier that direct care workers face — from low wages to limited career support. Every “climb” represents a real pathway forward — through mentorship, education, and entrepreneurship. Together, we can make more climbs possible and fewer slides inevitable. Learn more on ncoa.org