Research & Special Projects
Aging & Gerontology
Retention of Home Care Workers: Assessing the
Impact of Worker Age
Project Director: Sandra S. Butler, Principal Investigator
Funded by: National Institute on Aging
Project Summary
This project will serve as a training grant for students in health
sciences, specifically social work and nursing. Each year of the
three-year project, a new cadre of three students will be involved in
all stages of the research project and will participate in a research
seminar. The research focus of the project is to address the current
crisis in our long-term care (LTC) system, namely maintaining an
adequate number of workers to provide the daily care needed by millions
of our nation's elders. Direct care workers tend to work for very low
wages, often without benefits, and under difficult working conditions.
Not surprisingly, there are high turnover rates for these positions and
vacancies are not always filled quickly. This phenomenon can result in
compromised care for elders and increased direct costs for individual
agencies and indirect costs for taxpayers supporting government
programs. Factors predicting turnover among home care workers have been
less well explored than for paraprofessional workers in nursing
facilities. In particular, the impact of the age of the worker on the
job experience of home care workers—and thus their job tenure— has not
been examined. The Bureau of Labor Statistics (BLS) projected that in
the first decade of the twentieth-first century, 1.2 million additional
direct care workers would be needed to both cover projected growth in
LTC positions and replace departing workers. This increase in need is
accompanied by a decrease in the pool of individuals from which the
paraprofessional LTC workforce is generally drawn: women 25 to 55 years
of age. One solution to this crisis could be to encourage older workers
to enter and/or remain in the field. A more complete understanding of
the experience of older home care workers will have practical
significance in terms of recruitment strategies and intervention
practices designed to increase retention.
There are four specific aims of this project:
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To increase the research experience and skills of
students in social work and nursing and inspire them to pursue doctoral
studies in health sciences;
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To investigate the interrelationships of age,
employment factors (i.e., net income, client behaviors, and occupational
injuries) and job experience factors (i.e., job satisfaction, burnout,
and perceived empowerment) among personal care attendants (PCAs)/Personal
Support Specialists (PSSs) in home care;
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To examine the effects of age in conjunction with
employment factors and job experience factors in predicting length of
employment and job termination; and
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To gain understanding of how individual (including
age), sociocultural, and environmental factors influence job retention.
This project will be an 18-month longitudinal study
of PCAs/PSSs in several home care agencies in Maine. A mail survey of
PCAs/PSSs will gather data on multiple factors potentially related to
job tenure. A shorter survey will be sent to all participants either at
the time they leave the agency or, if still employed, at the end of the
study period. This second survey will be followed by a telephone
interview to collect data on the factors leading workers to stay with or
leave the agency. Statistical analysis will be used to examine the
direct and indirect effects of age, employment factors, and job
experience factors on predicting length of employment. Qualitative data
analysis techniques will be used to analyze the narrative data from the
telephone interviews. The study findings will have practical
implications in terms of recruitment and retention of home care workers,
particularly older workers. Moreover, this investigation will inform the
development and testing of an intervention geared to the needs of older
home care workers with the goal of extending their job tenure. In
addition to its primary goal of training students in health sciences
research, this study ultimately aims to contribute to a reduction in the
negative effects of worker turnover, such as compromised care of elders
and increased costs for agencies and government health care programs. It
also aims to increase the employment of older workers in the field of
home care, thereby promoting their psychological, physical, financial
and emotional well-being.
