Promoting Sustainability in Frontline Home Care Aides: Understanding Factors Affecting Job Retention in the Home Care Workforce

Abstract

With the growth of the older adult population increasing at an exponential rate, caring for this population has become increasingly difficult. As many choose to age in place (i.e., in the home environment), both the public and private sectors are being forced to respond. The emergence of home health care and the employment of home care aides is one of the ways that the industry has evolved to meet this crisis. However, retention of home care aides has proven problematic. This study explores factors affecting home care aide retention in agencies that employ home care aides. A sample of 116 home care aides employed by three agencies was surveyed to identify retention issues relative to the home care aide. A hypothetical model of home care aid job retention was tested with a hierarchical regression analysis, where 11 variables were entered in five steps, using a time-sequenced order. The results indicated that the hypothetical model was able to explain 41% of the variance in months employed as home care aides, with age, education, wages earned, and intrinsic satisfaction as the most significant contributors to the model. Being able to predict retention of home care aides allows employing agencies to realign themselves to retain workers and improve quality of care. However, it is important to realize that the same traits that predict retention among home care aides may also leave these workers vulnerable to exploitation.

The evolving role of health care aides in the long-term care and home and community care sectors in Canada

“…Health Care Aides (HCAs) are of increasing importance to the delivery of care to older adults living in their own homes [1,2], and in nursing homes [3]. The term HCA is often used synonymously with Personal Support Worker (PSWs), along with other synonymous titles that are health care setting-dependent, including: home support workers, health care aide, hospital attendant, long-term care aide, nurse aide, nursing attendant, patient care aide, psychiatric aide, and resident care aide.…”

“…These are admirable efforts that underscore the importance to elder care of understanding this understudied workforce [13-15] about which we ‘know’ very little with respect to fairly basic information including the nature of their preparation, their work motivations, their attitudes toward their work, and their aspirations. Work retention, for example, is an acknowledged problem among these workers [1] that we do not yet know how to solve; there are differences in worker preparation and expectations [4,15] with unknown impacts on the quality of care delivered to older Canadians. A first step in developing informed human resources strategies, then, must be to endeavor to learn more about these workers.…”

Future Demand For Long-Term Care Workers Will Be Influenced By Demographic And Utilization Changes

“…7 Well-crafted training programs not only improve the job skills of direct care workers but also reduce occupational injury rates and job turnover. 43,44 Conclusion The Institute of Medicine has recommended increases in the minimum training hours for certified nursing assistants and home health aides and suggested that states create a framework of minimum training requirements for personal care aides. 4 Some states have achieved high levels of rigor and uniformity of training standards across their Medicaid-funded personal care programs to bring consistency to standards across programs and to ensure a basic level of preparedness among personal care aides.…”

When Task Conflict Becomes Personal

“…This combination of cognitive and physical demands is comparable to other work environments, such as nursing, and related research has shown team conflicts to be inevitable in such demanding environments (e.g., Almost, 2006). Other factors may further exacerbate team conflicts, such as budget cuts, low salaries and irregular work hours, all typical for the health care industry (Faul et al, 2010; Ouweneel, Taris, Van Zolingen, & Schreurs, 2009; Stacey, 2005). All things considered, the health care teams on which this study focuses make an appropriate sample for studying team conflicts.…”