The Home Care Worker Retention Study: A Longitudinal, Mixed-Methods Inquiry

Abstract

As our population ages, there is increasing demand for personal care assistance at home. The personal care aide position is projected to be the fastest growing occupation in the United States between 2010 and 2020, despite its very low pay. Low compensation contributes to high turnover rates, which are costly to employers, society and elders needing care. This article reports on a thematic analysis of interviews with 252 home care aides-employed by agencies throughout a rural state-whose employment status was tracked for 18 months. "Leavers" (n = 88, 34.9%) were interviewed at the point of termination regarding reasons for job separation; "stayers" (n = 164), interviewed at the end of the study period, were asked what might cause them to leave their jobs. The issue of compensation was central to both groups, with low pay; insecure hours; and lack of health insurance, mileage reimbursement, and paid holidays and sick days emerging as themes in most (82.3%) of the interviews. While low pay and lack of health insurance were equally important reasons for terminating for both groups, insecure hours (p < .001) and lack of mileage reimbursement (p < .05) were of greater concern to "leavers" and lack of paid sick time (p < .05) and paid holidays (p < .1), for those who stayed. Themes are illustrated through quotes from study participants. Implications are explored within the context of improving job conditions and increasing retention of this critical component of the long-term care workforce.