How client death impacts home care aides’ workforce outcomes: an exploratory analysis of return to work and job retention

ABSTRACT

Home health aides face a range of stressors that may result in departing the workforce. One stressor that has emerged in multiple qualitative studies as potentially influencing retention is client death. Using 2019 data from a single agency in New York City employing approximately 1700 aides, we used logistic and linear regression to explore case and aide factors associated with workforce outcomes after client death. We found that longer case length (Beta = 0.01, p < .001) was associated with longer return to work for aides experiencing client death and longer job tenure (Beta = −0.002, p = .002) was associated with shorter return to work (n = 67). We found no difference in retention between aides who experienced client death and those who did not (n  216). This analysis suggests the importance of research on the period of time following client death and of offering support to aides after clients die, particularly after longer cases.

KEYWORDS:

• Caregiving: Work Issues
• Community and home care
• Long-term care: staff roles/turnover/staffing pattern

Acknowledgments

The authors would like to acknowledge the work of Martha Montufar in helping to construct the dataset on which this analysis was based. We are also deeply grateful to the mentors who are part of the broader project of which this was a part: Kathrin Boerner, Paul Landsbergis, and Jennifer Zelnick, and to Marita LaMonica who coordinates the project.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Note that two additional aides in our sample experienced two deaths each, and the dataset included six client deaths where aides’ employee IDs and demographic information were missing. We removed these from our sample since multiple client death experiences by a single aide could be correlated, thus requiring a different analytic approach.

2. Note that the “other” category for race-ethnicity was dropped from all subsequent analyses because of small sample size.

3. Note that we know 80 to be an undercount of aides experiencing client death, given that we removed from the dataset aides whose demographic data were missing.

Additional information

Funding

This work was supported by the National Institute for Occupational Safety and Health/Centers for Disease Control and Prevention under Grant K01OH011645. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control and Prevention.