Top Reasons Home Health Aides Want to Quit

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Consistent patient assignment, job satisfaction, benefits, work hours and injuries are among the top factors that could decide whether a home health aide wants to leave their job, according to a study conducted by LeadingAge LTSS Center @ UMass Boston, formerly known as the LeadingAge Center for Applied Research. Social & Scientific Systems, a public health research firm, also helped conduct the study.

With the home health industry facing a caregiver shortage, understanding why workers want to quit—and why they stay—is crucial, according to Natasha Bryant, managing director and senior research associate at LeadingAge and one of the study authors. The study, which will be published in The Gerontologist in October, examined data from the 2007 National Home and Hospice Care Survey (NHHCS), a survey of Medicare- and Medicaid-certified home health and hospice agencies, and the National Home Health Aide Survey (NHHAS), a survey of workers employed by the agencies participating in the NHHCS.


Agencies will need to boost workplace satisfaction and reduce turnover in the years ahead or face worsening care quality and increased costs.

“If we’re seeing constantly new aides coming in, then that can have an impact on the type of care provided,” she explained. “You also have the cost to the agency, when they’re constantly turning over people that they have to train.”

What makes caregivers want to quit


—Inconsistent patient assignments. Aides with inconsistent patient assignments were more likely to say they intend to leave their job, the study found. This link between workers’ intent to leave a job and consistent assignments was previously seen in nursing home settings, but this study marks the first time such a link was found for in-home caregivers, according to Bryant.

—Part-time work. Caregivers who worked part time and wanted more hours were more likely to want to leave. Additionally, aides who worked part time and wanted fewer hours or who worked full time and wanted more hours were also less likely to want to quit their jobs.

—Workplace injuries. Researchers noted that 13% of caregivers said they experienced at least one injury in the last year, and injuries were among the top reasons caregivers intend to leave their job.

“Lifting or moving clients, that can create an injury,” Bryant said. “Home health workers have been seen as some of the top occupations for injuries.”

—Worker Characteristics. Home health workers who were African American, younger or worked for a chain-owned, for-profit agency were also more likely to want to quit, according to the study.

—Supervisors. A worker’s perception of their supervisors was not linked with an aide’s intent to quit, at least in this study. However, another study using the same dataset that measured whether workers felt “valued by the supervisor” found a significant relationship between the perception of the supervisor and intent to leave, Bryant noted.

What makes caregivers want to stay

—Wages. Surprisingly, no link was found between caregivers’ wages and their intent to quit, as there was little variation in pay offer to aides in the study. Workers intending to leave earned a higher median hourly wage ($11.25) than workers intending to stay ($10.52), suggesting that factors other than wages affect a worker’s decision to stay or leave.

Still, other studies have shown some connection between wages and intent to leave, Bryant cautioned.

—Job satisfaction. Caregivers with higher job satisfaction were less likely to quit, and home health workers who participated in formal training programs and felt valued or challenged had higher job satisfaction overall.

The office of the Assistant Secretary for Planning and Evaluation (ASPE), which is part of the U.S. Dept. of Health and Human Services (HHS), funded the study.

Written by Tim Regan

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