Where Have All The Home Care Workers Gone?
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Because of the on-going need to co-ordinate care and ensure its
continuity, issues of retention and recruitment are of major concern to
home care agencies. The purpose of this study was to examine the
factors affecting turnover decisions among visiting home care workers.
In 1996, 620 visiting nurses and personal support workers from three
non-profit agencies in a mid-sized Ontario city participated in a survey
on their work and health. By the fall of 2001, 320 of these respondents
had left the agencies. Analysis of the turnover data showed a temporal
association between the implementation of managed competition and
We mailed a self-completion questionnaire asking about
their reasons for leaving the agency and about their subsequent work
experience. One hundred and sixty nine (53%) responded to this
survey. Respondents indicated dissatisfaction with the implementation
of managed competition, with pay, hours of work, lack of
organizational support and work load as well as health reasons,
including work-related stress, as reasons for leaving. Less than
one-third remained employed in the home care field, one-third worked
in other health care workplaces and one-third were no longer working
in health care.
Their responses to our 1996 survey were used to predict
turnover. Results show that nurses were more likely to leave if they had
unpredictable hours of work, if they worked shifts or weekends and had
higher levels of education. They were more likely to stay with the
agency if they reported working with difficult clients, had predictable
hours, good benefits, had children under 12 years of age in the home,
and were younger. Personal support workers were more likely to leave
if they reported higher symptoms of stress, and had difficult clients.
They were more likely to stay if they worked weekends and perceived
their benefits to be good.