Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-23T22:59:13.051Z Has data issue: false hasContentIssue false
  • English
  • Français

One-year predictors of turnover among personal-care workers for older adults living at home in Italy

Published online by Cambridge University Press:  21 December 2010

CLAUDIO BILOTTA ,
PAOLA NICOLINI  and
CARLO VERGANI
CLAUDIO BILOTTA*
Affiliation:
Geriatric Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
PAOLA NICOLINI
Affiliation:
Geriatric Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
CARLO VERGANI
Affiliation:
Geriatric Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
*
Address for correspondence: Claudio Bilotta, Department of Internal Medicine, Geriatric Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Pace 9, 20122, Milan, Italy. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper reports a study that aimed to identify the predictors of the turnover of privately-employed personal-care staff that provide community-dwelling older adults in Italy with assistance in the activities of daily living. The prospective cohort study enrolled 121 older adults (mean age 85.6 years) living at home, along with their personal-care workers and 107 informal carers. The older participants underwent a comprehensive geriatric assessment. At a one-year follow-up between May 2006 and June 2008, 12 of the older participants had been placed in a nursing home and 26 had died. Of the 83 still living at home, 22 had changed their personal-care staff (26.5% turnover). Multivariate logistic regression analysis identified one characteristic of the personal-care staff, living far away from their families (odds ratio (OR) 16.30, p=0.01), and two characteristics of the elders, namely being widowed (OR 0.09, p=0.01) and having cognitive impairment (OR 0.10, p=0.01), as one-year predictors of turnover and of the retention of personal-care workers, respectively. Further studies are needed both to evaluate whether immigration politics that enable family reconjunction would reduce the turnover of personal-care workers, and to investigate the lower turnover among personal-care staff caring for widowed elders and older adults with cognitive impairment.

Keywords

older adultsdisabilitieshome carepaid personal careworkforce turnoverItaly
Type
Articles
Information
Ageing & Society , Volume 31 , Issue 4 , May 2011 , pp. 611 - 624
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alemani, C. 2008. Il welfare invisibile. Il lavoro di cura con persone anziane [The invisible welfare state: caring for older people]. Pedagogika.it, 12, 1, 24–6.Google Scholar
Ayalon, L. 2009. Family and family-like interactions in households with round-the-clock paid foreign carers in Israel. Ageing & Society, 29, 5, 671–86.CrossRefGoogle Scholar
Bilotta, C., Bergamaschini, L., Arienti, R., Spreafico, S. and Vergani, C. 2010. Caregiver burden as a short-term predictor of weight loss in older outpatients suffering from mild to moderate Alzheimer's disease: a 3-months follow-up study. Aging and Mental Health, 14, 4, 481–8.CrossRefGoogle Scholar
Bilotta, C., Nicolini, P. and Vergani, C. 2009. Quality of private personal care for older people in Italy living at home with disabilities: risk of nursing home placement at a one year follow-up. Health and Social Care in the Community, 17, 6, 543–7.CrossRefGoogle Scholar
Bilotta, C. and Vergani, C. 2008. Quality of private personal care for elderly people with a disability living at home: correlates and potential outcomes. Health and Social Care in the Community, 16, 4, 354–62.CrossRefGoogle ScholarPubMed
Brannon, D. 2007. Job perceptions and intent to leave among direct care workers: evidence from the better jobs better care demonstrations. The Gerontologist, 47, 6, 820–9.CrossRefGoogle ScholarPubMed
Castle, N. G. and Engberg, J. 2005. Staff turnover and quality of care in nursing homes. Medical Care, 43, 6, 616–26.CrossRefGoogle ScholarPubMed
Chou, R. J. and Robert, S. A. 2008. Workplace support, role overload, and job satisfaction of direct care workers in assisted living facilities. Journal of Health and Social Behavior, 49, 2, 208–22.CrossRefGoogle Scholar
Cooper, C., Selwood, A., Blanchard, M., Walker, Z., Blizard, R. and Livingstone, G. 2009. Abuse of people with dementia by family carers: representative cross sectional survey. British Medical Journal, 338, b155.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. 1994. The Neuro Psychiatric Inventory: comprehensive assessment of psychopatology in dementia. Neurology, 44, 12, 2308–14.CrossRefGoogle Scholar
Dawson, S. L. and Surpin, R. 2000. The home health aide: scarce resource in a competitive marketplace. Care Management Journal, 2, 3, 226–31.Google Scholar
Degiuli, F. 2010. The burden of long-term care: how Italian family care-givers become employers. Ageing & Society, 30, 5, 755–77.CrossRefGoogle Scholar
Doyle, M. and Timonen, V. 2009. The different faces of care work: understanding the experiences of the multi-cultural care workforce. Ageing & Society, 29, 3, 337–50.CrossRefGoogle Scholar
Farina, P. 2005. Stranieri e anziani: un profilo sintetico della popolazione che si prende cura degli anziani in Lombardia [Foreigners and older people: a brief profile of the population caring for the elders in Lombardy]. I luoghi della cura, 1, 3, 19–23.Google Scholar
Fleming, G. and Taylor, B. J. 2007. Battle on the home care front: perceptions of home care workers of factors influencing staff retention in Northern Ireland. Health and Social Care in the Community, 15, 1, 67–76.Google ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. 1975. ‘Mini-mental state’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 3, 189–98.CrossRefGoogle Scholar
Hokenstad, A., Hart, A. Y., Gould, D. A., Halper, D. and Levine, C. 2006. Closing the home care case: home health aides' perspectives on family caregiving. Home Health Care Management and Practice, 18, 4, 306–14.CrossRefGoogle Scholar
Howes, C. 2008. Love, money, or flexibility: what motivates people to work in consumer-directed home care? The Gerontologist, 48, special issue 1, 46–60.CrossRefGoogle ScholarPubMed
Hussein, S., Stevens, M., Manthorpe, J., Rapaport, J., Martineau, S. and Harris, J. 2009. Banned from working in social care: a secondary analysis of staff characteristics and reasons for their referrals to the POVA list in England and Wales. Health and Social Care in the Community, 17, 7, 423–33.CrossRefGoogle Scholar
Italian Ministry of Labour and Social Policy (MLSP) 2010. Rapporto sulla non autosufficienza in Italia [Report on Disability in Italy]. MLSP, Rome, 44–6. Available online at http://www.lavoro.gov.it/Lavoro/Notizie/20100721_Rapporto_nonautosufficienza_2010.htm [Accessed 18 September 2010].Google Scholar
Jorgensen, D., Parsons, M., Gundersen, M., Weidenbohm, K., Parsons, J. and Jacobs, S. 2009. The providers' profile of the disability support workforce in New Zealand. Health and Social Care in the Community, 17, 4, 396–405.CrossRefGoogle ScholarPubMed
Katz, S., Downs, T. D., Cash, H. R. and Grotz, R. C. 1970. Progress in development of the index of ADL. The Gerontologist, 1, 1, 20–3.CrossRefGoogle Scholar
Kaye, S., Chapman, S., Newcomer, R. and Harrington, C. 2006. The personal assistance workforce: trends in supply and demand. Health Affairs, 25, 4, 1113–20.CrossRefGoogle ScholarPubMed
Kemper, P., Heier, B., Barry, T., Brannon, D., Angelelli, J., Vasey, J. and Anderson-Knott, M. 2008. What do direct care workers say would improve their jobs? Differences across settings. The Gerontologist, 48, special issue 1, 17–25.CrossRefGoogle ScholarPubMed
Konetzka, R. T., Stearns, S. C., Konrad, T. R., Magaziner, J. and Zimmerman, S. 2005. Personal care aide turnover in residential care settings: an assessment of ownership, economic, and enviromental. Journal of Applied Gerontology, 24, 2, 87–107.CrossRefGoogle Scholar
Lawton, M. P. and Brody, E. M. 1969. Assessment of older people; self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 3, 179–86.CrossRefGoogle ScholarPubMed
Litwin, H. and Attias-Donfut, C. 2009. The inter-relationship between formal and informal care: a study in France and Israel. Ageing & Society, 29, 1, 71–91.CrossRefGoogle ScholarPubMed
Mesini, D. 2006. Qualificare il lavoro privato di cura in Lombardia [To improve the quality of private care in Lombardy]. Prospettive Sociali e Sanitarie, 36, 1, 3–8.Google Scholar
Montgomery, R. J., Holley, L., Deichert, J. and Kosloski, K. 2005. A profile of home care workers from the 2000 census. The Gerontologist, 45, 5, 593–600.CrossRefGoogle ScholarPubMed
Novak, M. and Guest, C. 1989. Application of a multidimensional Caregiver Burden Inventory. The Gerontologist, 29, 6, 798–803.CrossRefGoogle ScholarPubMed
Parmelee, P. A., Thuras, P. D., Katz, I. R. and Lawton, M. P. 1995. Validation of the Cumulative Illness Rating Scale in a geriatric residential population. Journal of the American Geriatric Society, 43, 2, 130–7.CrossRefGoogle Scholar
Piercy, K. W. and Woolley, D. N. 1999. Negotiating worker–client relationships: a necessary step to providing quality home health care. Home Health Care Services Quarterly, 18, 1, 1–24.CrossRefGoogle ScholarPubMed
Robine, J. M., Michel, J. P. and Herrmann, F. R. 2007. Who will care for the oldest people in our ageing society? British Medical Journal, 334, 7593, 570–1.CrossRefGoogle ScholarPubMed
Ryan, T., Nolan, M., Enderby, P. and Reid, D. 2004. ‘Part of the family’: sources of job satisfaction amongst a group of community-based dementia care workers. Health and Social Care in the Community, 12, 2, 111–8.CrossRefGoogle ScholarPubMed
Seavey, D. (ed.)2004. The Cost of Frontline Turnover in Long-term Care. Better Jobs Better Care Practice and Policy Report, Institute for Aging Services, American Association of Homes and Services for the Aging, Washington DC.Google Scholar
Simoni, M. and Zucca, G. (eds)2007. Il ‘welfare’ fatto in casa. Indagine nazionale sui collaboratori domestici stranieri che lavorano a sostegno delle famiglie italiane [The Home-made Welfare State. A National Survey on Foreign Home-care Aides Working for Italian Families]. Istituto di Ricerche Educative e Formative, Rome. Available online athttp://www.irefricerche.it/news.interna.php?notizia=5 [Accessed 28 November 2009].Google Scholar
Stone, R. I. 2004. The direct care worker: the third rail of home care policy. Annual Reviews in Public Health, 25, 521–37.CrossRefGoogle ScholarPubMed
US Department of Health and Human Services. 2003. The Future Supply of Long-term Care Workers in Relation to the Aging Baby Boom Generation. Report to Congress, Department of Health and Human Services, Washington DC.Google Scholar
US Department of Labor. 2009. Personal and Home Care Aides. Occupational Outlook Handbook, 2008–09 edition, Department of Labor, Washington DC. Available online at http://www.bls.gov/oco/ocos173.htm [Accessed 4 April 2009].Google Scholar
Yamada, Y. 2002. Profile of home care aides, nursing home aides, and hospital aides: historical changes and data recommendations. The Gerontologist, 42, 2, 199–206.CrossRefGoogle ScholarPubMed
Zanfrei, L. 2008. La nostra idea di welfare contro il mercato nero. Il nodo badanti. Il ruolo dell'impresa sociale nell'assistenza a domicilio [The private welfare state or the black market? The paid personal aide issue: the role of social companies in the home care]. Vita, 15, 22, 40–1.Google Scholar