Unaffiliated workers are directly hired personal assistance workers who are not employed through an agency and are not family members or close friends. This article examines the working conditions of unaffiliated workers in a consumer-directed setting in comparison to agency workers and to other consumer-directed workers. Unaffiliated workers earned higher wages than their peers but were less satisfied with these wages and benefits than other directly hired workers. Findings for consumer-directed programs are discussed in terms of the recruitment and retention of unaffiliated workers, implications for consumers and workers, and future research recommendations.
© 2010 Springer Publishing Company Unafﬁliated workers are directly hired personal assistance workers, that is, workers who are not employed through an agency workers who are not employed through an agency and and are not family members or friends. Understanding the experi- are not family members or close friends. This article ences and needs of these workers can inform worker recruitment examines the working conditions of unafﬁliated workers and retention efforts and further expand the supply of direct care in a consumer-directed setting in comparison to agency workers in a consumer-directed setting. workers and to other consumer-directed workers. Unafﬁliated workers earned higher wages than their peers but were less satisﬁed with these wages and beneﬁts than INCREASING AGING POPULATION other directly hired workers. Findings for consumer-directed There are approximately 37.3 million Americans over age 65. programs are discussed in terms of the recruitment and This number is expected to reach 71.5 million (about 20% of retention of unafﬁliated workers, implications for the population) by 2030, when the youngest of the baby-boom consumers and workers, and future research generation reaches age 65 (U.S. Administration on Aging, recommendations. 2008). Elders are also expected to live longer, with an overall life expectancy of up to 87.5 years by 2050 (U.S. Census Bureau, Keywords: direct-care workers; recruitment; retention; consumer- 2008). Although estimates of disability trends vary, functional directed services disabilities and chronic conditions that will require long-term care resources are increasing (Parker & Thorslund, 2007 ), and the National Council on Disability (2004) estimates that that 68% of individuals will need assistance with two or more activi- ties of daily living at some point in their lives. Most consumers with disabilities wish to remain at home or within their com- Expanding the Consumer- munity ( National Council on Disability, 2004), and the services of paid and unpaid caregivers may help elders with disabilities avoid nursing home placement ( Foster, Dale, & Brown, 2007). Directed Workforce by However, the number of family caregivers available to provide services for home care for the elderly is decreasing ( Wolff & Attracting and Retaining Kasper, 2006). This decrease is due to a number of factors, including smaller family sizes, more “never-married” or child- Unafﬁliated Workers less consumers, dispersion of families, and more women working outside the home (Institute of Medicine, 2008). Not surprisingly, a signiﬁcant percentage of caregivers, 17% to 24%, are caring for a friend or neighbor as opposed to a family member (Family Lori Simon-Rusinowitz, MPH, PhD Caregiver Alliance, 2005). Dawn M. Loughlin, PhD Robert Chan, PhD SHORTAGE OF WORKERS Kevin J. Mahoney, PhD The National Council on Disability (2004) reports a widespread
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