Expanding the Consumer-Directed Workforce by Attracting and Retaining Unaffiliated Workers by ProQuest


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									© 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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