scholarly journals The Benefit of Autonomy and Control: A Positive Characteristic of the Home Health Aide Position

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 244-244
Author(s):  
Hayley Gleason ◽  
Edward Miller

Abstract Home Health Aides’ (HHAs) are one of the fastest growing workforces in the country, yet the industry struggles to recruit new aides into the field and retain current workers. This study explored HHAs’ experiences with the level of autonomy and control granted to them within their day-to-day work. Findings from six focus groups with 37 HHAs showed that many aides select home care because of the control and independence the positions offer. Interacting one-on-one with clients and being able to self-structure their daily tasks were major benefits that drew HHAs to the field. Additionally, the HHAs highlighted the control they have over their schedule and the flexibility the position offers to enable them to accommodate other responsibilities, like childcare or other jobs. Being able to decline a client because of travel distance, the hours required, or not feeling that it is a “good fit” was also a welcomed aspect of the position. Despite complaints about the job, such as low pay, lack of benefits, and limited support, many of the HHAs admitted staying on in their positions because of the flexibility, autonomy, and control provided. Findings highlight the value that HHAs place on autonomy and control and the potential benefit that these job qualities have for promoting greater recruitment and retention of the home care workforce. Amplifying opportunities for these aspects of the job may thus entice new individuals to pursue a career as an HHA, as well as help to maintain those individuals currently in the position.

2006 ◽  
Vol 18 (4) ◽  
pp. 306-314 ◽  
Author(s):  
Alene Hokenstad ◽  
Andrea Y. Hart ◽  
David A. Gould ◽  
Deborah Halper ◽  
Carol Levine

2020 ◽  
Author(s):  
Sunniva Grønoset Grasmo ◽  
Ingeborg Frostad Liaset ◽  
Skender Elez Redzovic

Abstract Objective: The need for home care services is rapidly growing due to an increasing elderly population, earlier discharge from hospital and clients’ preference of being treated at home. While this need increases, there is high sickness absence among home health aides, and research show that home health aides have one of the highest probabilities of being granted a disability pension. A high prevalence of musculoskeletal disorders has been reported in occupations with physically demanding work, and this aspect is a major health problem among home health aides. Studies have shown that home health aides find their work stressful, physically demanding and exhausting. The objectives of this study were to summarise peer-reviewed literature on how home health aides experience their occupational health and conduct an ethnographic meta-synthesis with the aim of identifying and describing key concepts across studies. Methods: A qualitative ethnographic meta-synthesis was used to develop new insights into home health aides’ occupational experiences. By using this method, we directed attention to the interpretation of studies, development of concepts and expansion and specification of theories that concern these concepts. The first author conducted searches in the electronic databases CINAHL, MEDLINE and PsycINFO. Results: This meta-synthesis includes 27 articles. The review of these sources identified four key concepts as important to gain an understanding of occupational health among home health aides: exposure to physical demands , physical environmental factors , organisational conditions of employment and psychosocial working environment . Conclusion: The findings in this synthesis are consistent with previous research showing that occupational health among home health aides is a complex phenomenon. Specifically, physical, psychosocial and psychological exposure aspects have potential negative and positive effects on home health aides’ occupational health. In order to increase employee’s well-being, create a healthier workplace that provides well-functioning and high-quality home care services and cope with future health challenges, more investigations into the organisation of home care are needed.


2021 ◽  
pp. 102-123
Author(s):  
Richard Schweid

This chapter addresses how Cooperative Home Care Associates (CHCA), since its inception in 1985, had offered benefits to all its home health aides (HHAs), whether members of the cooperative or not. However, a persistent complaint from class graduates after they went to work for CHCA was that they were sent to assignments without being given any details in advance of what to expect. In addition, scheduling was uncertain, and cases could be haphazard. Clients, too, had their complaints about CHCA. Generally, though, CHCA's clients were grateful for their aides, and the aides were satisfied enough with the job that better than half of each class would still be working for Cooperative after a year. Many of them would eventually be offered a job in CHCA's office, and others would continue as aides for decades.


2021 ◽  
pp. 6-27
Author(s):  
Richard Schweid

This chapter discusses the training and working conditions of home health aides (HHAs). The largest home care agency franchisers employ tens of thousands of HHAs. Home care is a lucrative business, and part of that profitability is based on keeping wages as low as legally possible. Because the job is hard and the salary is minimum wage, the workers are usually women of color, or white women with a limited education, who do not have a wide choice of jobs and are trying to survive on the low end of the income-inequality gap. Many aides are African Americans, and many others are first-generation immigrants or their daughters. Indeed, the home care industry in both urban and rural settings depends on immigrant labor. The chapter then looks at the experiences of HHAs from Cooperative Home Care Associates, a home health care agency located in the South Bronx, which provided home health aides to elderly and disabled Medicaid recipients.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 218-219
Author(s):  
Kimberly Judon ◽  
Eve Gottesman ◽  
Tessa Runels ◽  
Nicholas Koufacos ◽  
Emily Franzosa

Abstract Home health aides are essential members of the home care team, but often report limited communication with agency supervisors. To explore the impact of COVID-19 on these dynamics, we conducted semi-structured interviews with providers (n=9), contracted home health agencies (n=6), and aides caring for veterans (n=8) at an urban Veterans Affairs medical center. Data were analyzed through thematic analysis. Agencies relied on aides to observe and report on patients’ conditions, including COVID-19 symptoms, but aides were not always aware of follow-up and wanted more information about their patients’ health and COVID-19 status. Agencies also reported providing personal protective equipment (PPE) and infection prevention guidance to aides; however, some aides reported purchasing their own PPE and seeking out private COVID-19 testing. Supporting aides by providing needed training and protective resources, and engaging them more collaboratively in medical care, may help improve job satisfaction and quality of care.


2019 ◽  
Vol 32 (2) ◽  
pp. 105-109
Author(s):  
William Cabin

There has been a 75% decline in home health aide visits between 2000 and 2016, the only Medicare home health nonskilled service. A literature review indicates no studies addressing reasons for the decrease. This study summarizes interviews of nine executives from three for-profit chain-owned Medicare-certified home health agencies. Results indicate agreement on three themes: Medicare home health uses a medical model, focusing on intermittent skilled care; the Medicare home health prospective payment system exacerbated the focus on skilled care by rewarding higher reimbursement for skilled care–based episodes; and a “less is better” synergy has evolved regarding utilization of home health aide services and reimbursement. Policymakers are urged to use the forthcoming Medicare home health Patient-Driven Groupings Model Reform and recent Medicare Advantage changes covering nonmedical services to encourage greater utilization of home health aides and other nonmedical services addressing patient and caregiver social needs affecting care.


2017 ◽  
Vol 29 (3) ◽  
pp. 191-198 ◽  
Author(s):  
David Russell ◽  
Ana Mola ◽  
Nicole Onorato ◽  
Sheniqua Johnson ◽  
Jessica Williams ◽  
...  

This article highlights findings from a mixed-method evaluation of two pilot programs that utilized Home Health Aides (HHAs) as health coaches for home care patients with chronic illness, including (1) a dedicated health coaching program for patients with heart failure and (2) an integrated program for HHAs working with chronically ill patients. Interviews were conducted with HHAs and staff to understand their experiences implementing program activities. Data from clinical assessments and surveys were employed to examine the characteristics and outcomes of patients. HHAs viewed health coaching positively and described it as an informative process that is dependent on patient motivation and willingness to change. Patients in both programs reported improvement in self-care maintenance. Patients in the chronic illness program also reported improved quality-of-life.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 217-218
Author(s):  
Emily Franzosa ◽  
Robyn Stone

Abstract Paid caregivers (e.g., home health aides, personal care attendants, and other direct care workers) who care for functionally impaired older adults in the home frequently report that while rewarding, their work is logistically, physically, and emotionally demanding. Unlike direct care workers in institutional settings, paid caregivers work with care recipients one-on-one in private settings and often have limited contact with or support from their employers. These factors contribute to high workforce turnover and may impact the quality of patient care. In this symposium, we explore ways that home care agency policies and practices influence the experience of giving and receiving care in the home. First, Bryant et al. describe the range of agency-based models and the impact of workplace design in creating supportive working environments. Next, Fabius et al. explore characteristics of direct care agencies across Maryland, with implications for worker training and support. Reckrey et al. describe the differing perceptions of aides, caregivers and providers around the role agencies play in defining paid caregivers’ roles, and how this may lead to conflict within the caregiving team. Finally, in the context of COVID-19, Franzosa et al. examine communication and coordination between Veterans Affairs-paid agencies and home health aides during the pandemic, while Tsui et al. present a case study of an agency’s efforts to support paid caregivers through group support calls. Together, these studies highlight challenges in the structure, organization and perceptions of home care agencies, and identify potential avenues for agencies to support paid caregivers and their clients.


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