Key issues in human resource planning for home support workers in Canada

Janice M. Keefea,b,c,?, Lucy Knightd, Anne Martin-Matthewse and Jacques Le?gare?f aDepartment of Family Studies and Gerontology and Nova Scotia Centre on Aging, Mount Saint Vincent University, Halifax, Nova Scotia, Canada bMount Saint Vincent University, Halifax, Nova Scotia, Canada cNova Scotia Centre on Aging, Mount Saint Vincent University, Halifax, Nova Scotia, Canada dMaritime Data Centre for Aging Research and Policy Analysis, Mount Saint Vincent University, Halifax, Nova Scotia, Canada eDepartment of Sociology, University of British Columbia, Vancouver, BC, Canada fDe?partement de de?mographie, Universite? de Montre?al, Montreal, QC, Canada

Received 7 December 2009

Accepted 22 February 2010

Abstract. Objective: This paper is a synthesis of research on recruitment and retention challenges for home support workers (HSWs) in Canada. Participants: Home support workers (HSWs) provide needed support with personal care and daily activities to older persons living in the community. Methods: Literature (peer reviewed, government, and non-government documents) published in the past decade was collected from systematic data base searches between January and September 2009, and yielded over 100 references relevant to home care human resources for older Canadians. Results: Four key human resource issues affectingHSWswere identified: compensation, education and training, quality assurance, and working conditions. To increase the workforce and retain skilled employees, employers can tailor their marketing strategies to specific groups, make improvements in work environment, and learn about what workers value and what attracts them to home support work. Conclusions: Understanding these HR issues for HSWs will improve recruitment and retention strategies for this workforce by helping agencies to target their limited resources. Given the projected increase in demand for these workers, preparations need to begin now and consider long-term strategies involving multiple policy areas, such as health and social care, employment, education, and immigration.

Keywords: Home care, recruitment and retention, compensation, working conditions

1. Introduction

Recruitment and retention of home support work- ers (HSWs) is of increasing interest to home support agencies, governments, and national organizations in Canada and other developed countries. HSWs provide paid, non-professional services such as personal care,

?Address for correspondence: Janice M. Keefe, Mount Saint Vin- cent University, 166 Bedford Highway, Halifax, Nova Scotia B3M 2J6, Canada. Tel.: +1 902 457 6466; Fax: +1 902 457 6226; E-mail: Janice.keefe@msvu.ca.

housework, and meal preparation to individuals with demonstrated need in their homes, and are the largest occupational group in home care. It is estimated that 1.2 million people in Canada use home care services annually [11], the majority of whom are aged 65 and older. The demand for these services is expected to in- crease in the next twenty-five years, as the baby boomer cohort (1946–1964 in Canada) moves into later adult- hood and experiences increased life expectancy [40]. Also contributing to the demand for workers is home care policy that emphasizes “aging in place,” reflecting older adults’ desires to remain in their own homes and

1051-9815/11/$27.50 ? 2011 – IOS Press and the authors. All rights reserved

22 J.M. Keefe et al. / Key issues in human resource planning for home support workers in Canada

communities for as long as possible [12,28,44]. Ad- ditional factors include the decreased supply of formal caregivers due to pressures on health and social service systems to contain costs, the difficulty attracting people to long- term care work [26], and the high percentage of HSWsnearing retirement age [31]. These issues are not unique to Canada. Recruitment and retention are also priority issues in home care in most U.S. states [62] and growing demand in the long-term care workforce has been noted in other developed countries including the United Kingdom, Australia, Denmark, and others [26].

Family and friends remain the greatest contributors to meeting home support needs in Canada and the Unit- ed States [12,35]. However, research has called in- to question the capacity of family and friends to con- tinue providing this care at the levels required [39]. Reasons include fewer adult children available to pro- vide support; more women working outside the home; adult children who are less likely to live geographical- ly proximate to aging parents; and increasing divorce rates [39].

These challenges point to a need to address recruit- ment and retention of HSWs. Furthermore, home sup- port services are considered paramount to preventing health decline in the older population [58] and may be cost saving. Research in Canada has indicated that home care for older people can be cost effective when compared to institutional care and acute care [30]. Hol- lander et al. [30] argue that there is a strong case to push for policies that support the integration of home care and support into a broader integrated system of care in which they can substitute for facility and acute care.

Many jurisdictions in Canada are already facing shortages or anticipating shortages of HSWs [8,38]. The province of Alberta, for example, is projected to need an additional 5,000 Health Care Aides (who work in private homes and institutions) by 2016 [1]. How- ever, health human resources planning has tended to focus on strategies to meet the demand for doctors and nurses [59], despite wide consensus in the literature that recruitment and retention of adequate staffing is also a key problem facing home care [8,15,39]. The purpose of this literature review is to identify human re- source issues for HSWs,1 to inform long-term recruit- ment and retention strategies. In Canada, home care is

1We use the term “home support worker” because we are inter- ested in the non-professional front-line workers who work in clients’ homes. There is no common term used for this workforce in Canada. In the United States, these workers form a large part of the Direct Care workforce.Topics
1. Human Resource Planning and Retention
2. Recruiting and Labor Markets

Rules:
Your ABs should be ½ to ¾ pages long. It should be double-spaced, and you are to use Times New Roman 12 font. For your AB, you must have:
Your name, date, course, and AB number at the top (see example)
APA Reference before the information (see example) Annotated bibliographies must be written in a manner, in which, they are understandable. You must describe all important data such as:
The participants
The reason the study was conducted
What research design was used (surveys, interviews, case study, etc.)
Which research analysis was used (MANOVA, ANOVA, Kruskal Wallace, etc.)
The results of the study along with any conclusions of the author(s)