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

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.