Love, Money, or Flexibility

What Motivates People to Work in Consumer-Directed Home Care?

Consumer-directed home care, where consumers can hire friends or family to provide home care, is one of the lowest paying types of long-term care jobs. To understand why people take consumer-directed home care jobs, an investigation of the California In-Home Supportive Services (IHSS) program was undertaken.

This article examined IHSS workers across eight counties in California. Study participants were 2,260 workers who completed a survey focused on reasons workers took or stayed in jobs. Data analysis involved logistic regression.

Key Findings:                       

  • Approximately 66 percent of workers stated that commitment to consumers was the top motivation for taking their jobs. Flexibility was the second most important reason.
  • When made available to county residents who worked part-time jobs, health insurance became the most important reason for taking a consumer-directed home care job.
  • Wages played a role in taking and remaining in jobs when they were above $9 an hour and a wage increase had occurred recently. For both family and non-family providers wages and benefits mattered alongside consumer commitment as reasons for staying in jobs.

Recommendations for recruiting and retaining consumer-directed home care workers include allowing family and friends to be caregivers, providing flexible jobs that do not necessarily have to be part-time and offering part-time workers access to health insurance.