Abstract

Purpose of ReviewTo identify important home care (HC) aide occupational safety and health (OSH) hazards and examine how addressing these can improve aide health and the delivery of HC services overall. Specifically, this review seeks to answer: Why is HC aide OSH important? What are the most significant OSH challenges? How can improving HC aide OSH also improve the safety and health of their clients? What implications do the findings have for future research?Recent FindingsHC is one of the fastest growing US industries. Aides comprise its largest workforce and are increasingly needed to care for the rapidly aging population. There is an aide shortage due in part to instabilities in HC work organization and to serious job-specific hazards, resulting in aides losing work time.Recent social, economic, and technological factors are rapidly changing the nature of HC work, creating OSH hazards similar to those found in nursing homes. At the same time, aides are experiencing social and economic inequities that increase their vulnerability to OSH hazards. These hazards are also a burden on employers who are challenged to recruit, retain, and train aides. OSH injuries and illness interrupt the continuity of care delivery to clients. Many OSH hazards also put HC clients and families at risk.SummaryA new framework and methodologies are needed to assess aide and client safety together in order to guide future HC research, policies, and practices. Government, industry, and labor commitment is needed to fund and coordinate a comprehensive, multidisciplinary research program.

Highlights

  • Home care (HC) workers provide essential health and personal care supportive services that enable people to live at home rather than receive care in a nursing home or other facility

  • Home care aides have often been overlooked as part of the medical team [83]; their role in healthcare gained new visibility during the COVID-19 pandemic when hospitals were over capacity, and there was concern about increased risk of infection in congregate care settings [3,4,5, 23, 84]

  • Many occupational safety and health (OSH) hazards derive from and are intensified by social and economic inequities experienced by HC aides

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Summary

Introduction

Home care (HC) workers provide essential health and personal care supportive services that enable people to live at home rather than receive care in a nursing home or other facility. Most of the HC workforce is composed of aides, who are vulnerable to COVID-19 due to their work exposures and to their experience of social and economic inequities (housing where social distancing is not possible, limited health care access) that present infection risks [6, 7, 8, 9].

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