Grad Student Leads Study that Aims to Improve Aide Safety

Home care worker helping elderly with medications
New research shows that home health care aides frequently face verbal abuse from clients and their families.

By Karen Angelo

A new study by university researchers shows that one in four home health care workers are verbally abused by clients and their families. 

The research, published in the Occupational and Environmental Medicine journal, is part of the university’s Safe Home Care Project, which is directed by Public Health Prof. Margaret Quinn and funded by the National Institute for Occupational Safety and Health (NIOSH). The study was led by public health student Nicole Karlsson, who recently completed her doctoral degree in work environment. 

Karlsson and the other researchers drew on 954 responses to the Safe Home Care Survey. The responses refer to a total of 3,189 separate home care visits. 

The researchers found that about one in four home care workers reported at least one incident of verbal abuse by clients or their relatives during the preceding 12 months. Around half of those workers experienced more than one type of verbal abuse, which was defined as being yelled at or spoken to in an angry or humiliating tone, being subjected to racial, ethnic, or religious insults and taunts, being threatened, or being made to feel bad about oneself. About one in 20 respondents said they had been subject to all four forms of verbal abuse. 

“Home care aides are an essential workforce for our rapidly aging population, yet they tend to be invisible because they work alone in private homes,” says Quinn, who was Karlsson’s advisor and co-author on the paper. “With our project and this study, we are bringing issues to light so that solutions can be found for this mostly female population.” 

The goals of the study were to learn the extent of verbal abuse during care visits and to identify factors that may contribute to abuse. 

Karlsson, the lead author on the published paper, conducted the research for her doctoral dissertation. 

“As a research assistant on Dr. Quinn’s Safe Home Care Project, I was excited to use the project’s survey data to quantitatively investigate this important issue as part of my doctoral research,” says Karlsson, who earned a master’s degree in industrial hygiene from UML in 2003 and plans to pursue a career in public health research and intervention. 

The study also identified risk factors – cramped living conditions in homes, clients with dementia and aides having unpredictable work schedules – that, if addressed, could improve the quality of home care work both for the aides and their clients. 

“Addressing these risk factors for aides receiving verbal abuse from clients and families can improve the safe delivery of care for everyone – a win-win,” says Quinn. 

The challenges facing home health workers are only expected to grow, as more workers are needed to help care for the country’s aging population. In the U.S., there were about 2.9 million home health and personal care workers in 2016, with an additional 1.2 million projected to join the workforce by 2026, according to the Bureau of Labor Statistics.