using technology, and the wage expectations of the older workers who were surveyed were higher than the average for these positions. Furthermore, the older workers expressed more interest in the emotional support of patients than in hands-on tasks.

The recruitment and retention of older workers may require the creation of positions with fewer physical demands. Parsing CNA responsibilities might enable the productive use of older adults in the workforce who lack the strength to do all CNA tasks. In one example of such an approach, McKesson, a health care services company, has recruited older workers for their call centers to advise patients on medication use (Taylor, 2007). Similarly, strategies to retain existing older workers in clinical positions will likely demand the creation of health care delivery processes that are more ergonomically oriented (Buerhaus et al., 2000). Emerging technologies may assist in this regard (see Chapter 6).


In addition to recruiting new paid workers, workforce needs could be partially satisfied by using volunteers, both in clinical and in academic settings. Older adults themselves would seem to be a likely target group from which to recruit such volunteers, given that baby boomers have the highest volunteerism rate of any age group—they volunteer more often than past generations did at the same ages—and they constitute a very large pool of potential volunteers (Foster-Bey et al., 2007).

Members of younger generations may also be willing to provide needed services, especially community-based personal- and home-care services that would allow fellow community members to remain in their homes. Community-based models such as Beacon Hill Village in Boston have been developed to allow older adults to “age in place” (Gross, 2006). In these models older adults within a narrow community pay dues to receive support, such as accompaniment to medical appointments, delivery of meals, exercise classes, lectures on aging-related topics, and assistance with daily errands. Volunteers provide many of these services, such as transportation. Other more advanced services, such as home health aide services and home repairs, are often available for a discounted fee. These options may become more appealing as more older adults prefer to stay in their home settings and trends toward consumer-directed care continue (see Chapter 6).

Examples of Efforts to Improve Recruitment and Retention

While some efforts to improve the recruitment and retention of direct-care workers focus on a single strategy, other programs and organizations have developed a mixture of policy- and provider-based interventions. Some

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