Home care workforce participation and household co-residence with people with LTSS needs

Introduction: Workforce shortages represent a critical barrier to efforts to divert older adults and people with disabilities from institutional care. We seek to understand whether co-residence with persons with Long Term Services and Supports (LTSS) needs is associated with employment in the home care workforce. Methods: Using data from the Current Population Survey (CPS) and American Community Survey (ACS), we use cardinality matching to match home care workers with demographically similar non-home care workers and assess whether home care workers have statistically different rates of co-residence with persons with LTSS needs and persons aged 85+. Results: In the CPS-matched sample, 14.8% of home care workers resided with people with LTSS needs and 2.8% resided with persons aged 85+ as compared to 4.2% and 0.8% of demographically similar non-home care workers, respectively (both P < 0.0001). Results were substantively similar in the ACS analysis, which excluded workers employed within their own household. Conclusions: These findings document an association between home care employment and household caregiving responsibilities, suggesting that home care employment may be useful for persons managing household caregiving responsibilities, home care workers may better be able to assist disabled household members to stay in their own homes, or both.