One-year predictors of turnover among personal-care workers for older adults living at home in Italy

Privately-employed personal-care workers for community-dwelling older adults are widespread in Italy. There have been estimated to be over 700,000 personal-care workers in Italy, with 93% being foreigners. The turnover of these workers is known to be high. This study aimed to identify the predictors of the turnover of personal-care workers. This prospective cohort study in Milan, Italy enrolled 121 older adults living at home along with their personal-care workers and 107 informal carers. The older participants underwent a comprehensive geriatric assessment. At 1 year follow-up, 12 of the older participants had been placed in a nursing home and 26 had died. Of the 83 still living at home, 22 (26.5%) had changed their personal-care staff. Analysis found that the only characteristic of personal-care staff significantly associated with turnover at 1 year follow-up was living far away from their families. Two characteristics of the elders, namely being widowed and having cognitive impairment, were found to be predictors of a low turnover of personal-care workers. These older adults were more likely to keep their personal-care workers at the one-year follow-up independently of the perceived quality of care