"Let Them Know That They're Appreciated": The Importance of Work Culture on Direct Care Worker Retention

Retaining direct care workers (DCWs) in all areas of long-term services and supports (LTSS) remains an unending challenge. The current study purposively selected 12 high-performing LTSS communities (e.g., nursing homes, assisted living, home care agencies) in Ohio with high family satisfaction and staff retention. Qualitative interviews were conducted in 2022 with 21 personnel in leadership positions and 16 DCWs (e.g., certified nursing assistants, personal care aides). Interviews were audio recorded, transcribed, and a team of two coders conducted the thematic analysis. Three themes of work culture emerged as important for retention: (1) Family-Like Organizational Approach, (2) Supportive Working Conditions, and (3) Worker Empowerment. DCWs valued empathic relationships with their clients and supervisors. Favorable working conditions consisted of choice, participative leadership, and effective communication. DCWs experienced empowerment through appreciation, financial incentives, and career advancement opportunities. Findings suggest practical changes for person-centered care practitioners that are feasible across any organizational work culture setting. [Journal of Gerontological Nursing, 49(8), 7-13.]