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Health and Safety for a Critical Workforce

photoHome care makes independent living more possible, healthier, and safer for millions of people across the United States. The Safe Home Care Project aims to investigate and promote health and safety for the largely invisible home-care professionals who do this important work. Historically, little attention has been paid to homes as workplaces, or to the occupational safety and health hazards of home-care workers, who may encounter highly variable and sometimes challenging circumstances in delivery of critical services. Among these may be physical hazards of procedures in the home environment, client physical or mental status, security issues, or family/social dynamics.

Home care is a dynamic and fast-growing service sector; this growth is driven by multiple factors, including: availability of some in-hospital medical procedures to the home; technological advances; healthcare cost containment; improved infection prevention; increased longevity (sometimes with multiple chronic conditions); and the desire of most people to be cared for at home. An anticipated increase of 50%, by 2018, in the demand for home-care services means hundreds of thousands more home-care workers in the field in the coming years.* Protection of this workforce is essential to the long-term well-being of an aging population, and the related issues are of vital interest to researchers, the home-care industry, labor organizations, government bodies, and the insurance industry. Learn more from A Statistical Snapshot of Home Healthcare.

A Day in the Life

Jean, the home health aide, was on her way to the day's second patient, the elderly and diabetic Mrs. Walker, a client with limited mobility who lived alone. Heavy snow made driving treacherous and slow. Jean knew Mrs. Walker would be worried; she needs help getting her breakfast, and late meals can cause complications for diabetics.

Jean parked in the normal spot on the street, slogged along the un-shoveled walkway, and waited a long time for Mrs. Walker to answer her door. She was upset when Jean arrived, but calmed down as Jean cheerfully began the morning routine of making breakfast, and helping Mrs. Walker get showered and dressed — no easy task when working alone with a patient with limited mobility. The grab bars, hand-held shower, and shower chair installed by Mrs. Walker's family have somewhat reduced the stress on Jean, who has chronic back pain from handling clients, a task that can require strenuous transfers.

Jean felt much better once Mrs. Walker was settled. She prepared the day's other meals, cleaned the dishes, and washed, folded, and put away the laundry. After ensuring Mrs. Walker was comfortable, she reached her car and found a $50 parking ticket, not having known of the city's parking ban due to weather.

About the Project

The Safe Home Care Project — whose formal title is Safety and Health for Home Care Workers in Social Assistance and Healthcare — is an initiative of the University of Massachusetts Lowell’s Department of Work Environment and the Lowell Center for Sustainable Production’s Sustainable Hospitals Program. Funded by a 2010, four-year grant from the National Institute for Occupational Safety and Health (NIOSH), the Safe Home Care Project (grant number 5R01OH008229-06) arose out of an earlier project on sharps injuries called Project SHARRP (Safe Homecare and Risk Reduction for Providers). The project team, in collaboration with the Massachusetts Department of Public Health’s Occupational Health Surveillance Program, will partner on the project with other sector stakeholders, such as care agencies, trade unions, and government agencies.

The Safe Home Care Project (SHC) seeks to improve safety and health in home care through investigation of the challenges, hazards, and promising practices in delivery of increasingly complex care in homes; identification of effective, preventive interventions; and development and distribution of educational materials for home-care workers, agencies, and other beneficiaries. For more information, see Project Objectives.

* Source: Bureau of Labor Statistics, www.bls.gov/oco/ocos326.htm