How Do Long-Term Care Workers Spend Their Time? Answers from the American Time-Use Survey

Introduction/Background

Long-term care (LTC) workers provide day-to-day care to patients in residential facilities, community-based settings, and private homes. Over the next decade, the U.S. Bureau of Labor Statistics (BLS) projects much faster growth in LTC-related occupations than other occupations. The challenge of meeting future demand for LTC workers is exacerbated by high rates of turnover, which is frequently associated with burnout. We examined time spent on work-related and non-work related activities by the LTC workforce and compared their activities with those of workers with comparable education/skills from other health professions (OHPs) to better understand factors that might contribute to work stress, burnout, and retention among LTC workers.

Methods

We examined 12 years of data from the American Time Use Survey (ATUS) conducted by the BLS to understand patterns of time use among LTC workers and compare their time use with that of workers in other sectors of the health care industry. We also categorized LTC occupations by higher-skill and lower-skill levels and compared workers in each of these groups with their counterparts in non-LTC health care occupations.

Findings

The LTC workforce has a significantly larger share of non-White workers, has less education, and is living in poverty more often compared with OHPs. While LTC workers spent more time on leisure, much of this time difference was attributable to more time watching TV and less time exercising. Unskilled workers spent less time on activities likely to promote overall well-being and health, such as exercising and sleeping. This was consistent with findings of poorer health of LTC workers relative to OHPs. Despite differences in health and health-promoting activities, LTC workers reported similar levels of work/life satisfaction and quality of life compared with OHPs. LTC workers more often provided eldercare to family members or friends several times per month or even daily, suggesting they may be providing such care both professionally and informally, potentially exacerbating the risk of burnout in this group of workers.