Staff Satisfaction and Burnout in Assisted Living and Validity of the DCW Job Satisfaction Scale

Objectives

Professional caregivers (ie, direct care workers) provide the majority of support for long-term care residents. Unfortunately, they have consistently high turnover, which is associated with low job satisfaction and decreased care quality. Most research on this topic has been conducted in nursing homes; in contrast, this study investigated relationships between staff satisfaction, burnout, and community and staff characteristics in assisted living (AL). Additionally, it evaluated the validity of the Direct Care Worker Job Satisfaction Scale in this population, a notable contribution to the literature.

Design

Questionnaires completed by AL staff and administrators.

Setting and Participants

559 staff from 68 AL communities in North Carolina.

Methods

Staff reported satisfaction, burnout, and demographics. Administrators reported community characteristics. Correlations were computed for bivariate relationships among variables. The Direct Care Worker Job Satisfaction Scale was evaluated with a principal component analysis.

Results

Staff reported satisfaction of 3.05 (scale 1-4; “satisfied”), and 18.5% were burned out; satisfaction and burnout were negatively correlated (adjusted −0.43, P < .001). Satisfaction was positively associated with the percent of residents with dementia (0.19, P < .001) and provision of special/memory care (0.17, P < .001); it was negatively associated with the staff-to-resident ratio (−0.18, P < .001) and presence of licensed nurses (−0.27, P < .001). Principal component analysis produced a single-factor solution with an eigenvalue of 10.8, the only eigenvalue above 1. All scale items loaded at least 0.70 on the single factor.

Conclusions and Implications

AL staff satisfaction and burnout are negatively associated, and almost one-fifth are burned out; the extent of burnout has not been reported previously and merits attention. Associations suggest caring for individuals with dementia may be particularly rewarding, while being responsible for more residents and working alongside nurses or with higher acuity residents may lessen satisfaction. These findings may inform approaches to staffing and have implications for resident well-being.