Home care co-ops could help seniors age at home

The oldest baby boomers turn 79 in 2025 as attention shifts from retirement savings to elder care. That suggests that there will be ever-greater need for professional caregivers in the next decade but currently, these caregivers are in short supply.

A UCLA-led study suggests that the solution to the country’s paid caregiver shortage may come not from tech startups or corporate expansions, but from the caregivers themselves — through worker-owned cooperatives.

Published in JAMA Network Open, the study reveals that caregivers working in home care cooperatives report better job satisfaction, higher pay, and more control over their work compared to those employed by traditional home care agencies. The findings offer a potential roadmap for transforming a sector long plagued by high turnover and low morale.

Redefining caregiver roles

The research team found that home care cooperatives  –  businesses owned and operated by their workers — provide a more collaborative and respectful environment for caregivers. These improvements in job quality, researchers say, are directly linked to significantly lower turnover rates.

Workers at cooperatives assist clients with the same tasks — bathing, meal prep, medication reminders — but the structural difference lies in agency governance. Caregivers in cooperatives have a say in company policies, scheduling, and client care strategies. This added agency could help build a sense of purpose and ownership often absent in traditional employer-employee arrangements.

Interviews with 23 home care workers and nine cooperative staff members from five different cooperatives highlighted four key factors that contribute to higher job satisfaction:

• Autonomy: Caregivers reported greater input in scheduling, agency decisions, and client care.

• Community: A sense of camaraderie and teamwork emerged from their shared ownership structure.

• Respect: Participants felt more valued, with a culture that recognized their essential contributions.

• Compensation: Better pay, benefits — especially health insurance — and profit sharing incentivized longer tenure.

These elements help explain why caregiver turnover in cooperatives is roughly half that of their traditional counterparts. While the findings are encouraging, the researchers caution that more work is needed. 

The study involved only English-speaking participants and relied on subjective comparisons to past experiences, introducing potential bias. Additionally, differences in agency size and regional policies may affect outcomes.