One in 4 home health aides report experiencing racism, violence on the job, new survey finds

One in four home health aides in New York State, including those working and living on Long Island, are burned out and have experienced racism or violence on the job, according to a new study by a Northwell Health geriatrician.

The anonymous survey, conducted between Nov. 30, 2023, and the end of 2024, was distributed to 224 aides at a large home health care agency that covers the greater New York region, including Long Island, said Dr. Liron Sinvani, the report's lead author and the director of research and innovation for the Northwell Institute for Healthy Aging.

The majority of aides surveyed were women between the ages of 41 and 60, Black or Hispanic and with more than a decade of experience, including caring for patients with dementia.

The survey was published in the Journal of General Internal Medicine.

'Critical workforce'

Home health aides, Sinvani said, are the largest and fastest-growing segment of the healthcare workforce with about 3.6 million workers nationwide, but are still an "invisible workforce" to the public and many policymakers.

"These are the people who go into older adults' homes every day and help with things like bathing, dressing, meals, medications, companionship," said Sinvani, who is also a professor of medicine at the Feinstein Institutes for Medical Research. "They spend more time with patients and older adults than almost any other healthcare provider. Yet we know they earn not a lot of money — basically, about $33,000 a year with few benefits."

Survey respondents relayed significant job-related difficulties, with annual turnover among home health aides nationally exceeding 60%.

Nearly one in four said they were burned out from the job and more than half reported moderate to high stress. The largest drivers, Sinvani said, are low pay, inadequate health insurance and transportation difficulties, along with the physical tasks of patient care, particularly nighttime behaviors that are common in older people, especially with dementia.

Just under 25% of home health aides said they have experienced racism, either from patients or their families, the report found. And more than 25% of respondents reported workplace violence committed by the person they were caring for, including being hit, bitten or pushed. The behavior generally went unreported, the survey said.

"Despite all these challenges, the really amazing thing that we found was that 87% of home health aides said they were incredibly proud of the work they do," Sinvani said. "They expressed wanting more training, especially in dementia care, since that's a very difficult population to care for and expressed interest in peer mentorship and online support. These home health aides are basically on their own. They're by themselves in someone else's home, doing this care all by themselves. They are a critical workforce."

Aging Long Islanders

Home health aides and personal care aides require training and licensure from the New York State Department of Health.

Lystra Sawney, vice president of 1199SEIU, a union that represents more than 125,000 home care workers throughout New York, New Jersey, Florida, Washington, D.C., Maryland and Massachusetts, said the survey results were not surprising.

"Home health aides have to go wherever they're sent," Sawney said. "They're at the mercy of the agency. And so they walk into someone's home and they don't know what they're about to experience. They don't know how they're going to be treated. But yet, this is their job and they choose to do it day after day because they love what they do. "

The union has been working with 190,000 New York State home care aides to organize their own union within 1199SEIU.

As Long Island’s population ages, demand for home health aides is surging — with the workforce projected to grow nearly 40% statewide by 2030, according to the Center for Health Workforce Studies at the University at Albany.

But as Newsday reported in January, the industry is struggling to keep up, constrained by low wages, limited public transportation and tightening immigration policies that experts say could leave thousands of seniors without the help they need to safely age at home.

Long Island employed 44,770 home health and personal care aides in 2024, with the occupation projected to have about 9,500 openings a year through 2032, according to 10-year estimates from the state Labor Department.

Meanwhile, there are more Long Islanders 65 years or older today than a decade ago, Newsday previously reported. One in five, or nearly 111,000 seniors, are now living alone while coping with the challenges of aging in the suburbs, according to 2023 U.S. Census Bureau data analyzed by Newsday. 

By Robert Brodsky

robert.brodsky@newsday.com@BrodskyRobert

Robert Brodsky is a breaking news reporter who has worked at Newsday since 2011. He is a Queens College and American University alum.