Volume 68, Issue 8 p. 1657-1660
Brief Report

Essential Long-Term Care Workers Commonly Hold Second Jobs and Double- or Triple-Duty Caregiving Roles

Courtney Harold Van Houtven PhD, MSc

Corresponding Author

Courtney Harold Van Houtven PhD, MSc

Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina, USA

Department of Population Health Sciences and Duke-Margolis Center for Health Policy, Duke University School of Medicine, Durham, North Carolina, USA

Address correspondence to Courtney Harold Van Houtven, PhD, MSc, Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Department of Population Health Sciences and Duke-Margolis Center for Health Policy, Durham, NC 27705. E-mail: [email protected]. Twitter: @chvanhoutven Twitter handle for co-author: @nbcoe1Search for more papers by this author
Nicole DePasquale PhD

Nicole DePasquale PhD

Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA

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Norma B. Coe PhD

Norma B. Coe PhD

Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA

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First published: 27 April 2020
Citations: 80

Abstract

OBJECTIVES

Long-term care (LTC) facilities are particularly dangerous places for the spread of COVID-19 given that they house vulnerable high-risk populations. Transmission-based precautions to protect residents, employees, and families alike must account for potential risks posed by LTC workersʼ second jobs and unpaid care work. This observational study describes the prevalence of their (1) second jobs, and (2) unpaid care work for dependent children and/or adult relatives (double- and triple-duty caregiving) overall and by occupational group (registered nurses [RNs], licensed practical nurses [LPNs], or certified nursing assistants [CNAs]).

DESIGN

A descriptive secondary analysis of data collected as part of the final wave of the Work, Family and Health Study.

SETTING

Thirty nursing home facilities located throughout the northeastern United States.

PARTICIPANTS

A subset of 958 essential facility-based LTC workers involved in direct patient care.

MEASUREMENTS

We present information on LTC workersʼ demographic characteristics, health, features of their LTC occupation, additional paid work, wages, and double- or triple-duty caregiving roles.

RESULTS

Most LTC workers were CNAs, followed by LPNs and RNs. Overall, more than 70% of these workers agreed or strongly agreed with this statement: “When you are sick, you still feel obligated to come into work.” One-sixth had a second job, where they worked an average of 20 hours per week, and more than 60% held double- or triple-duty caregiving roles. Additional paid work and unpaid care work characteristics did not significantly differ by occupational group, although the prevalence of second jobs was highest and accompanying work hours were longest among CNAs.

CONCLUSION

LTC workers commonly hold second jobs along with double- and triple-duty caregiving roles. To slow the spread of COVID-19, both the paid and unpaid activities of these employees warrant consideration in the identification of appropriate clinical, policy, and informal supports. J Am Geriatr Soc 68:1657-1660, 2020.