Date of Conferral

2-18-2026

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Sciences

Advisor

Miriam Ross

Abstract

Home care workers play a vital role in supporting older adults, yet retaining staff in these positions can often be challenging. The purpose and review question for this integrative review concerned the strategies and best practices for home health agencies to retain formal caregivers and implement in-home/informal caregiving as an integral component of the caregiving team. Penchansky and Thomas’s theory of access supported this study by highlighting how the qualities and expectations of home care workers align with their patients. A comprehensive review of the literature resulted in 53 articles, which were screened for quality and relevance. Of these, 24 studies were selected for further analysis using the Johns Hopkins evidence-based practice model. A comprehensive thematic analysis identified seven main themes and seven supporting subthemes. The seven main themes identified the need to increase patient satisfaction, strengthen agency staffing, improve human resources, reinforce employee training, develop education programs, increase compensation and benefits, and explore reimbursement improvements. Key subthemes emphasized adopting a patient-first approach in home care, combining courses and fieldwork experience, and partnering with colleges and universities. Three recommendations provided ways to strengthen home care services by creating a fund for home care workers’ incidental expenses, leadership training, and promoting new career advancement opportunities for home care workers. By following these recommendations, home and community-based services can create an encouraging environment for both agency-based and in-home care workers. This approach may improve patient care and promote positive social change within communities.

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