# Strengthening the Dementia Care Workforce: Analyzing Economic Policies' influence on Workers and their Patients Living with Dementia

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $671,042

## Abstract

Project Summary
The long-term care industry is one of the fastest growing sectors of the economy1, while also creating some of
the lowest-paid and lowest-quality jobs. These precarious working conditions are costly for workers – who are
disproportionately women and women of color2,3 – and the patients they care for. On the worker side, the
conditions of long-term care jobs keep families in poverty and contribute to gender and racial economic
disparities in the workforce.2,3 Worker turnover is high, and worker shortages are pervasive.4-6 These
precarious working conditions may deteriorate the quality of care workers can provide and have a detrimental
impact on patient outcomes, potentially contributing to or exacerbating health disparities among patients.6,7
This could be particularly an issue for people living with Alzheimer's disease and Alzheimer's disease and
related dementias (AD/ADRD), where continuity of care and communication between the care team is
paramount.8,9
The working conditions of this workforce, both wages and workload, have important implications for turnover
and overall well-being. In Aim 1, we will study the impact of wage changes, instrumented through minimum
wage laws and pandemic-related wage protections, on home health care worker outcomes, including wages,
turnover, and poverty. In Aims 2 and 3, we will study the impact of staffing regulations and unionization,
respectively, in nursing home settings, on the welfare of the workers, measured by wages, turnover, and
reliance on contract staff. We will look for heterogeneity in the effects of workplace policies on workers, based
on geography (urban vs. rural), and agency/facility metrics (star rating, percent Medicaid, percent patients who
are of a racial/ethnic minoritized group).
In each aim, we will take the next important step, which is to estimate how these workforce changes are
related to patient outcomes, including functional status, physical and mental health, and health care utilization
and mortality. We will focus our analysis on people living with dementia; over one-third of home health care
recipients and one-half of residents in nursing homes have AD/ADRD.10 This group is likely the most
vulnerable to staffing changes, training, and disruptions. We will look for heterogeneity in the effects of
workplace policies on patients by both facility (e.g.,profit status, rurality) and patient-level characteristics (e.g.,
race, ethnicity, sex).
This project will build the evidence base on which we can make informed policy recommendations that could
improve the lives of the dementia care workforce and their patients.

## Key facts

- **NIH application ID:** 10975719
- **Project number:** 1R01AG088901-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Norma B Coe
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $671,042
- **Award type:** 1
- **Project period:** 2024-09-01 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10975719

## Citation

> US National Institutes of Health, RePORTER application 10975719, Strengthening the Dementia Care Workforce: Analyzing Economic Policies' influence on Workers and their Patients Living with Dementia (1R01AG088901-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10975719. Licensed CC0.

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