Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Communication

Content Description

1 online resource (x, 147, [7] pages) : color illustrations.

Dissertation/Thesis Chair

Annis G. Golden

Committee Members

Mary P. Gallant, Matthew D. Matsaganis


Home care, Home Health Aides, Role dialectics, Role negotiation, Social Ecological Model, Home health aides, Home care services

Subject Categories



Home health aides are paraprofessionals who are critical to the health and well-being of elderly adults and their ability to continue living in their own homes for as long as possible. However, a crisis is looming because the demand for home health aides is rapidly increasing as America ages. Filling today's need for home health aides is already difficult, and turnover rates are high across the country. The job is physically and emotionally challenging, while financial rewards are severely constrained by public policy and the lack of value placed on the position. Conflicting expectations of home care agency supervisors, clients and the aides themselves lead some aides to call their job a no win situation. Increasing our understanding of how members of this low status, understudied group make sense of their role and how they negotiate the competing expectations that they often face can help shed light on a difficult but important job and identify strategies to enhance the working conditions of aides and to improve aide recruitment and retention. Using interpretive research methods, this study examines the talk of home health aides, supervisors, and clients from both rural and urban areas in order to understand their perspectives about their working environment and interactions. I propose a Social Ecological Model of Role Influences to examine the proximal and distal influences on the role of home health aides. Finally, this study identifies role dialectics that home health aides face and examines strategies that aides use to manage those dialectics.

Included in

Communication Commons