Work-Related Values, Preferences, and Expectations of Millennials: Implications for Long-Term Care Administrators

The purpose of this research is to examine millennials’ work-related values, preferences, and expectations and to understand the impact for administrators in long-term care (LTC) facilities. Supervisors at LTC facilities must understand millennials’ work behavior, and strive to meet their needs, so as to effectively recruit, train, and retain these millennial employees. Allowing for management understanding of millennials work-related values, preferences, and expectations and how these support or detract from employment within LTC settings may pinpoint how facilities may retain these workers. This study will also provide information about work satisfaction of millennial employees and how employers can improve to enhance the working environment. The structured analysis of the literature may help with providing understanding and direction to effectively recruit, train, manage, and retain millennials. WORK-RELATED VALUES OF MILLENNIALS IN LONG-TERM CARE 3 TABLE OF CONTENTS Abstract. 2 Definition of the Problem. 4 Literature Review. 4 Statistical Overview of the Trends in Long-Term Care. 4 Overview of Millennials as Employees. 4 Brief look at employee retention and resident satisfaction.4 Methods . 9 Studies Summarized . 10 Individual Studies Examined. 14 Pattern Recognition. 29 Implications. 31 Conclusion.32 References. 34 WORK-RELATED VALUES OF MILLENNIALS IN LONG-TERM CARE 4 Definition of the Problem Long-term care depends on the commitment of the staff to the well-being of the residents. The residents need help with dressing, toileting, and walking, as well as bathing (Federal Interagency Forum on Aging-Related Statistics, 2016). Residents will become more ethnically diverse, will experience multiple health issues, including heart disease, hypertension, stroke, asthma, chronic bronchitis or emphysema, cancer, diabetes, and arthritis. (Federal Interagency Forum on Aging-Related Statistics, 2016). The people who serve this population in long-term care will be millennials. Research shows this generation has specific values, preferences, and expectations regarding their work life. The administrators and supervisors will best retain these employees if they understand those values, preferences, and expectations to appropriately recruit, train, manage, and retain these employees. The following paper will outline some of the issues and then analyze some specific studies that shed light on some of the work behaviors administrators need to be prepared to address and effectively harness the capacities of this next generation of employees. Literature Review Retention of long-term care (LTC) staff is urgent; continuity of care means that the residents received better care (Dasgupta, 2015, p. 11). Between now and 2030, there will be an increasing number of the baby boomer generation needing LTC, and which will be provided by millennials. By 2030, the elderly population will double from today (Stork, Martone, Osterman, Savage, & Mukherjee, 2018, p. 94). It is necessary for LTC providers to understand the common issues for staff retention within the millennial population, while taking care of our elderly in nursing homes. Turnover rates are quite high for nurse aides and licensed practical nurses (86 %) in a study of over 300 facilities and more than 55 % for registered nurses (Castle, & Engberg, WORK-RELATED VALUES OF MILLENNIALS IN LONG-TERM CARE 5 2005, p. 616). A study by Chou in 2012 was prefaced by this important review of the statistics for direct care workers (DCW): High voluntary turnover of DCWs is a prevalent and serious issue. A national study on job turnover of DCWs (nursing assistants) in nursing homes showed an average yearly turnover rate of 75% (Donoghue, 2010). Average annual turnover rates among DCWs in assisted living facilities have been reported to range from 55% to 200% (Hawes, Rose, & Phillips, 1999; Konetzka, Stearns, Konrad, Magaziner, & Zimmerman, 2005). About 80% of DCWs who enter the LTC workforce leave within the first year (Wike, 2007). DCW turnover not only is costly to providers, because replacement entails costs in hiring and training (Seavey, 2004), but also disrupts care continuity (Dawson & Surpin, 2001) and results in poor quality of resident care (Greene et al., 1997). (338) Health Resources and Services Administration (HRSA), the primary federal agency for improving health care to people who are geographically isolated, economically or mentally vulnerable, uses an assumption model that projects healthcare delivery until 2030. The HRSA projects supply and demand for registered nurses (RN) and licensed practical nurses (LPNs). Millennials, as the turnover rates provided above suggest, can and do readily find other jobs if they are not satisfied in the one they are at. As the boomers age and need care, there will be more demand and less supply, making it critical that LTC facilities understand millennial employees’ values, preferences, and expectations in order to optimize training and working conditions and reduce turnover in these facilities. Turnover is the norm now. An essay in a health care encyclopedia reports that “employees now tend to focus more on advancing their self-interests and careers, even if it means switching jobs frequently. According to the U.S. Department of Labor's Future work report, the average 32-year-old has already held nine jobs” (Leap, 2004, p. 171). This alternative plan paper will examine the literature about millennials’ work values, preferences, and expectations, as they are demonstrably different than the generation of workers that preceded them and they contribute to turnover rates. WORK-RELATED VALUES OF MILLENNIALS IN LONG-TERM CARE 6 Generational gaps develop because of circumstances and context of that birth cohorts’ life, usually calculated through the span of a ten or twenty-year interval (Shapiro, 2005). Millennials are defined as those born between 1981-1997 and make up the largest part of the United States labor force, 75.4 million, more than the 74.9 million baby boomers (Fry, 2016). What are some of the events that shaped the millennials? They were young when 9/11 happened, they grew up with No Child Left Behind, they had play dates and their time was scheduled for them. They received praise for just showing up and have an inflated idea of their worth (Anderson, Buchko & Buchko, 2016). The possible ramifications for this are a sense of insecurity, entitlement, and a desire for immediate and often repeated affirmations. This population surge is not solely because families are having more children but also because the United States has a large immigrant population as well. This has implications for the client and staff needs of the LTC industry, as the communication between both can be hampered by cross-cultural (mis)understandings. These differences also have implications in the workplace. The United States workforce is shifting. Pew Research Center projects the baby boom generation, ages 52-70 years in 2016, retiring or near retirement and the millennials, ages 20-33 years, will fill many of those vacant jobs (Fry, 2018). Mead defines generational gap as differences of values, attitudes, or behaviors between birth cohorts, as is referenced in Shapiro (Shapiro 2005). Shapiro explains that these birth cohort’s major life experiences affects their development. Additionally, these cohort experiences generate deep bonds amongst them. Work/life balance is more fluid for this generation. Millennials want what they do professionally to have a purpose. They value education. Eddy, Ng, Schweitzer & Lyons (2010) examined a study of 23,413 undergraduate millennials on academic achievement on career expectations and priorities. These factors included demographic (i.e., gender, race, and year of WORK-RELATED VALUES OF MILLENNIALS IN LONG-TERM CARE 7 study) and academic performance. The results revealed an increase of accepting a less-than-ideal job with every additional year of study, and a decrease with each additional grade point. However, differences do exist in the expectations and priorities amongst gender, minority status, academic achievement, and work experience. “One must be careful not to paint the entire generation with the ‘same brush’” (Eddy, Ng, Schweitzer & Lyons, 2010, p. 290). What are the characteristics of the millennials? Highlighting the characteristics of Millennials, Stringer (2015) claims that: Millennials typically want jobs with a good salary and benefits and expect promotions every 2 years, sometimes regardless of performance. They are on track to have 25 to 29 jobs in their working life, becoming “surface dwellers”—knowing a little bit about a lot but being experts in little. They have inherited enormous global problems and are anxious about the economy. At the same time, they have shown little passion for solving big issues, and some observers have noted lower levels of civic engagement and political involvement than for any previous generation. Although millennials can seem