Scoping review identifies solutions for staff turnover and training in home care for older adults, suggesting effective career pathways.
Background As populations age, there is a growing global shift toward supporting older adults to live independently at home rather than in institutional settings. Health systeworldwide are grappling with how to deliver effective, person-centred home care while ensuring safety, sustainability, and workforce stability. A major barrier is the limited professional recognition, training opportunities, and career development available to home support workers, contributing to high staff turnover and persistent recruitment difficulties. In Ireland, these issues have created significant service backlogs, leaving thousands of older people waiting for essential home support. This scoping review examined international evidence and best practices to inform the development of a structured career pathway for Ireland’s home support workforce, aligned with training and system-wide workforce development priorities. Methods A scoping review was undertaken using Joanna Briggs Institute methodology, with structured searches across relevant databases and grey literature. Inclusion criteria and relevance grading were applied, and findings were thematically analysed using a “what works, for whom, when, and why” lens. Results The 261 included articles highlight the global significance of the issues. Four overarching themes were identified: 1) Attract and develop a competent and motivated workforce 2) Enhance working lives and retention 3) Utilise career pathways for quality and impact 4) Invest in data and digital for home care. Conclusion Based on the evidence, a Green Paper was developed proposing a safe, sustainable model for ageing in place. Following stakeholder consultation, which confirmed the proposals’ relevance, a White Paper was produced. It integrates feedback and presents recommendations grounded in the best available evidence and stakeholder input on advancing a career pathway for home support workers—targeted at providers, policymakers, educators, workers, clients, and family caregivers. Key aspects includes roles and responsibilities, career progression, training and development, quality careers and data analysis.
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Lynch et al. (2025) studied this question.
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