Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Frank J. Whittington - Chair

Second Advisor

Mary M. Ball

Third Advisor

Elisabeth O. Burgess


Direct care worker turnover and shortages plague long-term care, weakening its quality, heightening costs for governments and employers, and cyclically breeding further turnover and shortages of workers. To address these issues, I investigate why direct care workers chose employment in long-term care (LTC), assisted living (AL) and specific AL facilities. Data come from a mixed-methods study of 45 AL facilities in Georgia, including interviews with 400 direct care workers. Findings include qualitative data analyzed using a grounded theory approach and descriptive quantitative data. Care workers’ motivations for employment in LTC, AL, and specific AL facilities reflect a split between moral and material values for care work, and care workers’ motivations illustrate a process of reconciling moral and material values. Individuals become care workers for reasons that are both materialistic, like earning a living wage, and moralistic, like the desire to care for others. They take employment expecting it to be consistent with their moral ideals and to satisfy their economic needs. Various individual, facility, industry, and community level factors influence workers’ motivations, and these factors reinforce the inconsistency between moral and material values for care work. Considering the heightening demand for LTC and short supply of care workers, as well as the deindustrialization of the economy, several recommendations are made for policies and practices that would support workers’ motivations for employment in LTC. Areas for future research also are highlighted.

Included in

Sociology Commons