Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Kay A. Snyder, Ph.D.

Second Advisor

D. Alex Heckert, Ph.D.

Third Advisor

Valerie Gunter, Ph.D.


There is a current and growing nursing shortage in the United States, at the same time that more aging baby boomers require health services. This problem is further complicated by continued growth in the home health industry and an aging RN workforce. The purpose of this study was to understand the work perceptions of older home health nurses and identify ways to keep older home health RNs working when appropriate. My initial goal involved using a mixed methodology, including not only in-depth qualitative interviews with older home health RNs but also quantitative analysis of secondary national and state surveys of all types of RNs. Due to the lack of significant statistical findings and limitations in the available secondary data, my main focus then became the qualitative part of my study. I completed 30 in-depth interviews with older home health RNs living in western Pennsylvania, who shared both positive and negative feelings about working in home health. Five major themes emerged from these interviews: (1) Older home health RNs expressedboth satisfaction and dissatisfaction with their work. (2) Various factors impacted older home health nurses’ retirement decisions – e.g., the availability of health insurance, age, personal health, financial responsibility for dependents, care-giving responsibilities. (3) These RNs had many suggestions for improving the likelihood that older home health RNs would want to work longer. (4) Older home health RNs had both positive and negative perceptions of younger home health RNs. (5) One-third brought up the fact that they planned to volunteer after retirement. The results both provide support for, as well as extend and contrast with existing research, adding to understanding of older home health RNs and suggesting new directions for research. Additionally, the results have implications for policy makers and health leaders(especially those working in home health care) trying to develop ways to either retain older RNs or identify those who no longer able to work in this environment. Overall, this study underscores the importance of conducting additional research to better understand how older RNs in home health care perceive their work.