Investigating Factors Influencing Personal Support Workers' Turnover in Long-Term Care.

The greatest threat to the health and well-being of older adults is not disease alone, but the growing shortage of a stable long-term care (LTC) workforce. During the COVID-19 pandemic, LTC homes became epicentres of suffering, where thousands of older adults died and long-standing structural gaps were exposed. As Canada's aging population expands and is projected to reach one-quarter of the population by 2040, the need for personal support workers (PSWs), who provide most hands-on care, continues to rise. Despite significant federal and provincial investments, LTC facilities remain chronically understaffed. Nearly 40% of PSWs leave within their first year, and turnover continues to worsen, undermining care quality and contributing to preventable harms such as avoidable falls, pressure ulcers, and unnecessary hospitalizations. Recruitment alone is insufficient; understanding why PSWs stay or leave is essential to building a stable workforce. Existing research typically treats PSWs as a homogeneous group, overlooking how age, race, gender, and citizenship status shape workplace experiences and turnover intentions. This study seeks to identify the key factors driving PSW turnover in LTC and examine how these drivers differ across demographic groups. By uncovering these variations, the study aims to inform targeted and equitable retention strategies that strengthen workforce stability and protect older adults. As climate-related emergencies intensify, older adults, particularly those in LTC, face increased risks from extreme heat, global pandemics, and degraded air quality. Without a stable, well-prepared workforce, these events will expose residents to greater harm and preventable health impacts. Understanding and addressing the drivers of PSW turnover is therefore critical to ensuring safe, consistent, and resilient care for Canada's aging population.