Why do aged care employees leave? Two explanations compared

The aim of the study was to compare the explanatory power of the dissatisfaction-based account of aged care employee turnover against that of Lee and Mitchell's (1994) unfolding theory of turnover.

Mixed method prospective cohort study with three waves of employee survey data and an exit interview drawn from employees of a large Australian not-for-profit aged care provider. Independent t tests and mediated logistic regression analyses were conducted. Final sample: nStayers at Wave 3 = 138; nLeavers by Wave 3 = 42).

The classic dissatisfaction-based theory accounts for 19% of actual leavers. The five unfolding theory exit pathways accounted for 73.8% of all leavers. Stayers had the same dissatisfaction as leavers. Shock-based turnover (40.5% of all leavers) was more common than dissatisfaction-based turnover (33.5%). An additional 11.9% of leavers resigned to retire from paid work.

Dissatisfaction-based theory provided a relatively weak explanation of aged care turnover in this organisation. The unfolding theory provided a better and more nuanced account of employee leaving.

Unfolding theory exit interviews will assist aged care employers to better identify organizationally specific exit patterns and assist in finding appropriate organizational solutions to employee turnover.

This paper provides the first direct comparison of two explanations of aged care employee turnover and provides guidance to better retention at a time of labour shortage.