Organizational Hierarchy, Work Environment, and Job Satisfaction in Dementia Care Settings

• In Event: Aging and the Life Course Section Roundtables
  In Refereed Roundtable (90 minute): 13: Institutional Care Arrangements and Experiences

Abstract

The growing prevalence of dementia and projected expansion of long-term services and supports have intensified demand for a stable and satisfied care workforce, yet workforce shortages and turnover remain persistent challenges. While prior research emphasizes individual-level factors, less is known about how organizational environments shape multilevel job satisfaction among dementia care workers, and whether these processes vary across institutional settings. Guided by Job Demands–Resources theory and distinctions between intrinsic and extrinsic job satisfaction, this study examines how workplace culture, schedule control, and training exposure influence worker satisfaction in assisted living facilities and nursing homes. Using nationally representative cross-sectional data from the National Dementia Workforce Study (2024-2025), we estimate a series of multivariate regression models predicting intrinsic and extrinsic job satisfaction while adjusting for job characteristics and demographics. Results indicate that supportive work culture, particularly supervisor appreciation and inclusion in the care team, is the strongest predictor of both intrinsic and extrinsic satisfaction across settings. Greater schedule control is associated with higher extrinsic satisfaction in both assisted living and nursing homes, while the burden of direct dementia care is linked to lower extrinsic satisfaction, especially in nursing homes. Training shows modest and setting-specific associations with intrinsic satisfaction but does not predict extrinsic satisfaction. Overall, findings highlight the central role of organizational resources in shaping workforce experiences and demonstrate that intrinsic and extrinsic satisfaction respond differently to workplace conditions. These results underscore the importance of improving workplace culture and schedule stability as key strategies for enhancing workforce well-being and supporting retention in long-term care settings.

Authors

• Yaqi(Sam) Yuan, Georgia Institute of Technology

• Zhiyong Lin, University of Texas-San Antonio