The Contribution of Home Care Workers' Emotional and Social Vulnerabilities and the Older Adult's Functional Condition to Ageism

Background and Purpose: The Terror Management Theory links death anxiety to ageism, suggesting that ageism may emerge from unconscious fears associated with old age. Although previous studies have revealed a connection between death anxiety and ageism, particularly among health care workers, little research has investigated whether death anxiety mediates the relationship between vulnerability factors and ageism. The current study therefore aims to enhance the understanding of ageism risk factors among home care workers of older adults by examining the relationships between psychological vulnerability (psychological distress), social vulnerability (loneliness and poor social support), the functional condition of the older adult, and ageism, while exploring the mediating role of death anxiety.

Methods: A sample of 400 home care workers, mandated by the National Insurance Nursing Law, completed a quantitative questionnaire evaluating the research variables. Structural equation modeling (SEM) was employed to analyze direct and mediating effects.

Results: The findings indicate that death anxiety mediates all relationships between predictor variables and ageism. For loneliness and the functional status of the older adult, death anxiety fully mediates the relationship. In the case of psychological distress, the mediation is partial, strengthening the association with ageism. Surprisingly, for social support, a suppression effect emerges, resulting in two contradicting associations: the negative direct association of social support with ageism, and its positive association with death anxiety.

Conclusions and Implications: The results expand the existing knowledge of ageism risk factors and emphasize the need to identify vulnerable care workers, underscoring the importance of providing them with support and training.