(In)Decent work conditions and quality care: an issue for long-term care policy

2021 ◽  
pp. 1-26
Author(s):  
Ana Paula Gil
Keyword(s):  
Working Conditions ◽  
Quality Care ◽  
Work Conditions ◽  
Care Work ◽  
Decent Work ◽  
Physical And Mental Health ◽  
Structured Interviews ◽  
Care Needs ◽  
Term Care ◽  
Care Workers

Abstract The availability of informal care will remain a key factor influencing future demand for formal services and the analysis cannot be dissociated from formal care. Based on the ‘unpaid care work–paid work–paid care work circle’, proposed by the International Labour Office, this paper focuses on the individual, interpersonal and organisational determinants that most influence quality care. This paper is based on 40 semi-structured interviews with care workers, in 16 Portuguese care homes, in one council in the metropolitan area of Lisbon. In spite of social change processes in the care worker profession in Portuguese nursing homes, in the last decade, in terms of numbers, age and education, the interviews allowed me to unveil qualitatively what the numbers hid: precarious working conditions, insufficient staffing, excessive workloads and long working hours, high rotation and insufficient skills. All these determinants have consequences not only on the quality of the care that these care workers can offer, but also on their physical and mental health, job satisfaction and work environment. The high demand of care needs due to the ageing of the population, calls for continued efforts in improving working conditions, and a national strategy to promote recruitment of a diverse, younger and more-qualified workforce. The professionalisation of care work must be integrated with migration and employment policies (improvement of job quality and working conditions).

The epistemological complexity of ideal care: long-term care professionals’ perspectives

2022 ◽  
Author(s):  
Antti Hämäläinen
Keyword(s):  
Long Term Care ◽  
Cognitive Impairments ◽  
Care Work ◽  
Structured Interviews ◽  
Term Care ◽  
Care Workers ◽  
Care Practices ◽  
Epistemological Basis ◽  
Epistemological Complexity

The article elaborates what aspects of knowledge eldercare workers describe concerning everyday long-term care practices. The article utilises a thematic analysis of Finnish long-term care workers’ semi-structured interviews (n = 25), and in doing so, it contributes to the discussion concerning the epistemological basis of care. The analysis specifies four aspects of knowledge in long-term care work: objective/objectifying, particular, corporeal and tacit. In line with existing literature on knowledge and care, the findings indicate that rational-technical epistemological approaches are insufficient when complex and fluid care relations are concerned. Moreover, cognitive impairments and other particularities of eldercare provide previously under-researched epistemological perspectives for consideration.

“Then They Trust You …”

2017 ◽  
Vol 27 (2) ◽  
pp. 225-245 ◽  
Author(s):  
Marsha Love ◽  
Felipe Tendick-Matesanz ◽  
Jane Thomason ◽  
Davine Carter ◽  
Myra Glassman ◽  
...  
Keyword(s):  
Home Care ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Team Members ◽  
Physical Independence ◽  
Care Workers ◽  
Communications Skills ◽  
Home Care Workers

The home care workforce, already at 2.7 million caregivers, will become the nation’s fastest growing occupation by 2024 as the senior boom generation accelerates the demand for in home services to meet its long-term care needs. The physically challenging work of assisting clients with intimate, essential acts of daily living places home care workers (HCWs) at risk for musculoskeletal disorders (MSDs); yet, HCWs typically receive little formal job training and may lack appropriate assistive devices. In this qualitative pilot study, HCW focus groups described workplace MSD risk factors and identified problem-solving strategies to improve ergonomic conditions. The results revealed that HCWs rely on their behavioral insights, self-styled communications skills and caring demeanor to navigate MSD risks to themselves and increase clients’ physical independence of movement. We suggest changes in employer and government policies to acknowledge HCWs as valued team members in long-term care and to enhance their effectiveness as caregivers.

Formal and informal long term care work: policy conflict in a liberal welfare state

2017 ◽  
Vol 37 (3/4) ◽  
pp. 134-147 ◽  
Author(s):  
Caroline Murphy ◽  
Thomas Turner
Keyword(s):  
Welfare State ◽  
Informal Care ◽  
Long Term Care ◽  
Care Work ◽  
Formal Care ◽  
Term Care ◽  
Content Type ◽  
Care Workers ◽  
Informal Carers

Purpose The undervaluing of care work, whether conducted informally or formally, has long been subject to debate. While much discussion, and indeed reform has centred on childcare, there is a growing need, particularly in countries with ageing populations, to examine how long-term care (LTC) work is valued. The purpose of this paper is to provide an overview of the way in which employment policies (female labour market participation, retirement age, and precarious work) and social policies (care entitlements and benefits/leave for carers) affect both informal carers and formal care workers in a liberal welfare state with a rapidly ageing population. Design/methodology/approach Drawing the adult worker model the authors use the existing literature on ageing care and employment to examine the approach of a liberal welfare state to care work focusing on both supports for informal carers and job quality in the formal care sector. Findings The research suggests that employment policies advocating increased labour participation, delaying retirement and treating informal care as a form of welfare are at odds with LTC strategies which encourage informal care. Furthermore, the latter policy acts to devalue formal care roles in an economic sense and potentially discourages workers from entering the formal care sector. Originality/value To date research investigating the interplay between employment and LTC policies has focused on either informal or formal care workers. In combining both aspects, we view informal and formal care workers as complementary, interdependent agents in the care process. This underlines the need to develop social policy regarding care and employment which encompasses the needs of each group concurrently.

scholarly journals ‘It’s a real fine balancing act’: directly employed care workers’ experiences of engaging with health services

2021 ◽  
Author(s):  
Jane Wilcock ◽  
Jill Manthorpe ◽  
Jo Moriarty ◽  
Steve Iliffe
Keyword(s):  
Health Services ◽  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Well Being ◽  
Care Work ◽  
Structured Interviews ◽  
Care Workers ◽  
The Impact ◽  
Health And Well Being

Little is known of the experiences of directly employed care workers communicating with healthcare providers about the situations of their employers. We report findings from 30 in-depth semi-structured interviews with directly employed care workers in England undertaken in 2018–19. Findings relate to role content, communication with healthcare professionals and their own well-being. Directly employed care workers need to be flexible about the tasks they perform and the changing needs of those whom they support. Having to take on health liaison roles can be problematic, and the impact of care work on directly employed workers’ own health and well-being needs further investigation.

scholarly journals Developing Care Professionals: Changing Disability Services in Sweden

2018 ◽  
Vol 8 (2) ◽  
pp. e2017 ◽  
Author(s):  
Richard Gäddman Johansson ◽  
Ulla Hellström Muhli
Keyword(s):  
Close Contact ◽  
Care Service ◽  
Care Work ◽  
Disability Services ◽  
Intellectual And Developmental Disabilities ◽  
Front Line ◽  
Structured Interviews ◽  
Care Services ◽  
Care Workers ◽  
Line Contacts

In Sweden, professionalization projects in disability care services are currently being undertaken in order to differentiate and establish a professional identity for professionals within care work. The aim of this paper was to analyse the experiences of care workers’ meaning of the professionalization process concerning their occupation and their occupational identity in relation to tasks they perform in front-line contacts with persons with intellectual and developmental disabilities at respite care service homes. Semi-structured interviews were conducted with ten care workers. The meaning of the professionalization projects is an ongoing process of a connected mission, meaning that the care work is performed in close contact with care receivers and that it takes place within an informal and free framework, predicated on a logic of possessing a particular kind of “care-feeling.”

scholarly journals The different faces of care work: understanding the experiences of the multi-cultural care workforce

2009 ◽  
Vol 29 (3) ◽  
pp. 337-350 ◽  
Author(s):  
MARTHA DOYLE ◽  
VIRPI TIMONEN
Keyword(s):  
Long Term Care ◽  
Care Work ◽  
Term Care ◽  
Care Services ◽  
Care Givers ◽  
Experience Of Care ◽  
Care Workers ◽  
Cultural Care ◽  
Industrialised Countries

ABSTRACTAn increased demand for long-term care services coupled with the decreased availability of informal (family) carers in many industrialised countries has led to the employment of growing numbers of ‘migrant care workers’. Little is known about this heterogeneous group or of their experience of employment in long-term care. Providing an important insight into a hitherto little researched and poorly understood topic, this article presents the findings of a qualitative study in Ireland that sought greater understanding of migrant carers' experience of care work and of the intra-group differences among them. The findings suggest that some members of the long-term care workforce are more likely to confront obstacles and discrimination than others. The data indicate that the experiences of European, South Asian and African carers are significantly different and that relationships may exist between carers' region of origin and their experience of care work, employment mobility and long-term plans for remaining in the sector. The findings underscore the significance of acknowledging the unique barriers and obstacles faced by particular populations of care workers. A better understanding of the changing demographic profile and needs of both care recipients and their paid (migrant) care-givers is required to ensure that appropriate policy and practical interventions are developed to support both groups.

A Rapid Qualitative Appraisal of the Impact of COVID-19 on Long-term Care Communities in the United States: Perspectives from Area Aging Staff and Advocates

2020 ◽  
Vol 79 (4) ◽  
pp. 313-322
Author(s):  
Andrea Freidus ◽  
Dena Shenk ◽  
Christin Wolf
Keyword(s):  
Long Term Care ◽  
The United States ◽  
Qualitative Assessment ◽  
Physical And Mental Health ◽  
Term Care ◽  
Care Community ◽  
Care Workers ◽  
Key Points ◽  
The Impact

The COVID-19 epidemic has hit residents and staff of congregate long-term care communities particularly hard. In North Carolina, the site of this research, over half of registered mortality has been associated with congregate living communities. This article reports on phase one of a rapid qualitative assessment of long-term care professionals and regional aging staff navigating care during this epidemic. Our purpose is twofold. We demonstrate both the value of rapid qualitative appraisals to capture the perspectives and concerns of COVID-19’s long-term care workers and area aging staff, in this case, the staff and advocates that care for and protect the rights of long-term care community residents as well as present data collected in this phase. Key points raised focus on safety, including access and use of personal protective equipment, infection control, limited testing, and staffing issues. In addition, participants expressed concerns about the physical and mental health of residents because they have been isolated from family and friends since the executive order closed these communities to all non-essential people. We will utilize these data, in collaboration with staff and advocates, to inform policy and programming to better address the needs of both residents and staff of long-term care communities.

scholarly journals Measuring attentiveness toward oral care needs: a comparative study of Indonesian care workers in Japan and Indonesia

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuko O. Hirano ◽  
Susiana Nugraha ◽  
Hiroyasu Shiozu ◽  
Misako Higashijima ◽  
Tri Budi W. Rahardjo
Keyword(s):  
Older Adults ◽  
Migrant Workers ◽  
Response Rate ◽  
Oral Care ◽  
Care Needs ◽  
Term Care ◽  
Care Workers ◽  
Care Assessment ◽  
Economic Partnership ◽  
Negative Impacts

Abstract Background Japan has opened its labor market to care workers from Indonesia under the Japan–Indonesia Economic Partnership Agreement (EPA). However, few studies have examined the types of care skills transferred between countries. We therefore analyzed Indonesian care workers employed in Japan and Indonesia to identify discrepancies in their attentiveness toward oral care in older adults. Methods A checklist comprising 42 items of universal oral care assessment was developed prior to the study and distributed via the Internet to 418 Indonesian EPA care workers in Japan and via a paper survey to 213 Indonesian care workers in Indonesia. The Mann–Whitney U test was used to compare the distribution of scores for each checklist item for each group. Results The respondents were 110 Japan-based EPA care workers (response rate: 26.3%) and 213 Indonesia-based care workers (response rate: 99.1%). Japan-based care workers were significantly more likely to perform environmental observations of their older adult patients (p < 0.001) and to check items on the oral care checklist during feeding (p < 0.001) and post-meal (p = 0.001), while Indonesia-based care workers were more likely to check the overall condition of patients before meals (p = 0.021). Conclusions Discrepancies in checking oral care between the two groups were attributed to the differences in laws and regulations governing the care environments. Indonesian care workers employed in Japan have the advantage of learning to employ a more systematic approach in caring for older adults, in accordance with Japan’s Long-Term Care Act. This approach could contribute toward lowering the risk of aspiration pneumonia in Indonesia. A training program designed for returning migrant workers to transfer newly developed oral care skills will thus be essential for Indonesia to diminish the negative impacts of its aging population.

scholarly journals Love vs. money: Understanding unique challenges in care workers’ labor organizing

2021 ◽  
Author(s):  
Grace Flores-Robles ◽  
Ana P. Gantman
Keyword(s):  
Working Conditions ◽  
Care Work ◽  
Labor Organizing ◽  
Sacred Values ◽  
Care Workers ◽  
Additional Challenge

Care work pays less than it should, given the characteristics of the jobs and the qualifications of its workers (England et al., 2002). Care workers also face unique challenges as they organize for better working conditions, including better pay, because they do not want to threaten to withhold care from those in their charge (England, 2005). We propose that care workers face an additional challenge in organizing because, for some observers, it highlights that care workers are paid to care. To investigate this question, we examine how people respond to the organizing efforts of care workers through the lens of the Sacred Values Protection Model (SVPM; Tetlock et al., 2000). According to the SVPM, there are certain values that people assume to be sacred and unquestionable (e.g., love, justice). When we are forced to consider pitting a sacred value, like love, against a secular one, like money, the tradeoff is seen as taboo. As a result, people react with outrage, and the desire to see those who have engaged in the taboo tradeoff reaffirm the sacred value. In this chapter, we will argue that people’s opposition to care workers’ labor organizing can be partly explained by how much they view engaging in care work as trading love for money. For some, care work may be perceived as a taboo tradeoff, blurring the divide between activities performed out of love and those performed for pay. We suggest that labor organizing can inadvertently highlight this tension.

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