scholarly journals Grief and Loss During Care Transitions: Experiences of Direct Care Workers

2021 ◽  
pp. 003022282110387
Author(s):  
Stephanie P. Wladkowski ◽  
Nancy Kusmaul ◽  
Abigail Latimer

Direct Care Workers (DCW) provide both personal care to patients and emotional support to patients and caregivers in hospice and palliative care. DCWs often develop close ties and are then expected to work with new clients immediately following a care transition, with little or no time to grieve. A qualitative pilot study (n = 24) was conducted to explore the experience of DCWs during care transitions. Data was collected via focus groups and individual interviews. Thematic analysis was used. Results suggest DCWs managed their experiences (n = 19), by anticipating and accepting grief and loss (n = 21), employing personal coping strategies (n = 19), and saying good-bye (n = 15). Relational factors impacted the experience of care transitions (n = 22), including building and maintaining the relationship (n = 14), and the strength of perceived connections (n = 15). Increased organizational support and training to help address grief and loss will better support DCWs and the direct care workforce.

Author(s):  
Kezia Scales

Abstract Nearly 4.6 million direct care workers—including personal care aides, home health aides, and nursing assistants—provide daily support to older adults and people with disabilities across a range of settings in the United States, predominantly in long-term care (LTC). Even as the population grows older and drives up demand for LTC, the sector continues its decades-long struggle to fill direct care positions and stabilize this essential workforce. Recent events and emerging trends have converged, however, to produce new opportunities to address this longstanding workforce crisis, including the unprecedented attention generated by the coronavirus disease 2019 (COVID-19) pandemic and the systemic shifts to managed care and value-based payment in LTC. This Forum article outlines the pressing direct care workforce challenges in LTC before describing these potential levers of change, emphasizing the importance of not just expanding the workforce but also maximizing direct care workers’ contributions to the delivery of high-quality services for a growing and evolving population of LTC consumers.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 248-248
Author(s):  
Verena Cimarolli ◽  
Robyn Stone ◽  
Natasha Bryant

Abstract The COVID-19 pandemic has generated awareness of the value of the direct care workforce to provide care in settings serving those most at risk from the disease. However, few studies have gauged the impact of COVID-19 on this workforce and their pandemic-related challenges. The purpose of this study was to examine the challenges and stress experienced by direct care workers (N=1,414) and their perceptions of preparation and quality of employer communication during this health crisis. Nursing home (NH) workers reported separation from family members and understaffing as the top external and work-related challenges. They felt adequately prepared and gave their employers high marks for communicating with them during the pandemic. NH direct care workers were more likely to report increased workload and understaffing as a challenge compared to workers in home and community-based settings. They also experienced a significantly higher number of work-related challenges compared to workers in assisted living.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 86-86
Author(s):  
Zhenzhen Zhang ◽  
Shuangshuang Wang ◽  
Nengliang (Aaron) Yao ◽  
Zhang Zhenzhen

Abstract High retention rates among direct care workers (DCWs) affect the quality of aged care. However, limited research has explored factors associated with retention in the Chinese aged care industry. This study compared turnover intention and job satisfaction among DCWs in Chinese hospitals and nursing homes. A total 370 DCWs from 7 hospitals (297 contractual, 73 non-contractual) and 311 DCWs from 7 nursing homes (27 contractual, 284 non-contractual) located in Fujian, China were recruited to fill out a questionnaire. Overall, DCWs from hospitals reported lower turnover intention (20.5 % vs 37.0%) and higher levels of job satisfaction (31.1% vs 16.4%) than DCWs from nursing homes. Specifically, contractual DCWs from hospitals indicated lower turnover intention (14.8%) than non-contractual DCWs from hospitals (43.8%) and both types of DCWs from nursing homes (36.3% and 44.4%). Higher job satisfaction was associated with lower turnover intention, but did not mediate the association between DCW types and turnover intention. Findings suggested that the government and institutions should help DCWs complete the identity transformation from non-contractual DCWs to contractual DCWs to enhance job security and benefits. For nursing home DCWs, licensing and registration requirements shall meet the standards for hospital DCWs. Attention is also to be paid to working conditions and staff welfare of DCWs, including social insurance, pensions, and trainings, to improve job satisfaction and reduce turnover intention.


2017 ◽  
Vol 25 (2) ◽  
pp. 257-274 ◽  
Author(s):  
Ha Do Byon ◽  
Donna Harrington ◽  
Carla L. Storr ◽  
Jane Lipscomb

Background and Purpose: Workplace violence research in health care settings using the Job Demands-Resources (JD-R) framework is hindered by the lack of comprehensive examination of the factor structure of the JD-R measure when it includes patient violence. Is patient violence a component of job demands or its own factor as an occupational outcome? Method: Exploratory factor analysis and confirmatory factor analysis were conducted using a sample of direct care workers in the home setting (n = 961). Results: The overall 2-construct JD-R structure persisted. Patient violence was not identified as a separate factor from job demands; rather, two demand factors emerged: violence/emotional and workload/physical demands. Conclusions: Although the three-factor model fits the data, the two-factor model with patient violence being a component of job demands is a parsimonious and effective measurement framework.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S702-S702
Author(s):  
Christopher M Kelly ◽  
Jerome Deichert ◽  
Lyn Holley

Abstract Purpose: This study tracks the growing number of direct care workers (DCWs) employed by private households and describes the differences between this often ignored labor force and DCWs employed by agencies. Design and Methods: Data were from the 1% Public Use Microdata Sample (PUMS) of the 2000 and 2017 American Community Survey (ACS). Logistic regression was used to compare demographic and employment characteristics of DCWs employed by private households and DCWs employed by agencies, which include outpatient care centers, home health care services, and individual and family services. Results: Between 2000 and 2017, the number of DCWs employed by private households in the U.S. increased 32% and the majority of this growth was since 2007. Compared to DCWs employed by agencies, DCWs employed by private households were more likely to be over age 65, white, unmarried, have higher educational attainment, be more likely to be in poverty, receive health insurance from Medicare or direct-pay. DCWs employed by private households were less likely to be under age 25, nonwhite, Hispanic, speak a language other than English, work year-round and full-time, receive health insurance from an employer or through Medicaid, and have a disability. Implications: DCWs employed by private households represent a small, but growing proportion of the long-term care (LTC) workforce in the U.S. Further, these workers are distinct within the LTC workforce. This has important implications both for DCWs and for families, particularly those with limited LTC options due to location, financial resources, family support, or other factors.


2020 ◽  
Vol Volume 15 ◽  
pp. 2019-2029
Author(s):  
Dukyoo Jung ◽  
Jennie C De Gagne ◽  
Minkyung Lee ◽  
Hyesoon Lee ◽  
Kyuri Lee ◽  
...  

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