Residential Care Aides’ Experiences of Workplace Incivility in Long-Term Care

Work Employment and Society ◽

10.1177/0950017020977314 ◽

2021 ◽

pp. 095001702097731

Author(s):

Heather A Cooke ◽

Jennifer Baumbusch

Keyword(s):

Residential Care ◽

Long Term Care ◽

Participant Observation ◽

Quality Care ◽

Care Homes ◽

Workplace Relationships ◽

Structured Interviews ◽

Term Care ◽

Care Aides

Exposure to peer incivility and bullying potentially disrupts the respectful, collaborative workplace relationships essential to quality care provision in long-term care homes. This study critically examined the nature of peer incivility and bullying in residential care aides’ workplace relationships. Using critical ethnography, 100 hours of participant observation and 33 semi-structured interviews were conducted with residential care aides, licensed practical nurses, support staff and management in two, non-profit care homes in British Columbia, Canada. While residential care aides’ experiences of bullying were rare, peer incivility was pervasive, occurring on an almost daily basis. Two key themes, ‘gendered work environment’ and ‘seeking informal power and control’, reflect how residential care aides experienced and explained their uncivil encounters. Findings highlight the gendered, relationally aggressive nature of workplace mistreatment within this predominantly female workforce.

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Care Aides Working Multiple Jobs: Considerations for Staffing Policies in Long-Term Care Homes During and After the COVID-19 Pandemic

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2020.07.036 ◽

2020 ◽

Vol 21 (10) ◽

pp. 1390-1391 ◽

Cited By ~ 1

Author(s):

Yinfei Duan ◽

Ala Iaconi ◽

Yuting Song ◽

Peter G. Norton ◽

Janet E. Squires ◽

...

Keyword(s):

Long Term Care ◽

Care Homes ◽

Term Care ◽

Care Aides

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Enhancing Quality Care in Ontario Long-Term Care Homes Through Audit and Feedback for Physicians

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2019.11.017 ◽

2020 ◽

Vol 21 (3) ◽

pp. 420-425

Author(s):

Cara L. Mulhall ◽

Jonathan M.C. Lam ◽

Patrick S. Rich ◽

L. Gail Dobell ◽

Anna Greenberg

Keyword(s):

Long Term Care ◽

Quality Care ◽

Audit And Feedback ◽

Care Homes ◽

Term Care

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Challenges in Caring for Unbefriended Residents in Long-term Care Homes: A Qualitative Study

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa079 ◽

2020 ◽

Vol 75 (9) ◽

pp. 2050-2061

Author(s):

Stephanie A Chamberlain ◽

Wendy Duggleby ◽

Pamela B Teaster ◽

Janet Fast ◽

Carole A Estabrooks

Keyword(s):

Complex Adaptive Systems ◽

Adaptive Systems ◽

Long Term Care ◽

Care Staff ◽

Care Homes ◽

Term Care ◽

Complex Adaptive ◽

Care Aides

Abstract Objectives This study examined challenges experienced by long-term care staff in caring for unbefriended residents who are incapacitated and alone. These residents often are estranged from or have no living family or live geographically distant from them and require a public guardian as their surrogate decision-maker. To date, research on unbefriended older adults has focused on those living in acute care and community settings. Little is known about those living in long-term care homes. Method We conducted semi-structured interviews with 39 long-term care staff (e.g., registered nurses, care aides, social workers) and 3 public guardians. Staff were sampled from seven long-term care homes in Alberta, Canada. We analyzed interview transcripts using content analysis and then using the theoretical framework of complex adaptive systems. Results Long-term care staff experience challenges unique to unbefriended residents. Guardians’ responsibilities did not fulfill unbefriended residents’ needs, such as shopping for personal items or accompanying residents to appointments. Consequently, the guardians rely on long-term care staff, particularly care aides, to provide increased levels of care and support. These additional responsibilities, and organizational messages dissuading staff from providing preferential care, diminish quality of work life for staff. Discussion Long-term care homes are complex adaptive systems. Within these systems, we found organizational barriers for long-term care staff providing care to unbefriended residents. These barriers may be modifiable and could improve the quality of care for unbefriended residents and quality of life of staff. Implications for practice include adjusting public guardian scope of work, improving team communication, and compensating staff for additional care.

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THE NATURE OF PEER WORKPLACE INCIVILITY AND BULLYING AMONG RESIDENTIAL CARE AIDES IN LONG-TERM CARE

Innovation in Aging ◽

10.1093/geroni/igz038.2569 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S698-S698

Author(s):

Heather A Cooke ◽

Kaitlin Murray ◽

Jennifer Baumbusch ◽

Lisa Kelly

Keyword(s):

Residential Care ◽

Participant Observation ◽

Care Home ◽

Workplace Incivility ◽

Term Care ◽

Licensed Practical Nurses ◽

For Profit ◽

Not For Profit ◽

Care Aides

Abstract Residential care aides (RCAs; unregulated workers also known as certified nursing assistants or personal care assistants) provide much of the hands-on care in long-term residential care (LTRC). While many RCAs report being exposed to violent or aggressive acts from residents, we know little about their exposure to incivility and bullying from their colleagues. This is a significant knowledge gap as increased workplace incivility and bullying is associated with specific gender-dominated fields, hierarchical and stressful work environments, and low job autonomy, all of which characterize LTRC. Drawing on data from a critical ethnography examining workplace incivility and bullying among RCAs in a rural, not-for-profit care home, this presentation explores the types of incivility and bullying encountered by RCAs, and the contextual factors impacting their experiences with such behaviors. To date, more than 50 hours of participant observation, and 20 in-depth interviews with RCAs, licensed practical nurses, support staff, and management have been conducted. Findings illustrate the pervasiveness of incivility; while bullying acts (repeated, hostile behaviors intended to undermine, humiliate or injure) were rare, incivility (low-intensity acts with an ambiguous intent to harm) was an almost daily occurrence. Commonly-occurring behaviors included ignoring and refusing co-worker’s requests for help, social exclusion, acting impatient with, blaming and criticizing co-workers, and insisting on getting one’s own way. Chronic staffing shortages, staffing arrangements, and workload issues exacerbated RCAs’ experiences. Findings provide an important first step in understanding the nature of workplace incivility and bullying in LTRC.

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It takes time: Building relationships and understanding through an intergenerational ballet programme

Dementia ◽

10.1177/1471301218772895 ◽

2018 ◽

Vol 19 (2) ◽

pp. 270-284

Author(s):

Shelley E Canning ◽

Michael Gaetz ◽

Darren Blakeborough

Keyword(s):

Older Adults ◽

Residential Care ◽

Long Term Care ◽

Care Home ◽

Care Homes ◽

Term Care ◽

Negative Stereotypes ◽

Building Relationships ◽

Meaningful Relationships

Individuals living in long-term residential care homes are often viewed through a negative lens. These residents have increasingly complex care needs, and their functional, communication and cognitive challenges can support conceptualizations of difference and disability perpetuating negative stereotypes of age and dementia. However, engaging in meaningful activities and relationships with older adults, including those with dementia, has been shown to promote positive attitudes. Specifically, intergenerational programming that provides opportunities for meaningful engagement between children and older adults has been shown to support positive emotional experiences through socializing and building relationships. This qualitative study explored the development of relationships between school-aged children and older adults with dementia living in a long-term residential care home. Residents in long-term care homes and children typically have limited opportunities to interact with each other; in this study, participating in an intergenerational dance programme provided an opportunity for meaningful relationships to develop. This paper focuses on the development of the children’s attitudes and understandings of their much older dance partners. Seven girls between the ages of seven and nine participated in ballet classes with residents in a long-term care home for one hour each week over a six-month period. All of the residents had a diagnosis of moderate to advanced dementia. Further, all of the residents also had other chronic health issues such as cardiac, respiratory and/or neurological diseases. The children were interviewed at the baseline, three- and six-month intervals. Prior to beginning the dance programme, the children anticipated their dance partners to be unwell and unable. However, by the end of six months, the children described the residents much more positively highlighting their abilities and strengths. Over time, through participating in a structured intergenerational programme, the children’s views of disability and difference disappeared as they formed dance partnerships and developed meaningful relationships.

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Family Members’ Experiences of Maintaining an Older Relative’s Functional Ability in Long-Term Care

Innovation in Aging ◽

10.1093/geroni/igaa057.297 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 90-90

Author(s):

Vilhelmiina Lehto-Niskala ◽

Outi Jolanki ◽

Marja Jylhä

Keyword(s):

Functional Ability ◽

Long Term Care ◽

Quality Care ◽

Family Members ◽

Care Staff ◽

Structured Interviews ◽

Term Care ◽

Staff Members ◽

Care Family

Abstract Family members have important role in care of older people. In residential long-term settings family members can find themselves in an ambiguous situation: officially, responsibility for provision and quality of care rests with the care provider and staff members, but in practice family members participate in caring. This study explores the role of family members in residential long-term care settings, particularly in supporting their older relatives’ functional ability. Developing and maintaining functional ability lies at the very core of healthy ageing policies and long-term care. The data consist of semi-structured interviews with family members (n=16) from eight long-term care facilities in Finland. Thematic analysis yielded three themes: maintaining personhood, engaging in everyday life and monitoring care. Family members in our study were actively involved in care that supported the functional ability of their older relative. However, family members had also conflicting views about who was responsible for care provision. Some participants willingly accepted their caregiver responsibilities even in residential care, while others described their involvement in care not as a matter of choice but rather as one of necessity in order to ensure good quality care. It is important to see the family members’ viewpoint which, based on the results of this study, emphasizes personhood and continuity of care. If they are willing to participate, family should be able to take part in caregiving together with the care staff and their role should be recognized.

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Evaluating the integration of palliative care in national health systems: an indicator rating process with EAPC task force members to measure advanced palliative care development

BMC Palliative Care ◽

10.1186/s12904-021-00728-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Natalia Arias-Casais ◽

Eduardo Garralda ◽

Miguel Antonio Sánchez-Cárdenas ◽

John Y. Rhee ◽

Carlos Centeno

Keyword(s):

Primary Care ◽

Palliative Care ◽

Long Term Care ◽

Task Force ◽

National Level ◽

Structured Interviews ◽

Term Care ◽

Care Facilities ◽

Rating Process

Abstract Background Palliative care (PC) development cannot only be assessed from a specialized provision perspective. Recently, PC integration into other health systems has been identified as a component of specialized development. Yet, there is a lack of indicators to assess PC integration for pediatrics, long-term care facilities, primary care, volunteering and cardiology. Aim To identify and design indicators capable of exploring national-level integration of PC into the areas mentioned above. Methods A process composed of a desk literature review, consultation and semi-structured interviews with EAPC task force members and a rating process was performed to create a list of indicators for the assessment of PC integration into pediatrics, long-term care facilities, primary care, cardiology, and volunteering. The new indicators were mapped onto the four domains of the WHO Public Health Strategy. Results The literature review identified experts with whom 11 semi-structured interviews were conducted. A total of 34 new indicators were identified for national-level monitoring of palliative care integration. Ten were for pediatrics, five for primary care, six for long-term care facilities, seven for volunteering, and six for cardiology. All indicators mapped onto the WHO domains of policy and education while only pediatrics had an indicator that mapped onto the domain of services. No indicators mapped onto the domain of use of medicines. Conclusion Meaningful contributions are being made in Europe towards the integration of PC into the explored fields. These efforts should be assessed in future regional mapping studies using indicators to deliver a more complete picture of PC development.

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