Home Care Workers’ Experiences of Client Death and Disenfranchised Grief

2018 ◽  
Vol 29 (3) ◽  
pp. 382-392 ◽  
Author(s):  
Emma K. Tsui ◽  
Emily Franzosa ◽  
Kristen A. Cribbs ◽  
Sherry Baron
Keyword(s):  
Health Care ◽  
New York ◽  
Home Care ◽  
Health Care Workers ◽  
Patient Death ◽  
Disenfranchised Grief ◽  
Care Workers ◽  
Close Relationship ◽  
Care Systems ◽  
Home Care Workers

While many types of health care workers experience patient death, home care workers do so under vastly different social and economic circumstances. When a client dies, home care workers often lose both a close relationship and a job. Though research suggests that health care workers’ grief may frequently be disenfranchised, there is no in-depth study of the mechanisms that disenfranchise home care workers’ grief specifically. To address this gap, our study used focus groups and peer interviews between home care workers in New York City. We describe four interrelated grief strategies they employ to navigate social and employer-based “grieving rules.” Our findings suggest that home care workers’ grief is disenfranchised via employer and societal underestimations of their relationships with clients and their losses when clients die, particularly job loss. Building on our findings, we suggest alterations to agency practices and home care systems to improve support for workers.

scholarly journals What Is Important at the End of Life? Perspectives From Experienced Home Care Workers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 70-70
Author(s):  
Emma Tsui ◽  
Emily Franzosa ◽  
Kathrin Boerner
Keyword(s):  
New York ◽  
Home Care ◽  
End Of Life ◽  
Limited Information ◽  
Care Providers ◽  
Patient Death ◽  
Home Based ◽  
Care Workers ◽  
Home Care Workers ◽  
Eol Care

Abstract Home care workers (HCWs) make up a large and rapidly growing sector of the American health care workforce serving older adults. This study focuses on a common but understudied feature of home care labor: workers’ thoughts around what makes a "good" or "bad" patient death. While researchers have investigated patients’, families’, physicians’, and other care providers’ perspectives on this issue, the perspectives of HCWs, who contribute substantially to home-based care at the end of life, have yet to be explored. We conducted 40 in-depth interviews with HCWs in New York City on their experiences with and reflections on patient death. We used a inductive, iterative approach to analyze data on what HCWs believe is important for dying patients. HCWs described EOL values that align well with the views held in common by patients, families, and other care providers, like the importance of not being alone when dying and being physically comfortable (not in pain and not suffering). In particular, HCWs conceptualized a detailed role for themselves when providing EOL care near the time of death. HCWs’ sustained presence and relationships with patients may uniquely position them to assist in the attainment of patients’ EOL goals, particularly when HCWs understand what these goals are. HCWs’ potential for playing this role, however, is jeopardized by a lack of training in EOL care and by the limited information they receive about a patient’s health status.

Pandemic Influenza: Antiviral Preparedness and Health Care Workers

2010 ◽  
Vol 4 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Ruth B. Schneider ◽  
John G. Benitez ◽  
Anne D’Angelo ◽  
Kathee Tyo
Keyword(s):  
Health Care ◽  
New York ◽  
Health Care Workers ◽  
Pandemic Influenza ◽  
Antiviral Agents ◽  
Antiviral Drugs ◽  
Primary Objective ◽  
Patient Contact ◽  
Vaccination Rates ◽  
Care Workers

ABSTRACTObjectives: The primary objective of this study was to determine the preparedness for pandemic influenza of hospitals, in terms of amount of antiviral drugs on hand and employee vaccination rates, in the Finger Lakes region (FLR) of western New York.Methods: A survey of the 17 FLR hospitals was conducted via e-mail during the period of June 2007 to August 2007.Results: A total of 13 of 17 hospitals responded for a response rate of 76.5%. Only 23.1% of responding hospitals stockpile antiviral drugs. Vaccination rates for personnel with patient contact ranged from 36.8% to 76.1%.Conclusions: Hospitals in the FLR have insufficient quantities of antiviral agents stockpiled to provide for the protection of health care workers, and influenza vaccination rates for health care workers are low. To ensure that a high level of care is maintained during a pandemic, health care workers need to be provided with appropriate protection. This can be accomplished if hospitals stockpile antiviral agents designated for the treatment and prophylaxis of health care workers with patient contact and their families.(Disaster Med Public Health Preparedness. 2010;4:55-61)

scholarly journals Informal home care providers: the forgotten health-care workers during the COVID-19 pandemic

The Lancet ◽  
2020 ◽  
Vol 395 (10242) ◽  
pp. 1957-1959 ◽  
Author(s):  
Emily Ying Yang Chan ◽  
Nina Gobat ◽  
Jean H Kim ◽  
Elizabeth A Newnham ◽  
Zhe Huang ◽  
...  
Keyword(s):  
Health Care ◽  
Home Care ◽  
Health Care Workers ◽  
Care Providers ◽  
Care Workers ◽  
Home Care Providers

Commitment to Change Among Health Care Workers in Pakistan

2020 ◽  
Vol 22 (3) ◽  
pp. 330-347
Author(s):  
Haroon Bakari ◽  
Ahmed Imran Hunjra ◽  
Stephen Jaros
Keyword(s):  
Health Care ◽  
Factor Analysis ◽  
Organizational Change ◽  
Health Care Workers ◽  
Health Care Systems ◽  
Change Initiative ◽  
Commitment To Change ◽  
Research Attention ◽  
Care Workers ◽  
Care Systems

Commitment to organizational change as an important focus of commitment has received greater attention in the literature of action commitments. Research indicates that this construct represents employee attitude towards change initiative and may be a greater predictor of support for change. This is of particular import in health care systems, globally, and in developing nations, in particular, which are constantly seeking to change and adapt to new medical and administrative advances. However, commitment to change (C2C) has received very little research attention from Asian health care systems. Therefore, this study answers the call for validation, by validating a culture-specific translated version of the C2C scale in a sample drawn from the privatization context of public sector hospitals in Pakistan. The goals are to: (a) examine some psychometric properties of the major Western-derived measures of C2C in Pakistan to see if they are valid and reliable there; and (b) draw implications from our results for the management of change efforts in Pakistani health care systems. Thus, exploratory factor analysis and confirmatory factor analysis (CFA) were conducted using SPSS and analysis of moment structures (AMOS) to provide evidence of reliability, construct validity and predictive validity of C2C among Pakistani health care workers. Results found evidence of the measure’s cross-cultural validity and revealed a positive correlation between C2C and three dimensions of behavioural support for change. This study is a significant contribution to the literature, being the first to provide comprehensive evidence of validity of the C2C scale in Pakistan, a developing country. An important implication for leaders of organizational change in Pakistan is that they may use this construct to unearth employee level of understanding and attitude towards change initiative to envisage mechanisms to foster employee support for change. Researchers may also use this construct in Pakistan’s context to assess employee C2C.

Prenatal Care for Undocumented Immigrants: Professional Norms, Ethical Tensions, and Practical Workarounds

2019 ◽  
Vol 47 (3) ◽  
pp. 398-408 ◽  
Author(s):  
Rachel E. Fabi ◽  
Holly A. Taylor
Keyword(s):  
Health Care ◽  
New York ◽  
Prenatal Care ◽  
Health Care Workers ◽  
Undocumented Immigrants ◽  
Safety Net ◽  
Publicly Funded ◽  
Professional Norms ◽  
Care Workers ◽  
Depth Interviews

This paper examines the practice implications of various state policies that provide publicly funded prenatal care to undocumented immigrants for health care workers who see undocumented patients. Data were collected through in-depth interviews with purposively sampled health care workers at safety net clinics in California, Maryland, Nebraska, and New York. Health care workers were asked about the process through which undocumented patients receive prenatal care in their health center and the ethical tensions and frustrations they encounter when providing or facilitating this care under policy restrictions. Respondents discussed several professional practice norms as well as the ethical tensions they encountered when policy or institutional constraints prevented them from living up to professional norms. Using Nancy Berlinger's “workarounds” framework, this paper examines health care workers' responses to the misalignment of their professional norms and the policy restrictions in their state. These findings suggest that the prenatal policies in each state raise ethical and professional challenges for the health care workers who implement them.

scholarly journals ‘It’s what you do that makes a difference’ An interpretative phenomenological analysis of health care professionals and home care workers experiences of nutritional care for people living with dementia at home

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Louise Mole ◽  
Bridie Kent ◽  
Mary Hickson ◽  
Rebecca Abbott
Keyword(s):  
Health Care ◽  
Home Care ◽  
Health Care Professionals ◽  
Interpretative Phenomenological Analysis ◽  
Phenomenological Analysis ◽  
Care Practice ◽  
Nutritional Care ◽  
Care Workers ◽  
Home Care Workers ◽  
At Home

Abstract Background People living with dementia at home are a group who are at increased risk of malnutrition. Health care professionals and home care workers, are ideally placed to support nutritional care in this vulnerable group. Yet, few, if any studies, have captured the experiences of these workers in respect of treating and managing nutritional issues. This interpretative phenomenological study aimed to explore the experiences and perceptions of the nutritional care of people living with dementia at home from the perspectives of health care professionals and home care workers. Methods Semi-structured interviews were conducted between December 2017 and March 2018, and supplemented with the use of a vignette outlining a scenario of a husband caring for his wife with dementia. Health care professionals and home care workers were purposively recruited from local care providers in the south west of England, who had experience of working with people with dementia. An Interpretative Phenomenological Analysis (IPA) approach was used throughout. Results Seven participants took part including two home care workers, a general practitioner, dietitian, occupational therapist, nurse and social worker. The time in their professions ranged from 3 to 15 years (mean = 8.9 years). Following analysis, four superordinate themes were identified: ‘responsibility to care’, ‘practice restrained by policy’, ‘in it together’, and ‘improving nutritional care’. This group of health care professionals and home care workers recognised the importance of improving nutritional care for people living with dementia at home, and felt a responsibility for it. However they felt that they were restricted by time and/or knowledge. The importance of supporting the family carer and working collaboratively was highlighted. Conclusions Health care professionals and home care workers require further training to better equip them to provide nutritional care for people living with dementia at home. Models of care may also need to be adapted to enable a more flexible and tailored approach to incorporate nutritional care. Future work in this area should focus on how health care professionals and home care workers can be better equipped to screen for malnutrition, and support changes to nutritional intake to mitigate malnutrition risk.

Intrusion into Patient Privacy: a moral concern in the home care of persons with chronic mental illness

1999 ◽  
Vol 6 (5) ◽  
pp. 399-410 ◽  
Author(s):  
Annabella Magnusson ◽  
Kim Lützén
Keyword(s):  
Health Care ◽  
Mental Illness ◽  
Home Care ◽  
Health Care Workers ◽  
Ethical Decision Making ◽  
Chronic Mental Illness ◽  
Moral Concern ◽  
Patient Privacy ◽  
Care Workers ◽  
Constant Comparative Analysis

The aim of this study was to identify and analyse ethical decision making in the home care of persons with long-term mental illness. A focus was placed on how health care workers interpret and deal with the principle of autonomy in actual situations. Three focus groups involving mental health nurses who were experienced in the home care of persons with chronic mental illness were conducted in order to stimulate an interactive dialogue on this topic. A constant comparative analysis of the transcribed audiotaped sessions identified a central theme that concerned the moral symbolic meaning of ‘home’. This reflected the health care workers’ conflict between their professional role and their moral role, which they perceived as unclear.

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