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.

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 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.

Lessons for regulating informal markets and implications for quality assurance – the case of migrant care workers in Austria

2015 ◽  
Vol 36 (4) ◽  
pp. 741-763 ◽  
Author(s):  
ANDREA E. SCHMIDT ◽  
JULIANE WINKELMANN ◽  
RICARDO RODRIGUES ◽  
KAI LEICHSENRING
Keyword(s):  
Quality Assurance ◽  
Long Term Care ◽  
Family Care ◽  
Professional Status ◽  
Control Mechanisms ◽  
Care Providers ◽  
Structured Interviews ◽  
Term Care ◽  
Care Workers

ABSTRACTThe rising number of private care arrangements in which live-in migrant care workers are engaged as a functional equivalent to family care calls for special attention by policy makers and formal long-term care providers on their implications for quality assurance and professional standards in the long-term care sector. Austria is one of the first countries in Europe where tangible legal measures have been taken to regulate this area under the heading of ‘24-hour care’, typically provided by middle-aged women. Reform measures went beyond policing and control mechanisms, including also incentives and tangible subsidies for all stakeholders. This paper contributes to a better understanding of their impact on the transition from informal to formal economy, focusing on quality assurance and working conditions. Based on empirical data and findings from semi-structured interviews with relevant stakeholders, a framework for the analysis of ‘illegal markets', based on Beckert and Wehinger's theory, is used to discuss potential implications in terms of valuation, competition and co-operation for policy in Austria, and to draw lessons for other countries. Results indicate that even after efforts to ‘legalise’ migrant care, the sector remains a ‘grey’ area within modern labour market legislation and quality management. This is due to the very nature of personal care, low professional status associated with care work and the reluctance of political stakeholders to regulate private household activities.

scholarly journals Reasons for Turnover Intention among Direct Care Workers in Korea’s Long-Term Care Insurance

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 395
Author(s):  
Yongho Chon ◽  
Yun-Young Kim
Keyword(s):  
Turnover Intention ◽  
Long Term Care ◽  
Health And Safety ◽  
Direct Care ◽  
Direct Care Workers ◽  
Structured Interviews ◽  
Term Care ◽  
Care Workers ◽  
Long Term Care Insurance

This study explored reasons for turnover intention among direct care workers under the Korean long-term care insurance (LTCI) system. The author conducted semi-structured interviews with 19 care workers. The study revealed four main themes underlying the intention of care workers to change or leave their jobs. Care workers struggled with demanding working conditions, and their salaries were low. Moreover, the relationships with their directors and supervisors was not good, since some care workers felt that their directors despised them or gave them inappropriate instructions, and their supervisors did not complete administrative work fairly. Lastly, some workers’ health conditions prevented them from carrying out their care work. The results have implications for working practices of care workers, prices of LTCI services, training of directors and supervisors, and coverage of occupational health and safety insurance for care workers.

Gaining access to the field in medical ethnography: Reflections on ethical, methodological, and structural challenges in the study of long-term care facilities

2021 ◽  
pp. 136345932098887
Author(s):  
Neta Roitenberg
Keyword(s):  
Long Term Care ◽  
Ethnographic Research ◽  
Term Care ◽  
Medical Institutions ◽  
Care Workers ◽  
Care Facilities ◽  
Key Issues ◽  
Access To The Field ◽  
Medical Ethnography

The article extends the discussion on the challenges in gaining access to the field in medical ethnographic research, focusing on long-term care (LTC) facilities. Medical institutions have been documented to be difficult sites to access. The reference, however, is to the recruitment of patients as informants. The challenges of recruiting practitioners as informants have not been investigated at all. The article presents the key issues that emerged in the process of gaining social access at the sites of two LTC facilities as part of a study on care workers’ identities. The main obstacles encountered during the fieldwork were organizational constraints and negotiating control over the process of recruiting the lower occupational tier of care workers with gatekeepers. The article presents the coping strategies implemented to overcome the ethical and methodological obstacles: continually reassessing the consent and cooperation of participants and developing a rapport with nurse’s aides during interviews.

scholarly journals Intersectionality: Mapping Critical Relations for Quality in Long-Term Care Research

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 39-39
Author(s):  
Katie Aubrecht ◽  
Ivy Bourgeault ◽  
Tamara Daly
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Social Divisions ◽  
Care Workers ◽  
Power Differentials ◽  
Care Relationships ◽  
And Gender ◽  
Relations Of Power ◽  
Status Of Care

Abstract Intersectionality is a useful method (Lutz, 2015) for interdisciplinary long-term care (LTC) research to advance a more critical understanding of how experiences of quality are shaped by mutually reproducing social divisions, identities and relations of power that shape LTC. This paper discusses insights from the “Mapping Care Relationships” stream of the Seniors – Adding Life to Years (SALTY) project, a pan-Canadian program of research examining clinical, social and policy perspectives on quality in LTC. “Mapping Care Relationships” mapped how promising approaches to care relationships are organized and experienced in LTC. From January 2018-August 2019 our team of nine researchers conducted rapid ethnographies in eight nursing homes, two in each of four provinces across Canada. We purposively observed and interviewed workers from a wide variety of positions and backgrounds, informed by an intersectionality approach. We traced how promising approaches in person-centred dementia care (PCDC) in particular may reify the subordinated status of care workers (some more than others) and reinforce inequities within LTC systems. In multiple LTC homes, front-line care workers described experiencing physical and emotional harm in care relationships with residents which caused them distress. However, consistent with a PCDC approach, the harm was attributed to ‘behaviours’ clinically symptomatic of dementia. In framing power differentials from a medical perspective, PCDC makes it possible to interpret harmful experiences as 'part of the job’ and something workers should know to expect, prevent, avoid, redirect, or ignore. Lutz, H. (2015). Intersectionality as method. DiGeSt. Journal of diversity and gender studies, 2(1-2), 39-44.

scholarly journals 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

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.

We’re told, ‘Suck it up’: Long-Term Care Workers’ Psychological Health and Safety

2017 ◽  
Vol 43 (1) ◽  
pp. 91-109 ◽  
Author(s):  
Susan Braedley ◽  
Prince Owusu ◽  
Anna Przednowek ◽  
Pat Armstrong
Keyword(s):  
Psychological Health ◽  
Long Term Care ◽  
Health And Safety ◽  
Term Care ◽  
Care Workers
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