scholarly journals Rationalized aging

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Alana Lee Glaser
Keyword(s):  
United States ◽  
New York ◽  
The Elderly ◽  
The United States ◽  
Direct Care ◽  
Direct Care Workers ◽  
Home Health Aides ◽  
Care Workers ◽  
Flexible Accumulation ◽  
Direct Care Work

There are approximately 4.4 million direct-care workers in the United States. Comprising the labor of nurses, home health aides, certified nursing assistants, personal attendants, and companions to the elderly, direct-care work constitutes one of the fastest-growing labor niches in the United States. Within the commodified caregiving sector, cost-cutting imperatives to subdivide care labor introduce insalubrious complications for patients by cleaving – or attempting to do so – their physical needs from their emotional and relational needs, a process that I label ‘rationalized aging’. In this essay, I reflect on my experiences as a paid elder companion in New York City to argue that this process of subdivision combines earlier nineteenth-century rationalization strategies with neoliberal regimes of flexible accumulation and to highlight the consequences of subdivision in this sector both for care workers and for the patients in their care.

scholarly journals It Is Time to Resolve the Direct Care Workforce Crisis in Long-Term Care

2020 ◽  
Author(s):  
Kezia Scales
Keyword(s):  
Long Term Care ◽  
The United States ◽  
Direct Care ◽  
Direct Care Workers ◽  
Term Care ◽  
Home Health Aides ◽  
Emerging Trends ◽  
Care Workers ◽  
Direct Care Workforce

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.

The Homecare Aide Workforce Initiative: Implementation and Outcomes

2017 ◽  
Vol 38 (2) ◽  
pp. 253-276 ◽  
Author(s):  
Penny H. Feldman ◽  
Miriam Ryvicker ◽  
Lauren M. Evans ◽  
Yolanda Barrón
Keyword(s):  
New York ◽  
Logistic Regression ◽  
Home Health ◽  
Direct Care ◽  
Direct Care Workers ◽  
Entry Level ◽  
Home Health Aides ◽  
Care Workers ◽  
Training And Support ◽  
New Hires

Improved training and support are thought to improve retention among direct care workers. However, few studies have examined actual retention. This study examined satisfaction and retention among home health aides enrolled in the “Homecare Aide Workforce Initiative” (HAWI) at three New York agencies. Data included surveys of HAWI trainees and new hires and payroll data for HAWI graduates and others. Three months after hire, 91% of HAWI hires reported they were “very satisfied” or “satisfied” with the job; 57% reported they were “not at all likely” to leave their job in the coming year. At 365 days, 60% were still working. In logistic regression, the odds of being retained at 3, 6, and 12 months were significantly higher among HAWI graduates than non-HAWI new hires. Although not a randomized trial, the study demonstrates an association between participation in an innovative entry-level workforce program and superior 3-, 6-, and 12-month retention.

Bed-Ridden Elderly in Japan: Social Progress and Care for the Elderly

1998 ◽  
Vol 46 (2) ◽  
pp. 157-170 ◽  
Author(s):  
Kaori Imai
Keyword(s):  
United States ◽  
The Elderly ◽  
Developed Countries ◽  
The United States ◽  
Social Progress ◽  
Elderly Persons ◽  
Care For The Elderly ◽  
Social Welfare Services ◽  
Care Workers ◽  
Demand For Health

The demand for health care and social welfare services for the elderly has increased and in Japan, there is a need in the social system to improve the quality of life, especially for those who are disabled. This article directs attention to bed-ridden elderly persons from the standpoint of social problems attending economic development and population changes based on data from Japan, the United States, Sweden, and OECD countries. Compared to the United States, there are more bed-ridden elderly in Japan, and inadequate public resources for caring. Physicians, nurses, care workers, and rehabilitation specialists such as physiotherapist and occupational therapist per 1000 aged sixty-five or over are 89.5 in Japan while 237.4 in Sweden. Japan has the fewest such health and welfare personnel among developed countries. Even with increases in such personnel through the New Gold Plan, future increase in aged population would off-set the effect and the problem of providing care for the elderly remains.

scholarly journals A FEASIBILITY STUDY: THE DEVELOPMENT OF WEARABLE TECHNOLOGY FOR INJURY PREVENTION AMONG DIRECT CARE WORKERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S831-S831
Author(s):  
Yuchi Young ◽  
Yuchi Young ◽  
Mitch Leventhal ◽  
Jonathan Muckell ◽  
Peter E Raymond ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Physical Therapist ◽  
Direct Care ◽  
Sensor Data ◽  
Direct Care Workers ◽  
Sensor Technology ◽  
Home Health Aides ◽  
Lifting Technique ◽  
Care Workers ◽  
Lifting Techniques

Abstract Objectives: 1) create metrics for lifting techniques and transferring mechanisms, 2) calibrate sensors for data collection 3) identify potential injurious posture among home health aides (HHAs) while transferring patients. Participants: 7 HHAs and a physical therapist. Interview and sensor data were collected. Outcome variables included improper lifting techniques and improper body mechanisms. Obesity of HHAs was associated with worse scores of body mechanics (p < 0.0001), while fear of injury with better body mechanics (p < 0.0001). GEE results identified that twisting the spine during transfers (OR = 6.3; 95% CI: 1.09–36.7) and not using a wide support base when lifting from supine to sitting (OR= 6.0, 95% CI: 2.03–17.7) were associated with improper lifting technique and body mechanics. Results show it is viable to use sensor technology to collect HHAs’ data to design intervention for injury prevention. A larger-scale study is needed to validate the results.

scholarly journals Filipino Home Care Workers: Invisible Frontline Workers in the COVID-19 Crisis in the United States

2021 ◽  
pp. 000276422110004
Author(s):  
Katherine Nasol ◽  
Valerie Francisco-Menchavez
Keyword(s):  
United States ◽  
Home Care ◽  
Assisted Living ◽  
Elder Care ◽  
Health And Safety ◽  
The Elderly ◽  
The United States ◽  
State Regulation ◽  
Care Workers ◽  
Home Care Workers

Filipino home care workers are at the frontlines of assisted living facilities and residential care facilities for the elderly (RCFEs), yet their work has largely been unseen. We attribute this invisibility to the existing elder care crisis in the United States, further exacerbated by COVID-19. Based on quantitative and qualitative data with Filipino workers before and during the COVID-19 crisis, we find that RCFEs have failed to comply with labor standards long before the pandemic where the lack of state regulation denied health and safety protections for home care workers. The racial inequities under COVID-19 via the neoliberal approach to the crisis puts home care workers at more risk. We come to this analysis through Critical Immigration Studies framing Filipino labor migration as it is produced by neoliberalism and Racial Capitalist constructs. Last, while the experiences of Filipino home care workers during the pandemic expose the elder care industry’s exploitation, we find that they are also creating strategies to take care of one another.

scholarly journals Psychosocial Factors Contributing to Occupational Injuries among Direct Care Workers

AAOHN Journal ◽  
2009 ◽  
Vol 57 (8) ◽  
pp. 338-347 ◽  
Author(s):  
Tracy L. Zontek ◽  
Jody C. Isernhagen ◽  
Burton R. Ogle ◽  
Patricia B. Strasser
Keyword(s):  
Job Satisfaction ◽  
Organizational Climate ◽  
Musculoskeletal Disorders ◽  
Psychosocial Factors ◽  
The United States ◽  
Direct Care ◽  
Direct Care Workers ◽  
Injury Rates ◽  
Care Workers ◽  
And Training

Direct care workers have the highest injury rate in the United States, primarily due to work-related musculoskeletal disorders. This study examined the effect of psychosocial factors (i.e., stress, job satisfaction, organizational climate, safety climate, and training) on direct care workers' injuries. On the basis of divergent work characteristics of direct care workers in facilities versus private homes, injury rates were found to be significantly different between workplaces (χ2 = 4.179, df = 1, p = .041). Tenure (77% of injuries occurred after 1 year of tenure) was significantly correlated with training, satisfaction, organizational climate, and stress. Because of the chronic nature of musculoskeletal disorders, tenure was used to choose cases for injury prediction using logistic regression. When tenure was greater than 1 year, job satisfaction [Exp(B) = 0.048, p = .028] was a predictor of injury and when tenure was greater than 3 years, both job satisfaction [Exp(B) = 0.002, p = .033] and training [Exp(B) = 31.821, p = .044] were predictors of injury. Psychosocial factors and home- versus facility-based workplaces should be considered to improve injury rates and retention among direct care workers.

scholarly journals Support From a Distance: How Home Care Agencies Influence Paid Caregiving in the Home

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 217-218
Author(s):  
Emily Franzosa ◽  
Robyn Stone
Keyword(s):  
Home Care ◽  
Home Health ◽  
Direct Care ◽  
Direct Care Workers ◽  
Home Health Aides ◽  
Care Workers ◽  
Functionally Impaired ◽  
Workforce Turnover ◽  
The Impact ◽  
Paid Caregivers

Abstract Paid caregivers (e.g., home health aides, personal care attendants, and other direct care workers) who care for functionally impaired older adults in the home frequently report that while rewarding, their work is logistically, physically, and emotionally demanding. Unlike direct care workers in institutional settings, paid caregivers work with care recipients one-on-one in private settings and often have limited contact with or support from their employers. These factors contribute to high workforce turnover and may impact the quality of patient care. In this symposium, we explore ways that home care agency policies and practices influence the experience of giving and receiving care in the home. First, Bryant et al. describe the range of agency-based models and the impact of workplace design in creating supportive working environments. Next, Fabius et al. explore characteristics of direct care agencies across Maryland, with implications for worker training and support. Reckrey et al. describe the differing perceptions of aides, caregivers and providers around the role agencies play in defining paid caregivers’ roles, and how this may lead to conflict within the caregiving team. Finally, in the context of COVID-19, Franzosa et al. examine communication and coordination between Veterans Affairs-paid agencies and home health aides during the pandemic, while Tsui et al. present a case study of an agency’s efforts to support paid caregivers through group support calls. Together, these studies highlight challenges in the structure, organization and perceptions of home care agencies, and identify potential avenues for agencies to support paid caregivers and their clients.

A Will and a Way, What the United States Can Learn from Canada about Caring for the Elderly. R.L. Kane and R.A. Kane, New York: Columbia University Press, 1985 ($35.00).

1987 ◽  
Vol 6 (2) ◽  
pp. 177-180 ◽  
Author(s):  
Neena L. Chappell
Keyword(s):  
United States ◽  
New York ◽  
Management Practices ◽  
The Elderly ◽  
The United States ◽  
Columbia University ◽  
Term Care ◽  
Care Systems ◽  
Good Resource

SUMMARYIn A Will and a Way, Kane and Kane have once again demonstrated their ability to accumulate masses of data. This book offers a wealth of descriptive information on three long term care systems in Canada, as well as some of the features of these systems which may be appropriate for the United States (such as universal programs based on need, case management practices, panelling practices, and size of jurisdiction). Those interested in specific practical questions and/or figures on utilization will find this book a good resource. However, those interested in a broader discussion from a theoretically informed perspective or a good discussion of existing research in this area will be disappointed.

Educational Gerontology: International Perspectives. Frank Glendenning (Ed.). New York: St. Martin's Press, 1985, pp. 240. ($25.00 U.S.)

1986 ◽  
Vol 5 (2) ◽  
pp. 135-139
Author(s):  
C.T. Gillin
Keyword(s):  
United States ◽  
New York ◽  
Older People ◽  
The Elderly ◽  
The United States ◽  
Educational Opportunities ◽  
Retirement Preparation ◽  
International Perspectives ◽  
Educational Gerontology ◽  
International Character

Summary AbstractThe book identifies the three distinct but related aspects of Educational Gerontology, specifically, educational opportunities for older people, education about aging for the general population, and education of professionals and para-professionals who work with the elderly. The first aspect, education for older people—including pre-retirement preparation—is emphasized. The volume has an international character with contributions from Britain, the United States, Denmark and Canada.

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