Interlude

2019 ◽  
pp. 194-202
Author(s):  
Cati Coe
Keyword(s):  
Home Care ◽  
End Of Life ◽  
Social Actions ◽  
Ritual Space ◽  
Childhood And Youth ◽  
Care Workers ◽  
Cultural Script ◽  
The Dead ◽  
Home Care Workers

This coda explores the role of home care workers in helping patients and their kin establish rituals and meaning at the end of life. Kin often find themselves having difficulty creating the proper ritual space or sense of union and communion with the dead and with each other. They do not have a cultural script of what to do, which leads to greater grief. This lack of ritual around home deaths speaks to the cultural desire to avoid death as long as possible, the expertise of medical authorities in structuring the dying process in hospitals, and the fact that aging in general is somewhat unstructured, with relatively few rituals in comparison to the transitions of childhood and youth. Given the lack of structure in home deaths, kin are amenable to guidance about new kinds of social actions from others, including from home care workers, who become experts in dying. Such moments draw patients’ kin and home care workers closer together.

Between Home and State: Care Workers and Labor Strategy for the New Open-Shop Era of Trumplandia

2020 ◽  
pp. 206-225
Author(s):  
Jennifer Klein
Keyword(s):  
Home Care ◽  
Home Health Care ◽  
Political Action ◽  
Labor Laws ◽  
Training And Education ◽  
State Recognition ◽  
Care Workers ◽  
The Right ◽  
Home Care Workers

This chapter also tackles how to build power under challenging conditions. It analyzes the case of home health care, which stands outside New Deal labor laws and is one of the largest and fastest-growing low-wage occupations. Building on decades of organizing, persistent political action, and mobilization with clients, home-care workers' unions won legislative battles enabling states to take on the role of employer and winning the right to engage in collective bargaining. But anti-union groups are now aggressively encouraging union disaffiliation through door-to-door campaigns, though home-care unions are fighting back. A critical component is deep member training and education, including “leadership academies” to cultivate workers' political education and skills. This chapter is a reminder that members make the union—with or without state recognition.

Obscuring the costs of home care: restructuring at work

2006 ◽  
Vol 20 (1) ◽  
pp. 27-45 ◽  
Author(s):  
Jane Aronson ◽  
Sheila M. Neysmith
Keyword(s):  
Home Care ◽  
Work Force ◽  
Managed Competition ◽  
Role Of Government ◽  
Political Processes ◽  
Unfair Treatment ◽  
Care Workers ◽  
Local View ◽  
Home Care Workers

This study of displaced home care workers reveals how managed competition serves to produce a flexible and atomized work force. Laid off when their nonprofit employer could not compete in the local home care market, workers blamed their employer and their union for their jeopardy. Obscured from local view was the role of government policy in offloading services to the market, benefiting privileged participants in the hospital, professional and market health care sectors. Workers’ indignation at their own and their elderly clients’ unfair treatment dissipated: they had to attend to the practical imperatives in their lives, and were unable to locate a target for their protest. Resolving to be flexible and self-sufficient in the future, they struggled to rework identities as committed carers. The study illuminates how particular organizational and political processes render services more meagre and labour more flexible, and suggests particular possibilities for both accommodating and disrupting those trends.

Family and family-like interactions in households with round-the-clock paid foreign carers in Israel

2009 ◽  
Vol 29 (5) ◽  
pp. 671-686 ◽  
Author(s):  
LIAT AYALON
Keyword(s):  
Home Care ◽  
Qualitative Interviews ◽  
Family Members ◽  
System Of Care ◽  
Care Recipient ◽  
Social And Emotional ◽  
Care Givers ◽  
Care Workers ◽  
Home Care Workers

ABSTRACTThis paper reports a study of family and family-like interactions and transfers, or exchanges of goods and resources, between paid, round-the-clock, Filipino home carers and those they care for in a sample of households in Israel. Qualitative interviews about their experiences and attitudes concerning the care role were conducted with 22 family members and 29 Filipino home-care workers. A thematic analysis of the interview data identified three major themes: the structure and internal dynamics of the adapted family or family-like system of care; the role of family members; and the role of Filipino home-care workers in the new system of care. Sons and daughters tended to appropriate the care-management positions and to reduce their social and emotional support for the care recipient. In contrast, spouse care-givers continued to provide some of the personal and emotional care even when a Filipino home-care worker was employed. Filipino home-care workers were made responsible for daily care and domestic routines and provided emotional and social care. It was found that family members do not relinquish their role as care-givers when round-the-clock foreign carers are on hand, but the nature of their role changes. The results suggest that foreign home-care workers' job description needs to be redefined to acknowledge the substantial social and emotional care that they provide.

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.

scholarly journals Eliciting the educational needs and priorities of home care workers on end-of-life care for patients with heart failure using nominal group technique

2021 ◽  
pp. 026921632199996
Author(s):  
Dawon Baik ◽  
Peggy B Leung ◽  
Madeline R Sterling ◽  
David Russell ◽  
Lizeyka Jordan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Home Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Life Care ◽  
Care Workers ◽  
Patients With Heart Failure ◽  
Home Care Workers

Background: Home care workers, as paid caregivers, assist with many aspects of home-based heart failure care. However, most home care workers do not receive systematic training on end-of-life care for heart failure patients. Aim: To elicit the educational needs and priorities of home care workers caring for community- dwelling adults with heart failure at the end-of-life. Design: Nominal group technique involving a semi-quantitative structured group process and point rating system was used to designate the importance of priorities elicited from home care workers. Individual responses to the question, “ If you have ever cared for a heart failure patient who was dying (or receiving end-of-life care on hospice), what are some of the challenges you faced?”, were aggregated into categories using directed content analysis methods. Setting/Participants: Forty-one home care workers were recruited from a non-profit training and education organization in New York City. Results: Individual responses to the question were aggregated into five categories: (1) how to cope and grieve; (2) assisting patients with behavior changes, (3) supporting patients to improve their quality of life, (4) assisting patients with physical symptom management, and (5) symptom recognition and assessment. Conclusions: Our findings confirm the need for the formal development and evaluation of an educational program for home care workers to improve the care of heart failure patients at the end-of-life. There is also a need for research on integrating home care workers into the interprofessional healthcare team to support optimal health outcomes for patients with heart failure.

scholarly journals The need for flexibility when negotiating professional boundaries in the context of home care, dementia and end of life

2018 ◽  
Vol 39 (9) ◽  
pp. 1976-1995 ◽  
Author(s):  
RUTH ABRAMS ◽  
TUSHNA VANDREVALA ◽  
KRITIKA SAMSI ◽  
JILL MANTHORPE
Keyword(s):  
Home Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Working Environment ◽  
Care Staff ◽  
Life Care ◽  
Professional Boundaries ◽  
Emotional Labour ◽  
Care Workers ◽  
Home Care Workers

ABSTRACTProfessional boundaries may help care staff to clarify their role, manage risk and safeguard vulnerable clients. Yet there is a scarcity of evidence on how professional boundaries are negotiated in a non-clinical environment (e.g. the home) by the home-care workforce in the context of complex care needs (e.g. dementia, end-of-life care). Through analysis of semi-structured interviews, we investigated the experiences of home-care workers (N = 30) and their managers (N = 13) working for a range of home-care services in the South-East and London regions of England in 2016–17. Findings from this study indicate that home-care workers and their managers have clear perceptions of job role boundaries, yet these are modified in dementia care, particularly at end of life which routinely requires adaptability and flexibility. As a lone worker in a client's home, there may be challenges relating to safeguarding and risk to both clients and workers. The working environment exacerbates this, particularly during end-of-life care where emotional attachments to both clients and their family may affect the maintenance of professional boundaries. There is a need to adopt context-specific, flexible and inclusive attitudes to professional boundaries, which reconceptualise these to include relational care and atypical workplace conventions. Pre-set boundaries which safeguard clients and workers through psychological contracts may help to alleviate to some extent the pressure of the emotional labour undertaken by home-care workers.

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