Job Stress and Job Dissatisfaction of Home Care Workers in the Context of Health Care Restructuring

Changes in the social organization of home care work due to health care restructuring have affected the job stress and job dissatisfaction of home care workers. This article reports the results of a survey of 892 employees from three nonprofit home care agencies in a medium-sized city in Ontario, Canada. Survey results are complemented by data from 16 focus groups with 99 employees. For the purposes of this study, home care workers include both office workers (managers, supervisors, coordinators, office support staff, and case managers) and visiting workers (nurses, therapists, and visiting homemakers). Focus group participants indicated that health care restructuring has resulted in organizational change, budget cuts, heavier workloads, job insecurity, loss of organizational support, loss of peer support, and loss of time to provide emotional laboring, or the “caring” aspects of home care work. Analyses of survey data show that organizational change, fear of job loss, heavy workloads, and lack of organizational and peer support lead to increased job stress and decreased levels of job satisfaction.

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Computer-Mediated Peer Support Needs of Home Care Workers: Emotional Labor & the Politics of Professionalism

Proceedings of the ACM on Human-Computer Interaction ◽

10.1145/3476077 ◽

2021 ◽

Vol 5 (CSCW2) ◽

pp. 1-32

Author(s):

Anthony Poon ◽

Vaidehi Hussain ◽

Julia Loughman ◽

Ariel C. Avgar ◽

Madeline Sterling ◽

...

Keyword(s):

Home Care ◽

Peer Support ◽

Emotional Labor ◽

Support Needs ◽

Computer Mediated ◽

Care Workers ◽

Home Care Workers

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Working Conditions in Home Care: Negotiating Race and Class Boundaries in Gendered Work

International Journal of Health Services ◽

10.2190/3yhc-7et5-5022-8f6l ◽

1997 ◽

Vol 27 (3) ◽

pp. 479-499 ◽

Cited By ~ 38

Author(s):

Sheila M. Neysmith ◽

Jane Aronson

Keyword(s):

Home Care ◽

Women Of Color ◽

Care Work ◽

Political Issues ◽

Race And Class ◽

Care Workers ◽

Micro Level ◽

Home Care Workers ◽

Depth Interviews ◽

Case Basis

Home care work in metropolitan areas is a source of employment for immigrant women of color. Service work of this type intertwines domestic and caring labor in ways that reinforce the historically gendered and racialized nature of the work. Such macro level economic and political issues are played out at the micro level of daily service provided within elderly clients' homes. A study of these processes in home care work was carried out in urban southern Ontario in two nonprofit home care agencies. In-depth interviews and focus groups held with visible minority home care workers suggested that workers deal daily with racist attitudes and behaviors from clients and their families; agencies recognize these oppressive processes but usually handle them on a case-by-case basis through supervisors; and home care workers handle racism on the job as they do in their off-work hours—by avoidance, situating incidents within an analysis of the circumstances of elderly clients, setting boundaries on discussions, and occasionally, confrontation.

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‘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

BMC Geriatrics ◽

10.1186/s12877-019-1270-4 ◽

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.

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Home Care Workers’ Skills in the Context of Task Shifting: Complexities in Care Work

Canadian Review of Sociology/Revue canadienne de sociologie ◽

10.1111/cars.12078 ◽

2015 ◽

Vol 52 (3) ◽

pp. 289-309 ◽

Cited By ~ 6

Author(s):

Rachel Barken ◽

Margaret Denton ◽

Jennifer Plenderleith ◽

Isik U. Zeytinoglu ◽

Catherine Brookman

Keyword(s):

Home Care ◽

Task Shifting ◽

Care Work ◽

Care Workers ◽

Home Care Workers

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Home Care Workers’ Experiences of Client Death and Disenfranchised Grief

Qualitative Health Research ◽

10.1177/1049732318800461 ◽

2018 ◽

Vol 29 (3) ◽

pp. 382-392 ◽

Cited By ~ 5

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.

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Embodying Inequality

Inequalities of Aging ◽

10.18574/nyu/9781479810734.003.0004 ◽

2018 ◽

pp. 126-150

Author(s):

Elana D. Buch

Keyword(s):

Older Adults ◽

Home Care ◽

Care Work ◽

Social Hierarchies ◽

Care Workers ◽

Care Practices ◽

Home Care Workers ◽

Embodied Care

This chapter analyzes the embodied care practices at the center of home care work. The chapter argues that these practices generate deep but fragile entanglements between the lives and bodies of older adults and those of their home care workers. These practices involve forms of empathy that blur the boundaries between older adults’ and home care workers’ bodies and their personhoods. I show how home care transforms seemingly straightforward tasks like cooking into moral practices that help older adults feel independent. Home care workers’ bodies become the ground upon which moral hierarchies between persons are built, experienced, and justified on a day-to-day basis. Daily home care practices generate ways of embodying social hierarchies and shape individual subjectivities, thereby making those hierarchies feel morally legitimate.

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Welcome to These Shores

10.7591/cornell/9781501754104.003.0007 ◽

2021 ◽

pp. 124-149

Author(s):

Richard Schweid

Keyword(s):

Health Care ◽

Home Care ◽

Cultural Differences ◽

Home Health ◽

Care Recipient ◽

Federally Funded ◽

Cultural Attitudes ◽

Care Workers ◽

Software Engineers ◽

Home Care Workers

This chapter explains that while immigrants play an important role across the health care spectrum, a federally funded 2004 report found that their numbers were greatest among home care workers. Sensitivity to cultural differences will likely need to be applied to various aspects of a home health aide's (HHA) daily tasks. In addition, aides need to leave their own cultural attitudes at the door and communicate plainly and directly with the care recipient. The chapter then looks at the effects of the Trump administration's immigration program on immigrant HHAs. It is important to acknowledge that these immigrants are as important to the economy as the immigrant physicists and software engineers. In addition to increasing wages and benefits for HHAs, efforts could be made to recruit immigrants by facilitating a visa process for those women willing to commit to working as HHAs for a certain length of time.

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Job Stress and Job Satisfaction: Home Care Workers in a Consumer-Directed Model of Care

Health Services Research ◽

10.1111/j.1475-6773.2010.01112.x ◽

2010 ◽

Vol 45 (4) ◽

pp. 922-940 ◽

Cited By ~ 63

Author(s):

Linda Delp ◽

Steven P. Wallace ◽

Jeanne Geiger-Brown ◽

Carles Muntaner

Keyword(s):

Job Satisfaction ◽

Home Care ◽

Job Stress ◽

Model Of Care ◽

Care Workers ◽

Home Care Workers

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Ethno-cultural diversity in home care work in Canada

International Journal of Ageing and Later Life ◽

10.3384/ijal.1652-8670.105277 ◽

2011 ◽

Vol 5 (2) ◽

pp. 77-101 ◽

Cited By ~ 6

Author(s):

Anne Martin-Matthews ◽

Joanie Sims-Gould ◽

John Naslund

Keyword(s):

Home Care ◽

Cultural Diversity ◽

Daily Living ◽

Mixed Methods Study ◽

Care Work ◽

Immigrant Workers ◽

Foreign Born ◽

Care Workers ◽

Negative Context ◽

Home Care Workers

Worldwide, immigrant workers are responsible for much of the care provided to elderly people who require assistance with personal care and with activities of daily living. This article examines the characteristics of immigrant home care workers, and the ways in which they differ from non-migrant care workers in Canada. It considers circumstances wherein the labor of care is framed by ethno-cultural diversity between client and worker, interactions that reflect the character of this ethno-cultural diversity, and the strategies employed by workers to address issues related to this diversity. Findings from a mixed methods study of 118 workers in the metropolitan area of Vancouver, British Columbia, Canada, indicate that while the discriminatory context surrounding migrant home care workers persists, issues of ethno-cultural diversity in relationships are complex, and can also involve non-foreign born workers. Multi-cultural home care is not always framed in a negative context, and there often are positive aspects.

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