Search results

Within the context of residential care settings in England and Germany little consideration is given to the role of care assistants. Policies that determine the staffing levels in both countries have resulted in care assistants making a considerable contribution towards the ‘hands‐on’ care of dependent, older people. However, the policies overlook the need to encourage and support care assistants in developing the skills required to provide effective, efficient care to dependent, older people. This paper presents the findings of a small‐scale qualitative study conducted in residential care settings situated in the south east of England and north Germany. The study establishes the connection between the nature of ‘emotional labour’ and the need to provide suitable training to care assistants, thus influencing the quality of care provided to dependent, older people. At present training in both countries is focused on qualified staff. Overlooking care assistants and their contribution towards care could be detrimental to the quality of care provided to older people in both England and Germany.

The aim of this chapter was to analyze of the most hazardous aspects of home care work in Italy.

The chapter is based on a multi-method analysis conducted in Italy, including a survey on a sample of 867 home care assistants, and four focus groups organized with home care assistants.

The data collected show that: (1) there is a strong correlation between the physical and emotional complexity of the work and the workers’ malaise; (2) the live-in formula is not clearly linked with high levels of psychophysical malaise, while isolation is associated much more strongly with a high index of malaise; and (3) violence in the workplace is clearly one of the main risks to which home care assistants are exposed.

The findings may suffer from limitations due to the type of data collected. First, it was a convenience survey, so the results are not generalizable and they may be negatively influenced by bias relating to sample self-selection. Second, the empirical research was not designed to investigate occupational health alone, so accurate information on symptoms, causes of ill-health, experiences of violence, and the meaning of respondents’ malaise and of the episodes of violence were not available. Third, with the help of an epidemiologist, we could have included some diagnostic tests to better ascertain the workers’ state of health.

The chapter offers an original contribution to sociological research on the occupational health hazards from a gender-specific perspective. First, it investigates workers’ health risks in an understudied and highly feminized and racialized occupational sector. It also analyzes the implications of both the emotional and the body work on the workers’ health. It deals with the correlation between cohabitation and health problems. Finally, it looks into the impact of workplace violence on workers’ health, which is a strongly gendered issue, and rooted in social processes that stigmatize and racialize migrant women employed as home care assistants.

The purpose of this paper is to describe the findings from a pilot and a follow-on study in which care assistants in care homes were trained to use sporting memories work to better help and engage with residents with dementia and low mood. Care homes have to support increasingly more fragile people and often the range of activities in the homes do not offer the best engagement between residents and staff to benefit the residents. This is for reasons of time to run activities in a busy home, and because of the need to find financially viable means of running a range of activities. Care assistants in care homes are a group of non-professionally educated workers and are often overlooked for training beyond basic health and safety training to help them improve their work and the care they provide. This work sought to explore whether sporting memories work was viable as an activity to offer in care homes via the training of care assistants.

The paper discusses the evidence from a pilot and then follow-on project in care homes in one city area. In the pilot observation was made of a training session and follow up interviews were undertaken with care home managers to see how the implementation of sporting memories was going. In the follow-on project the support to those undertaking the training was modified to include three learning network sessions. Data were collected on the experience of participants and their use of sporting memories work.

The findings were that care assistants could be trained in using sporting memories work and they often found it easy to use and fulfilling for them and people they cared for. This was despite the care assistants who participated often not having much interest in sports and little experience in this kind of work. However, practical barriers to maintaining the use of sporting memories work did remain.

The evidence to date is of case studies of training staff in care homes in the use of sporting memories work, which provides good grounding for proof of the concept and key issues, but further research is needed on the costs and impacts of sporting memories work in care homes. The lack of direct feedback about experiences of care home residents of sporting memories work and its impact on them is a further limitation.

Sporting memories work is a flexible and readily adoptable intervention to engage older people in care homes and the evidence to date is that care assistants in care homes can be trained to use this approach to engaging older people. Practical challenges still remain to using sporting memories work in care homes, notably the issue of time for staff to do the work, but it is an approach for care homes to have available to them to match up to the interests of residents.

Sporting memories work can be an important part of meeting some of the challenges society faces with an ageing population profile and to enhancing the care home environment and care assistants can be trained to use the approach.

This is the first paper to discuss training care home staff in the use of sporting memories work.

The purpose of this paper is to explore the terms used in the Macmillan Dictionary and the Oxford English Dictionary to identify the people who are paid to provide care to the elderly and check their presence in a corpus – professional home care (PHC) – of three UK-based specialised websites.

This study is based on the frameworks and methods of corpus-assisted Discourse Analysis (Baker, 2006). The terms were extracted from a corpus of British websites of companies providing PHC services.

This study highlights that in the PHC corpus, the words “caregiver” and “carer” are used as synonyms at the level of popular communication, whereas “care assistant” and “care worker” are used for intra-specialistic communication. The analysis also points out the variations in terminology observed in the corpora that are intended for different communication contexts, e.g. how professionals define themselves compared to how external actors identify them.

This paper provides insight into the terminological aspects of caregiving in the professional field through a corpus-based study on specialised terminology integrating lexicographic considerations. This methodological framework can capture the sociolinguistic attitudes of speakers.

This article proposes a new disruptive innovation in healthcare through the development of a physician assistant business model, which can be most readily applied in vulnerable rural health care settings.

This study reviews the current state of the health care system in terms of physician assistant utilization and primary care shortages in rural communities. The study proposes that the physician assistant-owned and -operated primary care business represents a disruptive innovation, via the application of the five principles of Clayton Christensen’s (1997) thesis on disruptive innovation.

Considering the current state of the health care industry, the study logically defends the proposed model as a disruptive innovation in that it: focuses on an underserved market, has lower costs, has few competitors, offers high quality and provides a sustainable competitive advantage.

The physician assistant business model is a viable solution for providing primary care for rural communities with educational, financial, transportation and other resource limitations.

This is a unique application of the theory of disruptive innovation, which illustrates how a new business model can solve a chronic shortage in primary care, especially in underserved populations.

High turnover of staff in the long-term dementia care sector contributes to poor quality care and lack of continuity of care in the UK and many other countries. The purpose of this paper is to explore the research evidence on what care assistants report they enjoy when working in front-line dementia care jobs in long-term care facilities.

An integrative analysis was used to study research findings focusing on the front-line workforce in care homes. The literature review sought to capture key findings, including overviews of research, from studies from 1990 to mid-2014 that have considered the positive experiences of front-line care home staff working with people with dementia.

There is a great deal of research investigating care home staff's job satisfaction. Much of this highlights the importance of personal, social and managerial relationships. Common themes continue to be reported. There is potential for work on improving care assistant experiences in care homes but also a need to address long-standing inequities affecting the care home sector.

Some studies are not precise about which staff groups they are investigating in studies about care homes and many concentrate on the problems staff report. Measures of job satisfaction vary. When exploring dementia-related care not all studies are clear if care home residents have dementia or not.

Many studies have investigated the views of care assistants working with people with dementia in care homes that address happiness in their work, often reported as job or work satisfaction, and these should be consulted when developing dementia services or managing care homes. As with other parts of the social care workforce, employers and managers need to be aware of effective and acceptable workforce reforms and ways to reduce turnover.

This review suggests the value of investigating positive aspects of care work with people with dementia living in care homes. Greater attention could be paid to job satisfaction in social care more widely.

This chapter explores variation in direct care workers’ health risks within institutional and home-based settings, according to the demographic composition of workers and the gendered, raced, and citizenship-based expressions of their work roles.

This quantitative intersectional study draws on two nationwide datasets from the US National Center for Long-term Care Statistics, a division of the Centers for Disease Control and Prevention, the National Nursing Assistant Study (NNAS), and National Home Health Aide Survey (NHHAS).

Workplace context was the strongest predictor of workers’ health risks and working conditions. Physical injuries affected more than half of facility-based workers annually compared to less than 10% of home-based workers. Facility-based workers are more likely to report insufficient time for tasks, lower job satisfaction, and less respect and appreciation from patients. Home-based workers may be more likely to experience emotional distress, be offered fewer benefits, but experience fewer injuries, due to the better relative health of their patients and having more time for client care. Women reported more injuries and more time pressure than men across racial and citizenship groups within the same work setting.

There are limitations to the NHHAS and NNAS public-release data file data. We are unable to fully capture citizenship, some racial/ethnic categories, workers over age 65, supervisory workers, facilities with fewer than three residents, and facilities not certified with Medicare or Medicaid. The exclusion of these questions, workers, and contexts is a weakness of the present study.

Analyses draw on data from the first nationally representative sample surveys of home health aides and nursing assistants in the United States. Direct care workers are an important population to capture through intersectional research since care work is done predominantly by multiracial women and immigrants. This research also underscores the importance of workplace contexts in shaping the labor performed and the workers’ experiences.

Employing a participatory approach, the purpose of this paper is to identify possible areas for improvement in visiting nurses’ post-hospital medication management and to facilitate suggestions for changes in future practices.

Based on a previous study on visiting nurses’ post-hospital medication management, two workshops were conducted in a visiting nurse department in a Danish municipality.

The visiting nurses emphasised knowledge of patients’ basic needs and prioritised their performance of context-specific nursing assessments, with a preventive focus as a prerequisite for improved patient safety in post-hospital medication management.

The participatory approach can increase the acceptability and feasibility of changes regarding future practices and thereby reduce the gap between official documents and daily practice. Although the local development of suggestions for changes in practices does not provide general knowledge, a subsequent detailed description of the changes in practices can promote transferability to other healthcare settings after local adjustments are made.

Flexible home healthcare, with stable relationships enabling the continuous assessment of the patient’s needs and symptoms, along with subsequent adjustments being made in care and medical treatment, might enhance patient safety in post-hospital medication management.

This paper adds to the knowledge of the need for integrated care in medication management in patients’ homes. It argues for primary healthcare professionals as “experts in complexity” and suggests a reconsideration of the purchaser-provider division of care to patients with unstable health conditions and complex care needs during the first days following hospital discharge.

Key to successfully addressing the ongoing transitions being experienced in the care home sector is a transformation of the workforce. This is required in order to respond appropriately to the increasing dependency of older people moving into care homes. This article considers the policy framework surrounding the provision of care services in England and reviews the relevant research into the workforce and the changes needed if the sector is to meet the needs of vulnerable older people living in care homes. Building on present policy and practice, consideration is given to how this change could be achieved.

The purpose of this paper is to describe the employment conditions of social care personal assistants (PAs) in England. In England, disabled adults have been able to directly employ people to meet their care or support needs for a number of years, little is known about the employment conditions of people who are directly employed.

PAs were recruited mainly through third sector and user led organisations. A total of 105 social care PAs took part in a semi-structured telephone interview, which on average was an hour long. Interviews were fully transcribed. Quantitative data were analysed using SPSS (v.24) and qualitative data by NVIVO software.

The paper focuses on employment conditions: contracts, pay, pensions, national insurance, overtime, holiday and sick pay, etc. Access to training and support are also described. Though PAs enjoyed considerable job satisfaction, many did not enjoy good employment conditions. Though employer abuse was uncommon, many PAs could arguably be described as exploited. Occupational isolation and lack of support to resolve disputes was striking.

Though this may be currently the largest qualitative study of PAs in the UK, it is nonetheless relatively small and no claims for generalisability are made, though the geographical spread of the sample was wide and recruited from multiple sites.

PAs are an effective way of establishing relationship-based care, and confer direct control to disabled employers. Many PAs experienced high job satisfaction. However, lack of regulation and oversight creates considerable potential for exploitation or abuse. This may make the role less attractive to potential PAs in the medium term.

Social care PAs may be a very effective means of achieving genuinely person-centred care or support for many people. However, PAs do not always appear to enjoy satisfactory conditions of employment and their role is largely unregulated. Growth and long-term sustainability of this emergent role may be jeopardised by these employment conditions.

Little is known about PA working conditions. This study suggests that much more needs to be done to improve these.