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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.

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.

This study analyses the different factors contributing to the retention and turnover of local- and overseas-born workers in the elderly care sector as an integral part of ensuring a stable workforce and quality care for the growing elderly population.

Using a respondent-driven sampling method, a sample of individuals who worked or are working in residential aged care facilities in Dunedin, New Zealand were surveyed.

The factors associated with intention to stay or leave are not necessarily the same factors influencing workers to leave.

Policies need to consider how to make workers want to stay and address the issues that make workers leave the aged care sector.

Results of this study can be used to develop more relevant labour and migration policies that reflect a more grounded insight into the experiences of those who are directly and personally affected by these policies.

There are limited international or national empirical studies on the economics of care worker migration and the labour market. This study can provide practical policy advice to help improve recruitment and retention strategies for care workers in countries dependent on global labour markets for health workers. In New Zealand, changes in policies concerning remuneration and immigration highlight the importance of ensuring that care worker needs are met both financially and in terms of institutional support.

The purpose of this study is to identify the knowledge and management skills of health-care workers regarding psychosocial and mental health priorities and needs of individuals with COVID-19.

This is a cross-sectional descriptive study. The data collected conveniently from 101 health-care workers in Jordan directly managing care of individuals with COVID-19.

Health-care workers have moderate-to-high level of knowledge and management skills of psychological distress related to COVID-19; means ranged from 50%–70% agreement and confidence. In general, health-care workers were able to identify mental and psychosocial health needs and priorities at a moderate level. Health-care workers knowledge had a positive and significant correlation with age (r = 0.24, p = 0.012) and years of experience (r = 0.28, p = 0.004), and a significant difference was found in their management between those who are trained on psychological first aids and those who are not (t = −3.11, p = 0.003).

There is a need to train health-care workers to integrate psychosocial and mental health care to manage care psychological distress related to COVID-19.

This study is emphasizing the need for mental health psychosocial support training and in integration. Health-care workers providing care to individuals with COVID-19 are not aware of mental health priorities and needs of their patients. This paper contributes to the body of knowledge adding more understanding about competencies of health-care workers providing care and their preparedness to manage care individuals with COVID-19.

The purpose of this paper is to examine the marketization of domiciliary care, its consequences for employment practice, specifically fragmented time, and the implications for care quality.

Focus groups and face-to-face or telephone interviews were conducted with care commissioners, service providers and care workers across Wales. There were 113 participants in total.

These demonstrate fragmented time’s negative consequences for service providers, care workers and, ultimately, care quality.

No care recipients were interviewed and care quality was explored through the perceptions of other stakeholders.

For policy makers, tensions are evidenced between aspirations for high-quality care and commissioning practice that mitigates against it. Current care commissioning practices need urgent review.

The research extends the definition of fragmented time and integrates with a model of care quality to demonstrate its negative consequences. Links between employment practice and care quality have only previously been hinted at.

Care process quality (i.e. how care is enacted by a care worker toward a client at the interpersonal level) is a strong predictor of satisfaction in a wide range of health care services. The purpose of this paper is to describe the basic elements of care process quality as user-oriented care. Specifically, the questions of how and why quality in user-oriented care varies were investigated in the context of elderly care.

Two municipalities were selected for in-depth field studies. First, in each municipality, the authors interviewed and observed care workers’ interactions with the older persons in both home care and nursing homes during two weeks (Study 1). Second, in an attempt to gain a deeper understanding of why process quality in terms of user-oriented care varies, the authors conducted interviews with care workers and care unit managers (Study 2).

A new taxonomy for categorizing process quality variation, the Big Five of user-oriented care (task-focus, person-focus, affect, cooperation, and time-use), is proposed. In addition, the perceived reasons for process quality variation are reported in our own developed Quality Agents Model, suggesting that variations in care process evaluations may be explained from different perspectives at multiple levels (i.e., older person, care worker-, unit-, department-, and municipality level).

The proposed taxonomy and model are useful for describing user-oriented care quality and the reasons for its variations. These findings are of relevance for future quality developments of elderly care services, but also may be adapted to applications in any other enterprise employing a user-oriented approach.

Migrant home care workers constitute a vulnerable group in society, which is often exposed to work-related abuse. The purpose of this paper is to explore which characteristics are linked with their abuse.

Overall, 187 Filipino home care workers who work in Israel were recruited via snowball sampling and filled an anonymous questionnaire regarding work-related abuse incidents and working conditions.

More than half of the participants reported exposure to abuse (e.g. sexual, physical, or emotional) or exploitation (e.g. asking to do more than job requirements). Particularly vulnerable were migrant workers during their first year in the host country and those who were taking care of an older adult with cognitive impairment. Interestingly, men who served as care workers were more susceptible to abuse than women.

The findings point to specific characteristics which make home care workers more susceptible to abuse illustrate the need for a closer supervision on the working conditions of home care workers, especially during the initial period of their work. Training migrant home care workers in the area of dementia care is also important.

The purpose of this paper is to focus on care workers employed in clients’ own homes recognising the skills and responsibilities of home-based care workers.

Interviews and focus groups with domiciliary care workers in New Zealand centred on what these employees actually do during their working day.

Home-based care workers require the same skills as residential care workers, but they also have greater responsibilities and receive less supervision and support, as they work largely in isolation. In addition, they must spend a large part of their working day travelling between clients: this time is unpaid, and brings their average hourly pay below the minimum wage.

Although the home-based care workers who took part in this project love and are committed to making a positive difference to their clients, they also want the government, employers and the public to recognise their skills, efforts and their challenging working conditions.

In earlier days of deinstitutionalisation, Graham described caring work as a “labour of love”. More than three decades years later, a New Zealand government minister described paid care workers as working partly “for love”. Care work is also currently perceived as unskilled. Both these perceptions depress the pay and working conditions of care staff, and in future may undermine the quality of care delivered to vulnerable clients.

Despite the large number of Indonesian health-care workers working as migrant care workers in Japan, there is a lack of studies that have investigated this phenomenon or assessed the working conditions of Indonesian care workers working in Japanese aged-care facilities. This study aims to explore the work experiences of Indonesian care workers in Japan.

A qualitative descriptive research design was used, and a purposive sample of 18 Indonesian health-care workers (12 nurses and six midwives) who work as care workers in Japan participated in this study. Semistructured interviews were conducted with these participants between December 2022 and January 2023. The data were analyzed using content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report this study.

Four key themes emerged from the data: easy but mentally challenging, being a care worker is a blessing, working in a partially Muslim-friendly environment and enjoy living: prefer to stay longer.

The work experiences of Indonesian care workers in Japan are complex and multifaceted. By understanding their experiences and needs, the authors can work toward creating more inclusive and supportive workplaces for all.

This article asks how gender, ethnicity and other identities intersect and shape the employment experiences of social workers. During recent decades, governments have contracted social care to for-profit and nonprofit organizations (NPOs) globally as a part of the adaption of the neoliberal approach. Most employees in these organizations are women. However, there is a lack of knowledge about women working in social service NPOs and their unique working environments.

This article explores the experiences of women employed as social workers in social care NPOs in Israel regarding intersectionality. 27 in-depth interviews were conducted with women social workers working in social service NPOs. Participants reflected diversity in ethnicity, religion and full-time and part-time jobs. Thematic analysis was used.

The findings shed light on: (1) the contradiction social workers experienced between the stated values of the social care NPO and those values’ conduct, (2) intersectional discrimination among social workers from vulnerable populations and (3) the lack of gender-aware policies.

The need to raise awareness of the social care sector and governments to those contradictions and to promote diversity through gender-aware policies and practices.

The article suggests a conceptualization describing gender employment contradictions in social care NPOs, discusses how the angle of intersectionality expands the understanding of the complexities and pressures exerted on social workers from minority groups and emphasizes the need for social care NPOs to acknowledge and deal with these contradictions.