Search results

This is an adaptation of the opening address given by Sister Elizabeth Davis to the Canadian Healthcare Association’s intramural session for its Distance Education programme. The intramural session is an intensive week of plenary and programme‐specific sessions, working groups and student presentations.

Posits that Canadian home care services compete with hospitals and other community and public health agencies for scarce financial resources but as yet regional authorities are not responsible for paying physicians. Investigates all the various facets of home care services and concludes that by using joint ventures, there may be the possibility of making informed decisions for the Canadian healthcare system.

This paper examines job satisfaction and participation in decision making in three home health aide facilities with different organizational structures (worker-owned for-profit, for-profit with no participation or ownership by workers, and nonprofit).

More than 600 surveys were completed by home health aides across the three facilities. The author also engaged in participant observation during training sessions and other meetings and conducted a small number of interviews with caregivers and agency management.

Home health aides at the worker-owned, participative decision making organization were significantly more satisfied with their jobs than those at the other agencies. Results for the other agencies were not significantly distinguishable from one another.

This study involved respondents from one of each type of business. A study across several of each type of organization would allow more focus on the effects of the structural characteristics of the organizations.

In the United States, the work that home health aides perform provides a valuable service to society. On behalf of caregivers and those for whom they provide care, conditions of the work need improvement. If participative democratic workplaces provide better outcomes, they should receive more attention from lawmakers, the business community, and researchers.

This research highlights the working conditions of the people (primarily women) who perform this work. The poor compensation received is a reminder of inequality in opportunity for some workers and of the value placed on this type of caring labor.

This research is unique in its focus on work environment and outcomes in home health care across nonprofit, for-profit, and worker-owned for-profit organizations. The findings of different job satisfaction outcomes from the others in the worker-owned organization and similar outcomes in the nonprofit and conventional for-profit organizations are also unique.

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.

Within the existing health care system, a significant percentage of Americans over the age of 65 will have need of extended health care. Yet the extended care industry has little information as to how consumers will make a choice among placement options. The results of this study describe both the need recognition and pre‐selection search stages of the decision process and the impact of need recognition on subsequent search activity. The information obtained from an influential person as the problem is being defined appears to have a complex relationship with pre‐selection search, with initial information leading to less search but additional information increasing search activity. Contrary to previous studies, pre‐selection search was found to be fairly extensive, increasing with time availability.

The purpose of this paper is to develop an Internet of medical things (IoMT)-based geriatric care management system (I-GCMS), integrating IoMT and case-based reasoning (CBR) in order to deal with the global concerns of the increasing demand for elderly care service in nursing homes.

The I-GCMS is developed under the IoMT environment to collect real-time biometric data for total health monitoring. When the health of an elderly deteriorates, the CBR is used to revise and generate the customized care plan, and hence support and improve the geriatric care management (GCM) service in nursing homes.

A case study is conducted in a nursing home in Taiwan to evaluate the performance of the I-GCMS. Under the IoMT environment, the time saving in executing total health monitoring helps improve the daily operation effectiveness and efficiency. In addition, the proposed system helps leverage a proactive approach in modifying the content of a care plan in response to the change of health status of elderly.

Considering the needs for demanding and accurate healthcare services, this is the first time that IoMT and CBR technologies have been integrated in the field of GCM. This paper illustrates how to seamlessly connect various sensors to capture real-time biometric data to the I-GCMS platform for responsively supporting decision making in the care plan modification processes. With the aid of I-GCMS, the efficiency in executing the daily routine processes and the quality of healthcare services can be improved.

The purpose of the current study is to assess the efforts to control fraud in the home health care industry in the USA by examining the problems that criminal justice officials confronted in their attempts to control home health care fraud and abuse.

Attention is given to the history of the home health care industry in the USA, the types of fraud found in the health care field in general, and the officials who are given the duty of controlling health care fraud.

The results of this study suggest that the problems fraud control officials face in their response to home health care offenders are similar to those confronted in the response to white‐collar offending, but also similar to those confronted in the response to many conventional offenses.

Highlights the problems in controlling fraud and abuse in the US home care health field.

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.

As the population ages in the United States and globally, health-care demands are rising and varied, including the growth of home health care. Small, regional, qualitative studies indicate both satisfaction and exploitation in home health-care work. These intimate, caring relationships with clients may be especially challenging for minorities due to client prejudice and structural marginalization. This study broadens the scope of current research by addressing issues facing home health-care workers using large-scale, nationwide data.

Using nationally representative data of home health aides in the US, the National Home Health Aide Survey (NHHAS), we evaluate which features of work are related to overall satisfaction. The prevalence and sources of discrimination and working conditions are examined according to workers’ intersectional gender, race, ethnicity, and class identities.

Satisfaction was highest for those who were extremely satisfied with challenging work, learning new skills, and were most supported in their caring labor. Salary was the area with the most frequent dissatisfaction. Support for reproductive and caring labor was often inadequate. Black women and men reported the highest levels of discrimination (about 28.0%), followed by Hispanic women and men (16.5% and 10%, respectively). The largest source of discrimination was patients (80.4%). There were differences in job outcomes according to intersectional identities of race, class, and gender.

Discrimination, low wages, and not having enough support for both reproductive and caring labor are problems for home health aides. Improving home health aide work is also likely to improve patient outcomes.

Older women living in medically underserved areas (MUA) might have particular problems with access to health care. This is an in-depth report of the accessibility issues raised by six frail older women (age 82–93 years) during a longitudinal descriptive phenomenological study of the experience of home care. Three White women lived in the same rural MUA, and three Black women lived in the same urban MUA. The need for health service was understood subjectively and prospectively as the personal perception of a situation requiring relief or supply. Some women reported presenting needs for accessibility to providers, whereas others reported needs for their future accessibility to providers or services. Some intentions were likely linked to residence location, and residence in a rural MUA was relevant to the phenomenon of securing the help that I might need down the road. Feasibility was proposed as a new parameter of access. Research and practice implications were proposed.