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Who is Looking After Mom and Dad? Unregulated Workers in Canadian Long-Term Care Homes*

  • Carole A. Estabrooks (a1), Janet E. Squires (a2), Heather L. Carleton (a1), Greta G. Cummings (a1) and Peter G. Norton (a3)...

Older adults living in residential long-term care or nursing homes have increasingly complex needs, including more dementia than in the past, yet we know little about the unregulated workforce providing care. We surveyed 1,381 care aides in a representative sample of 30 urban nursing homes in the three Canadian Prairie provinces and report demographic, health and well-being, and work-related characteristics. Over 50 per cent of respondents were not born in Canada and did not speak English as their first language. They reported moderately high levels of burnout and a strong sense of their work’s worth. Few respondents reported attending educational sessions. This direct caregiver workforce is poorly understood, has limited training or standards for minimum education, and training varies widely across provinces. Workplace characteristics affecting care aides reflect factors that precipitate burnout in allied health professions, with implications for quality of care, staff health, and staff retention.


Les personnes âgées recevant soins de longue durée ou soins infirmiers résidentiels ont des besoins de plus en plus complexes, y compris exhibitant plus de la démence que dans le passé, mais on ne connait que peu en ce qui concerne la population non réglementée qui fournit leurs soins. Nous avons interrogé 1 381 aides dans un échantillon représentatif de 30 maisons de soins infirmiers en milieu urbain dans les trois provinces des Prairies canadiennes afin de signaler des caractéristiques démographiques, la santé et le bien-être, et des caractéristiques liées au travail. Plus de 50 pour cent des répondants ne sont pas nés au Canada et ne parlaient pas l'anglais comme leur première langue. Ils ont signalé des niveaux d'épuisement modérément élevés et un sentiment fort de la valeur de leur travail. Peu de répondants ont déclaré avoir participé à des séances de formation. Cette main d'oeuvre composée de fournisseurs de soins directs est mal comprise, leur formation et les normes pour l'emploi sont limitées, et la formation varie considérablement d'une province à l'autre. Les caractéristiques du lieu de travail qui touchent aux aidants reflètent des facteurs qui favorisent l'épuisement professionnel dans les professions connexes de la santé, avec des implications pour la qualité des soins, pour la santé du personnel et pour leur rétention.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Carole A. Estabrooks, R.N., Ph.D. Faculty of Nursing University of Alberta 11405 87 Avenue Edmonton (AB) T6G 1C9 (
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The research was funded by the Canadian Institutes of Health Research (MOP #53107). The TREC Team at the time of the study included: Carole Estabrooks (PI); Investigators: Greta G. Cummings, Lesley Degner, Sue Dopson, Heather Laschinger, Kathy McGilton, Verena Menec, Debra Morgan, Peter Norton, Joanne Profetto-McGrath, Jo Rycroft-Malone, Malcolm Smith, Norma Stewart, and Gary Teare; Decision-makers: Caroline Clarke, Gretta Lynn Ell, Belle Gowriluk, Sue Neville, Corinne Schalm, Donna Stelmachovich, Gina Trinidad, Juanita Tremeer, and Luana Whitbread; Collaborators: David Hogan, Chuck Humphrey, Michael Leiter, and Charles Mather; Special advisors: Judy Birdsell, Phyllis Hempel (deceased), Jack Williams, and Dorothy Pringle (Chair, Scientific Advisory Committee).

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Canadian Journal on Aging / La Revue canadienne du vieillissement
  • ISSN: 0714-9808
  • EISSN: 1710-1107
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