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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)...
Abstract
ABSTRACT

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.

RÉSUMÉ

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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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), 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 (carole.estabrooks@ualberta.ca)
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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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R. A. Baughman , & K. E Smith . (2012). Labor mobility of the direct care workforce: Implications for the provision of long-term care. Health Economics, 21(12), 14021415.

W. Berta , A. Laporte , R. Deber , A. Baumann , & B Gamble . (2013). The evolving role of health care aides in the long-term care and home and community care sectors in Canada. Human Resources for Health, 11, 25.

J. E Bostick . (2004). Relationship of nursing personnel and nursing home care quality. Journal of Nursing Care Quality, 19(2), 130136.

J. E. Bostick , M. J. Rantz , M. K. Flesner , & C. J Riggs . (2006). Systematic review of studies of staffing and quality in nursing homes. Journal of the American Medical Directors Association, 7(6), 366376.

A. M. Boström , J. E. Squires , A. Mitchell , A. E. Sales , & C. A Estabrooks . (2012). Workplace aggression experienced by frontline staff in dementia care. Journal of Clinical Nursing, 21(9–10), 14531465.

A Carr . (2003). Adult measures of quality of life. Arthritis and Rheumatism, 49(5S), S113S133.

M. Doupe , M. Brownell , P. St. John , D. G. Strang , D. Chateau , & N Dik . (2011). Nursing home adverse events: further insight into highest risk periods. Journal of the American Medical Directors Association, 12(6), 467474.

M. Doupe , P. St. John , D. Chateau , D. Strang , S. Smele , S. Bozat-Emre , & N Dik. . (2012). Profiling the multidimensional needs of new nursing home residents: Evidence to support planning. Journal of the American Medical Directors Association, 13(5), 487.e9487.e17.

C. A. Estabrooks , J. E. Squires , G. G. Cummings , G. F. Teare , & P. G Norton . (2009). Study protocol for the Translating Research in Elder Care (TREC): Building context –An organizational monitoring program in long-term care project (project one). Implementation Science, 4(52), 113.

K. I. Fredriksen-Goldsen , & R. P Bonifas . (2013). Long-term care: The global impact on women. In M. B. Goldman , R. Troisi & K. M. Rexrode (Eds.), Women and Health (2nd ed., pp. 15151526). Boston, MA: Academic Press.

A. Gruber-Baldini , B. Stuart , I. Zuckerman , V. D. Hsu , K. S. Boockvar , S. Zimmerman , & J Magaziner . (2009). Sensitivity of nursing home cost comparisons to method of dementia diagnosis ascertainment. International Journal of Alzheimer’s Disease, Article ID 780720.

D. Houttekier , J. Cohen , J. Bilsen , J. Addington-Hall , B. D. Onwuteaka-Philipsen , & L Deliens . (2010). Place of death of older persons with dementia: A study in five European countries. Journal of the American Geriatrics Society, 58(4), 751756.

N. Ikegami , J. N. Morris , & B. E Fries . (1997). Low-care cases in long-term care settings: Variation among nations. Age and Ageing, 26(Suppl 2), 6771.

N. Janes , S. Sidani , C. Cott , & S Rappolt . (2008). Figuring it out in the moment: A theory of unregulated care providers’ knowledge utilization in dementia care settings. Worldviews on Evidence-Based Nursing, 5(1), 1324.

K. Josefsson , L. Sonde , B. Winblad , & T. B Robins Wahlin . (2007). Work situation of registered nurses in municipal elderly care in Sweden: A questionnaire survey. International Journal of Nursing Studies, 44(1), 7182.

M. S. Kerr , H. K. Laschinger , C. N. Severin , J. M. Almost , & J Shamian . (2005). New strategies for monitoring the health of Canadian nurses: Results of collaborations with key stakeholders. Nursing Leadership, 18(1), 6781.

M. P. Leiter , & C Maslach . (2009). Nurse turnover: The mediating role of burnout. Journal of Nursing Management, 17(3), 331339.

C. Maslach , & S. E Jackson . (1981). The measurement of experienced burnout. Journal of Occupational Behaviour, 2(2), 99113.

S. L. Mitchell , J. M. Teno , S. C. Miller , & V Mor . (2005). A national study of the location of death for older persons with dementia.[Erratum appears in Journal of the American Geriatrics Society 2005; 53:741]. Journal of the American Geriatrics Society, 53(2), 299305.

D. G. Morgan , A. Cammer , N. J. Stewart , M. Crossley , C. D’Arcy , D. A. Forbes , & C Karunanayake . (2012). Nursing aide reports of combative behavior by residents with dementia: Results from a detailed prospective incident diary. Journal of the American Medical Directors Association, 13(3), 220227.

D. G. Morgan , K. M. Semchuk , N. J. Stewart , & C D’Arcy . (2002). Job strain among staff of rural nursing homes: A comparison of nurses, aides, and activity workers. Journal of Nursing Administration, 32(3), 152161.

D. G. Morgan , N. J. Stewart , C. D’Arcy , D. Forbes , & J Lawson . (2005). Work stress and physical assault of nursing aides in rural nursing homes with and without dementia special care units. Journal of Psychiatric and Mental Health Nursing, 12(3), 347358.

J. C. Morgan , J. Dill , & A. L Kalleberg . (2013). The quality of healthcare jobs: Can intrinsic rewards compensate for low extrinsic rewards? Work, Employment & Society, 27(5), 802822.

M Rose . (2003). Good deal, bad deal? Job satisfaction in occupations. Work, Employment & Society, 17(3), 503530.

W. B. Schaufeli , M. P. Leiter , & C Maslach . (2009). Burnout: 35 years of research and practice. Career Development International, 14(3), 204220.

J. Squires , C. Estabrooks , S. Scott , G. Cummings , L. Hayduk , S. Kang , & B Stevens .(2013). The influence of organizational context on the use of research by nurses in Canadian pediatric hospitals. BMC Health Services Research, 13(351), 110.

J. E. Squires , A. M. Hutchinson , A.-M. Bostrom , K. Deis , P. G. Norton , G. G. Cummings , & C Estabrooks . (2012). A data quality control program for computer-assisted personal interviews. Nursing Research and Practice, Article ID 303816.

M Stevens . (2008). Workload management in social work services: What, why and how? Practice: Social Work in Action, 20(4), 207221.

D. Tolson , Y. Rolland , S. Andrieu , J. P. Aquino , J. Beard , A. Benetos , & J.E Morley . (2011). International Association of Gerontology and Geriatrics: A global agenda for clinical research and quality of care in nursing homes. Journal of the American Medical Directors Association, 12(3), 184189.

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Canadian Journal on Aging / La Revue canadienne du vieillissement
  • ISSN: 0714-9808
  • EISSN: 1710-1107
  • URL: /core/journals/canadian-journal-on-aging-la-revue-canadienne-du-vieillissement
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