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Gleason HP, Miller EA, Boerner K. Focusing on the Positive: Home Health Aides' Desire for Autonomy and Control. J Appl Gerontol 2023; 42:728-736. [PMID: 36523133 DOI: 10.1177/07334648221145177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Home Health Aides (HHAs) are one of the fastest growing workforces in the country, yet the industry struggles to recruit and retain workers. This study explored HHAs' experiences with the level of control, autonomy, and decision-making authority in their work. Six focus groups with 37 HHAs were conducted in Massachusetts. Findings showed that HHAs viewed control as a positive job characteristic, which attracted them to and led them to remain in the position. Positive benefits included having control over client selection, location, hours, and the ability to determine their day-to-day tasks and schedules. The study results highlight the value that HHAs place on autonomy and control and the potential benefit that these job qualities have for greater recruitment and retention of these workers. Amplifying control by bolstering training and expanding scope of practice may entice new individuals to pursue a HHA career and help maintain those currently in the position.
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Affiliation(s)
- Hayley P Gleason
- 50252Colorado Department of Health Care Policy & Financing, Denver, CO, USA
| | - Edward Alan Miller
- Department of Gerontology and Gerontology Institute, John W. McCormack Graduate School of Policy & Global Studies, 14708University of Massachusetts Boston, Boston, MA, USA.,Department of Health Services, Policy and Practice, and Center for Gerontology and Healthcare Research, School of Public Health, Brown University, Providence, RI, USA
| | - Kathrin Boerner
- Department of Gerontology and Gerontology Institute, John W. McCormack Graduate School of Policy & Global Studies, 14708University of Massachusetts Boston, Boston, MA, USA
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2
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Kriegsmann-Rabe M, Maus K, Hiebel N, Klein C, Geiser F. Live-in migrant home care workers in Germany: Stressors and resilience factors. PLoS One 2023; 18:e0282744. [PMID: 36947488 PMCID: PMC10032493 DOI: 10.1371/journal.pone.0282744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/21/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Thousands of Eastern Europeans find employment caring for older individuals as transmigrating live-in home care workers in private households in Germany. Studies have shown that the stressors threatening their well-being are multifaceted and include inequalities and a high practical and emotional workload, but research on protective factors is still scarce. AIM & METHODS This qualitative descriptive study focuses on both the stressors and factors that promote care workers' well-being and contribute to their psychological resilience. In guideline-based interviews, 14 female and one male care workers were asked about their stressors and the factors that help them cope. RESULTS Identified stressors included separation from their own family, strained relationship with either or both the care recipient (dementia) and their relatives (violation of worker´s rights and devaluation of care work), and permanent availability and lack of free time due to a 24-h care schedule. Resilience factors were both external and internal and included positive social relationships, self-determination, experience in care work, and intrinsic job motivation. CONCLUSION Live-ins reside in an ambiguous setting, exposed to both structural and individual strains. However, external and internal resilience factors contribute to a generally positive attitude toward their job and indicate the agency of this precariously employed group. A socially anchored appreciation of their work and an officially controlled expansion of free time are mandatory to improve the working conditions of live-in care workers.
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Affiliation(s)
- Milena Kriegsmann-Rabe
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Katja Maus
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Constantin Klein
- University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
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3
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Abstract
The glaring lack of formal and informal caregivers in Germany has not only become apparent in hospitals and nursing homes but also in home care arrangements. One tension is particularly pertinent in such arrangements: a 'family-oriented' logic of the long-term care insurance and the individual wishes of those in need of care meet the actual possibilities of family carers. This care gap has been compensated for by 24-hour care workers, so-called 'live-ins', from Eastern Europe for some years. This contribution maps the 'live-ins' situation comprehensively from an ethical perspective. Based on different constellations regarding the 'live-ins' status as a professional nurse or non-professional caregiver, which ethical principles and moral norms are affected by whom and potentially conflict with each other in such home care arrangements at a micro and meso level of care are outlined. Special attention is paid to the tension between self-care and care for others, and to questions of the shared responsibility in and social responsibility of those external services that are involved in home care in addition to the 'live-in'.In order to uncover, understand and influence the current ethical problems, an ethical framework that considers both the divergent interests of all individuals involved in the home care arrangement and their mutual dependency and vulnerability is needed.
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Affiliation(s)
- Eva Kuhn
- Section Global Health, Institute for Hygiene and Public Health, 39062University Hospital Bonn, Bonn, Germany
| | - Anna-Henrikje Seidlein
- Institute of Ethics and History of Medicine, 60634University Medicine Greifswald, Greifswald, Germany
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4
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Roland D, Allan S, Chambers E, Smith D, Gousia K. Personal assistants in England and the factors associated with absenteeism. Front Public Health 2022; 10:970370. [PMID: 36299742 PMCID: PMC9589044 DOI: 10.3389/fpubh.2022.970370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/15/2022] [Indexed: 01/25/2023] Open
Abstract
Personal assistants (PAs) have become an increasingly important element of long-term care (LTC) in England since the introduction of Direct Payments in 1996 and the Care Act 2014 legislation. The PAs, who are directly employed by social care users, can perform a number of support tasks including vital assistance in activities of daily living (ADL). Internationally these roles would be classed as domestic care work, including the employment of migrant care workers, e.g. in Germany and Austria. High turnover rates and work absenteeism in this market can cause disruption of these important daily activities, causing LTC users to potentially suffer neglect and poorer quality of life. Although there is research on turnover and absenteeism in nursing workforce in hospitals and LTC workers in nursing homes, little attention has been given to reasons for turnover of PAs and even less for absenteeism, which often precedes turnover, in a workforce of over 100,000 people in England. This research aims to fill this gap in knowledge by analyzing the reasons behind the absenteeism of PAs using quantitative methods. We used survey data of PAs in England, exploring the factors associated to one form of absenteeism-sick leave from work. After controlling for a number of factors ranging from job characteristics such as number of hours worked and type of contract, socio-economic characteristics from the PA and their employer, and supply and demand factors at local government region, the findings suggest a number of factors that significantly influenced sick leave, including distances traveled to work and number of PAs employed. Following the analysis, two people with life experience of LTC discuss the findings of the study and how they compare to their experiences of the market for PAs, providing a unique perspective from the people who could benefit the most from improving PA retention and reducing absenteeism.
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Affiliation(s)
- Daniel Roland
- Personal Social Services Research Unit, School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, United Kingdom,*Correspondence: Daniel Roland
| | - Stephen Allan
- Personal Social Services Research Unit, School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, United Kingdom
| | - Eleni Chambers
- Patient and Public Involvement Research Advisor, Division of Nursing & Midwifery, Health Sciences School, University of Sheffield, Sheffield, United Kingdom,Patient and Public Involvement Research Advisor, Public Involvement Research Advisor Network, Personal Social Services Research Unit, University of Kent, Canterbury, United Kingdom
| | - Debs Smith
- Patient and Public Involvement Research Advisor, Division of Nursing & Midwifery, Health Sciences School, University of Sheffield, Sheffield, United Kingdom,Patient and Public Involvement Research Advisor, Public Involvement Research Advisor Network, Personal Social Services Research Unit, University of Kent, Canterbury, United Kingdom
| | - Katerina Gousia
- Personal Social Services Research Unit, School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, United Kingdom
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5
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Silarova B, Brookes N, Palmer S, Towers A, Hussein S. Understanding and measuring the work-related quality of life among those working in adult social care: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1637-1664. [PMID: 35066964 PMCID: PMC9543435 DOI: 10.1111/hsc.13718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/23/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
The main aim of this scoping review was to understand how work-related quality of life (WRQoL) in adult social care has been defined and measured in the literature and to map key components of WRQoL among those working in adult social care and similar contexts. The scoping review included studies that: 1- focused on WRQoL/work-related wellbeing (and their synonyms); and 2- included adult social care or community health care. We searched existing evidence from November 2019 until July 2020 through an electronic literature search of eight major databases complemented by the grey literature, searching the reference lists and by contacting our existing network of experts in the field. In addition, we repeated the searches to identify any relevant literature published in 2021. Reporting followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) checklist. In total, we included 68 publications. These publications indicate that there is an absence of agreement on a definition and measurement of WRQoL in adult social care. Based on a thematic analysis we identified six key components of WRQoL: organisational characteristics; job characteristics; mental wellbeing and health; physical wellbeing and health; spill-over from work to home; and professional identity. In summary, at the moment, there is no agreement on what WRQoL is and how to measure it in adult social care. As a result, there is very limited evidence on how to improve WRQoL among people working in adult social care. However, this scoping review suggests that there are six key components of WRQoL that researchers may consider to include in their future studies.
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Affiliation(s)
- Barbora Silarova
- Personal Social Services Research UnitUniversity of KentCornwallis CentralCanterburyUK
| | - Nadia Brookes
- Personal Social Services Research UnitUniversity of KentCornwallis CentralCanterburyUK
- Present address:
Centre For Health Services StudiesGeorge Allen WingCornwallis BuildingUniversity of KentCanterburyCT2 7NFUK
| | - Sinead Palmer
- Personal Social Services Research UnitUniversity of KentCornwallis CentralCanterburyUK
| | - Ann‐Marie Towers
- Centre For Health Services StudiesGeorge Allen WingCornwallis BuildingUniversity of KentCanterburyUK
| | - Shereen Hussein
- Personal Social Services Research UnitUniversity of KentCornwallis CentralCanterburyUK
- Present address:
Faculty of Public Health PolicyLondon School of Hygiene & Tropical MedicineLondonWC1E 7HTUK
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Factors Affecting the Job Satisfaction of Caregivers in a Home-Based Elderly Care Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159332. [PMID: 35954687 PMCID: PMC9368037 DOI: 10.3390/ijerph19159332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 12/10/2022]
Abstract
Population aging has increased the demand for elderly care worldwide. The home-based elderly care system plays an important role in meeting this demand in developing countries. The quality of home-based elderly care is associated with the job satisfaction of caregivers in home-based elderly care programs, which has rarely been studied. This paper explores the factors that affect the job satisfaction of these elderly caregivers, including personal characteristics, working conditions, employment status, training, caregiver–client relationships, welfare, work experience, and burnout. It utilizes data from the Shanghai Domestic-work Professionalization Survey (SDPS), which was conducted among four types of in-home caregivers (n = 1000) in Shanghai over the period from May to September 2021. This paper selected a sample of elderly caregivers (n = 285) to examine their job satisfaction. The results show that gender, age, marital status, how they earned the job, relation with clients, social insurance, and work experience are significantly associated with the job satisfaction of in-home elderly caregivers, and their job satisfaction is negatively associated with their burnout levels. However, training and working conditions have no significant effect on the job satisfaction of in-home elderly caregivers, which is different from previous studies on formal care workers, such as nurses, in the institutional care system.
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Shirmohammadi M, Beigi M, Richardson J. Subjective well-being among blue-collar immigrant employees: A systematic literature review. HUMAN RESOURCE MANAGEMENT REVIEW 2022. [DOI: 10.1016/j.hrmr.2022.100914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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8
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Yang A, Fu S, Liu L, Fan C, Jilili M. Act Tough and Soft: Video Monitoring, Hongbao Gifts, and the Job Satisfaction of Domestic Workers. Front Public Health 2022; 10:862162. [PMID: 35400073 PMCID: PMC8990934 DOI: 10.3389/fpubh.2022.862162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
There is a rapidly growing demand for domestic services among urban families in China. However, domestic work remains a low-status occupation with a high turnover rate. Focusing on the job satisfaction of domestic workers is useful to interpret this phenomenon. We investigate how the job satisfaction of domestic workers in China is affected by to two distinct labor control strategies used by their employers: the installation of video-monitoring devices in employers' homes (a “tough” control strategy), and the Chinese custom of giving monetary gifts, or “hongbao” (a “soft” control strategy). By analyzing data from surveys of domestic workers in four cities in China (N = 699), we find that video monitoring in employers' homes negatively impacts domestic workers' job satisfaction, and that hongbao gifts from employers significantly promote domestic workers' job satisfaction. The analysis of the causal mechanism based on a structural equation model suggests that video monitoring can increase the discrimination that domestic workers perceive, which in turn reduces their job satisfaction. In particular, we find that domestic workers' perception of discrimination completely mediates the effect of video monitoring on their job satisfaction. However, we also find that hongbao gifts significantly reduce domestic workers' perceptions of discrimination, and thus promote their job satisfaction; that is, the relationship between hongbao gifts and job satisfaction is partially mediated by discrimination. Our study provides a more comprehensive understanding of Chinese employers' labor control strategies and their effects on the job satisfaction of domestic workers.
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Affiliation(s)
- Anuo Yang
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Shuangle Fu
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Linping Liu
- School of Public Administration, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Linping Liu
| | - Changyu Fan
- School of Sociology, Central China Normal University, Wuhan, China
| | - Maitixirepu Jilili
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
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9
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Hodzi MB, Annor F, Darkwah E. An exploration of work-related experiences of domestic workers in Accra, Ghana. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2021. [DOI: 10.1080/15555240.2021.1941068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Francis Annor
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Ernest Darkwah
- Department of Psychology, University of Ghana, Accra, Ghana
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10
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Gleason HP, Miller EA. Maximizing Home Health Aide Retention: The Impact of Control and Support on the Job. THE GERONTOLOGIST 2021; 61:517-529. [PMID: 33423049 DOI: 10.1093/geront/gnab003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study examined relationships between the level of control and support and home health aides (HHAs) job satisfaction and intent to leave the job. RESEARCH DESIGN AND METHODS Data derive from a survey of 512 HHAs in Massachusetts. Logistic regression using generalized estimating equations was employed for the analysis. Dependent variables included satisfaction and intent to leave the job as a home care aide generally and satisfaction and intent to leave the job at the aide's current agency. RESULTS The findings showed that greater control and support on the job were important predictors of positive work outcomes, controlling for job demands and other covariates. The odds of HHAs being satisfied with their job as a home care aide increased with the degree of control, whereas the odds of HHAs being satisfied with their job at their current agency increased with the extent of support. Control was negatively associated with HHAs' intent to leave the job as an aide; no relationship was found between control or support and HHAs' intent to leave their current agency. DISCUSSION AND IMPLICATIONS The results from this study illustrate the importance for HHAs of having control and autonomy in their work, as well as the benefit of support from supervisors and the home care agency, on satisfaction and intent to leave. Expanding HHA's ability to maintain control over their day-to-day work, as well as enhancing the supports available to them, is likely to benefit home care workers, clients, and agencies through increased retention.
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Affiliation(s)
- Hayley P Gleason
- Colorado Department of Health Care Policy & Financing, Denver, USA
| | - Edward Alan Miller
- Department of Gerontology and Gerontology Institute, John W. McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, USA.,Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA
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11
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Cohen-Mansfield J, Golander H. Predictors of Migrant Live-in Care Workers' Burden/Burnout and Job Satisfaction When Caring for Frail Older Persons in Israel. J Gerontol B Psychol Sci Soc Sci 2020; 76:1151-1160. [PMID: 33031515 DOI: 10.1093/geronb/gbaa171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To clarify how work characteristics affect migrant live-in care workers' burden/burnout as well as their job satisfaction. METHODS Data from 116 migrant live-in care workers were collected in 2013-2014 in Tel Aviv and Jerusalem through structured interviews about their job satisfaction and their degree of burden/burnout. Due to the conceptual and empirical similarity (zero-order correlation and joint internal reliability), of burden and burnout, the 2 were combined into one variable. These outcome measures were examined in connection with the older person's level of disability, care workers' relationship with the older person, and their employment conditions. RESULTS According to the regression models, work characteristics (care recipients' functional status and care workers' relationship with the care recipient) had a direct impact on burden/burnout. Employment-related variables (employment conditions and satisfaction with those conditions) had an indirect effect. A combination of work characteristics (relationship with the older person) together with the care worker's response to employment conditions (satisfaction with employment conditions) had a direct influence on the care workers' job satisfaction. Problematic employment conditions had an indirect effect. DISCUSSION The results suggest that fostering better relationships and improving employment conditions could help reduce care workers' burden/burnout as well as improve their degree of satisfaction.
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Affiliation(s)
- Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel.,Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Israel
| | - Hava Golander
- Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Israel.,Department of Nursing, The Stanley Seyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
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12
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Abstract
UNLABELLED ABSTRACTObjective:With the aging of the population, the demand for long-term services is increasing accordingly and the recruitment of paid caregivers to older adults has become a critical issue. Hence, there is a great need to train people in the care of older adults. This study examined motivations to participate in a new program, which aims to train young people (ages 19-25) to become paid caregivers for older adults. METHODS The study is based on focus groups with program participants (N = 33) and on phone interviews with former participants (N = 8) and face-to-face interviews with staff members (N = 14). Transcripts were analyzed using qualitative content analysis. RESULTS Three major themes emerged: (1) "Motivations to participate in the program," referred to participants' motivations to work with older adults. (2) "Reduced motivations due to ambiguity of roles," referred to the unclear definition of the care worker's role, which created a decrease in participants' motivations to provide care. (3) "Inadequate financial compensation," concerned participants' reduced motivation to participate in the program as a result of financial promises that were not realized. CONCLUSIONS Findings suggest that it is important to be cautious about the motivations for participation in the program because by emphasizing the difficult situation of older adults, one stresses the low status assigned to older adults, rather than positive attributes. It is also suggested that care workers should be financially rewarded, so that despite the difficulties that may arise during work, they will feel valued and will want to remain in the profession.
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Shinan-Altman S, Ayalon L. Perceived control among migrant live-in and local live-out home care workers in Israel. Aging Ment Health 2019; 23:189-195. [PMID: 29156948 DOI: 10.1080/13607863.2017.1401584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine perceived control among live-in and live-out home care workers and to identify factors that contribute to perceived control among both types of caregiving. METHOD 338 migrant live-in home care workers and 185 local live-out home care workers were asked to report their perceived control. Burnout, satisfaction with the relationship with the care recipient and the care recipient's family, and satisfaction with social relationship were also gathered. RESULTS Both types of caregivers reported high levels of perceived control, although live-in home care workers expressed more perceived control. Higher age, higher levels of satisfaction with the relationship with the care recipient and the care recipient's family and lower levels of burnout, predicted perceived control. Satisfaction with social relationship was a stronger predictor of one's perceived control among live-in home care workers. CONCLUSIONS Promoting social relationships outside the home care context by allowing migrant live-in home care workers to take part in social gatherings is recommended as this can strengthen their sense of perceived control.
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Affiliation(s)
| | - Liat Ayalon
- a School of Social Work , Bar- Ilan University , Ramat Gan , Israel
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"I Can't Do This Alone": a study on foreign domestic workers providing long-term care for frail seniors at home. Int Psychogeriatr 2018; 30:1269-1277. [PMID: 29151397 DOI: 10.1017/s1041610217002459] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
UNLABELLED ABSTRACTBackground:Foreign domestic workers (FDWs) play an important role in long-term caregiving of seniors at home. However, how FDWs cope with the caregiving demands, the dynamic interaction between familial and FDW caregivers and its impact on care recipients remain largely un-explored. Existing caregiver interventions mainly target familial caregivers; little assistance is available for FDW caregivers. This study explores FDWs' challenges, coping strategies, and the support they need in caring for seniors. METHODS FDWs were recruited from a geriatric ward and outpatient clinic of a tertiary hospital in Singapore. Qualitative in-depth interviews were conducted with 25 FDWs caring for frail seniors and five healthcare staff. Interviews were transcribed and analyzed using thematic analysis. RESULTS FDWs were from Indonesia, Philippines, and Myanmar. Nineteen cared for seniors with dementia (SWDs). We derived six subthemes, clustered into three salient themes: two described social support to FDWs by the senior's family members, two described their coping strategies, and two described their job satisfaction. Those who cared for SWDs faced more difficulties. We derived two family models of care: FDW-centered family dynamics, where family members rely on FDWs to perform most duties, causing poor impact on seniors' well-being and team-based family dynamics, where family members and FDWs share the caregiving burden, resulting in better impact on seniors' well-being. CONCLUSION FDWs face significant challenges in eldercare. Improving FDWs' access to training courses in eldercare, providing them with more emotional support, engaging employers to create healthy caregiving spaces at home, and improving access to senior care services can be helpful.
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Bauleo MF, Van Dijk F, Radon K. One's Workplace, Other's Home? Work and Health of Domestic Workers in Argentina. Ann Glob Health 2018; 84:450-458. [PMID: 30835387 PMCID: PMC6748280 DOI: 10.29024/aogh.2311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Domestic workers around the world work and eventually live in private homes where control of working conditions is difficult. Objective: The aim of this study was to compare working conditions and its impact on general and mental health in live-in and live-out domestic workers in Argentina. Methods: In a cross-sectional study, the Spanish version of the European Workings Condition Survey and an ad hoc questionnaire were applied to 201 domestic workers (response 94%). Twelve months’ prevalence of verbal or physical workplace violence was assessed. Poor general health was defined by general health self-assessed as poor or fair. Symptoms of common mental disorders (CMD) were considered present if Goldberg’s general health score was above 4. Data were analyzed using Chi square’s test and logistic regression models. Findings: Live-in workers formed 66% of the participants. They were more likely to take care of the elderly, iron and cook than live-out workers. Workplace violence was reported by 17% of live-in and 24% of live-out workers (p = 0.25). Overall prevalence of poor general health was 23%; 53% reported CMD. After adjustment, violence remained a statistically significant predictor of poor general health (Odds Ratio 7.3; 95% Confidence Interval 2.8–19.1) and CMD (3.2; 1.1–9.3). Conclusions: Working conditions of live-in and live-out domestic workers are different. However, exposure to workplace violence is common in both groups and affects general and mental health.
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Affiliation(s)
- María Fernanda Bauleo
- MunBaus, Av. Mariano Acosta 1254, AR.,Center for International Health LMU @ Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Ziemssenstr. 1, D-80336 Munich, DE
| | - Frank Van Dijk
- MunBaus, Av. Mariano Acosta 1254, (1407), Buenos Aires, AR
| | - Katja Radon
- MunBaus, Av. Mariano Acosta 1254, (1407), Buenos Aires, AR
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Abstract
UNLABELLED ABSTRACTBackground:Although foreign domestic workers (FDWs) play a significant role in caring for frail seniors in Singapore and are vulnerable to caregiving burden, there has been little research conducted hitherto. We explored caregiver burden and its determinants in this study. METHODS FDWs (N = 221, Mage = 32.3, SD = 6.23) recruited from a hospital geriatric unit completed the Zarit Burden Interview (ZBI) administered in English, Bahasa Melayu, or Burmese. Univariate and multivariate regression were employed to investigate factors influencing caregiving burden in FDWs. RESULTS Majority were Indonesians (60.0%), married (57.5%) with children (62.4%), with secondary-level education (59.7%), and providing care for >1 year (79.9%). Importantly, 25.1% reported physical health problems and 23.1% encountered language difficulties with employers. Univariate analysis revealed three significant factors associated with caregiving burden: nationality (p < 0.001), lack of privacy (p = 0.029), and caring for persons with dementia (PWD) (p = 0.001). On multivariate regression, FDWs who cared for PWD were 5.47 times (p = 0.013) more likely to experience burden, while FDWs who encountered language difficulties were 5.46 times (p = 0.030) more likely to experience burden. Filipinos FDWs were 9.73 times more likely to express burden (p < 0.001) compared to their Indonesian and Burmese counterparts. CONCLUSION The study highlights caregiver burden in FDWs and potential ways to alleviate it by empowering FDWs with dementia-specific caregiving skills, providing language training opportunities, and supporting particular FDW ethnic groups with more emotional and practical help.
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Green O, Ayalon L. Violations of workers' rights and exposure to work-related abuse of live-in migrant and live-out local home care workers - a preliminary study: implications for health policy and practice. Isr J Health Policy Res 2018; 7:32. [PMID: 29929555 PMCID: PMC6011269 DOI: 10.1186/s13584-018-0224-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 05/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Home care workers work in an isolated environment, with limited supervision and guidance which makes them more prone to abuse and exploitation. While past research focused mostly on the well-being of care recipients, this study aimed to shed light on the care workers' daily reality and explore if and how boundaries of professional care work are blurred. Our primary aim was to assess the working conditions and the prevalence of abuse and exploitation among live-in migrant home care workers and live-out local home care workers. METHODS A random stratified sample of Israeli older adults aged over 70, who are entitled by law to home care services was used to recruit 338 migrant live-in home care workers and 185 local live-out home care workers to a face-to-face survey. The participants were asked about their relationship with the care recipient and their exposure to violations of workers' rights and work-related abuse. RESULTS Almost all the participants reported exposure to certain workers' rights violations. Among the migrant live-in care workers, it was found that 58% of them did not receive any vacation days besides the weekly day-off, about 30% reported not get even a weekly day-off on a regular basis, and 79% did not get paid sick days. Local live-out care workers also suffered from a high prevalence of exploitation - 58% did not get any vacation days besides the weekly day-off, and 66% did not get paid sick leave. 20% of the local live-out care workers, and 15% of the migrant live-in care workers did not receive a signed contract. A smaller portion (7.4% among migrant care workers, 2.5% among local care workers) reported work-related abuse. When compared to local workers, migrant home care workers were more vulnerable to some worker's rights violations, as well as emotional abuse. CONCLUSION These findings are disturbing, as work-related abuse and exploitation affect not only the well-being of the care worker but also the health of the care recipients, as the quality of care provided deteriorates. At the public policy level, more significant attention and regulation of the home care industry is needed. The frequency and the nature of home visits made by home care agencies must be changed. Also, home care workers should be offered emotional support.
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Yang FM, Kao ST. Commentary on "Rehabilitation Outcomes Associated With Foreign Domestic Workers as Caregivers". Arch Phys Med Rehabil 2017; 98:1903-1905. [PMID: 28559041 DOI: 10.1016/j.apmr.2017.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 04/22/2017] [Accepted: 04/22/2017] [Indexed: 10/19/2022]
Abstract
The purpose of this commentary is to illuminate the role of foreign domestic workers (FDW) as caregivers for patients undergoing rehabilitation in Asia. The authors of a published study in this issue of the Archives of Physical Medicine and Rehabilitation investigate the association between the characteristics of caregivers for patients recovering from sub-acute stroke and the rehabilitation outcomes of those patients in Singapore. The investigators examined over 4,000 caregivers and one of the findings showed that after controlling for characteristics of both caregivers and patients, there was a significant and negative association between having an FDW as a caregiver, compared to a spouse, and patient rehabilitation effectiveness. The inclusion of FDW's in this study is an important and understudied group of caregivers in the role of patient rehabilitation that is relatively new to the US, but common in other parts of the world.
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Affiliation(s)
- Frances M Yang
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA.
| | - Solon T Kao
- Department of Oral and Maxillofacial Surgery, Dental College of Georgia, Augusta University, Augusta, GA
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Ong PH, Tai BC, Wong WP, Wee LE, Chen C, Cheong A, Fong NP, Chan KM, Tan BY, Menon E, Lee KK, Ee CH, Petrella R, Thind A, Koh GCH. Caregivers: Do They Make a Difference to Patient Recovery in Subacute Stroke? Arch Phys Med Rehabil 2017; 98:2009-2020. [PMID: 28363700 DOI: 10.1016/j.apmr.2017.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/09/2017] [Accepted: 02/10/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the relationship between caregiver nature and availability, and rehabilitation outcomes in subacute stroke. DESIGN Retrospective cohort study. SETTING Four community rehabilitation hospitals. PARTICIPANTS Patients with subacute, first-time stroke (N=4042; 48.5% men; mean age ± SD, 70.12±10.4y; 51.5% women; mean age ± SD, 72.54 ±10.0y). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Rehabilitation effectiveness, defined as the percentage of potential improvement eventually achieved with rehabilitation; and rehabilitation efficiency, defined as the rate of functional improvement during rehabilitation. RESULTS In our cohort, 96.7% had available caregiver(s), of which 42.0% were primarily supported by foreign domestic workers (FDWs), 25.9% by spouses, 19.3% by first-degree relatives, 7.8% by other relatives, and 5.1% by other caregivers. Using quantile regression, we found that having a caregiver was independently associated with rehabilitation efficiency (β=-3.83; 95% confidence interval [CI], -6.99 to -0.66; P=.018). The relationship between caregiver availability and rehabilitation effectiveness was modified by patient sex in that the negative association was significantly greater in men (β=-22.81; 95% CI, -32.70 to -12.94; P<.001) than women (β=-5.64; 95% CI, -14.72 to 3.44; P=.223). Having a FDW as a caregiver compared with a spousal caregiver was negatively associated with rehabilitation effectiveness (β=-3.95; 95% CI, -6.94 to -0.95; P=.01) and rehabilitation efficiency (β=-1.83; 95% CI, -3.14 to -0.53; P=.006). The number of potential caregivers was only significantly associated with rehabilitation effectiveness at the bivariate level (P=.006). CONCLUSIONS Caregiver identity, and possibly availability, appears to negatively affect rehabilitation outcomes in subacute stroke. A better understanding of these relationships has potential implications on clinical practice and policy directions.
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Affiliation(s)
- Peck-Hoon Ong
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
| | - Bee-Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
| | | | - Liang En Wee
- Singhealth Internal Medicine Residency, Singapore
| | - Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
| | - Angela Cheong
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
| | - Ngan Phoon Fong
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
| | | | | | | | - Kok Keng Lee
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | | | - Robert Petrella
- Department of Family Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada; Lawson Health Research Institute, London, ON, Canada
| | - Amardeep Thind
- Department of Family Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada; Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada; Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - Gerald Choon-Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore.
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Recommended Vs. Reported Working Conditions & Current Satisfaction Levels among Migrant Caregivers in Israel. JOURNAL OF POPULATION AGEING 2016. [DOI: 10.1007/s12062-016-9170-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nugraha S, Ohara-Hirano Y. The Mental Health Predictors of Indonesian EPA Nurses and Certified Care Worker Candidates in Japan. JAPANESE PSYCHOLOGICAL RESEARCH 2015. [DOI: 10.1111/jpr.12100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ben-Arie A, Iecovich E. Factors Explaining the Job Satisfaction of Home Care Workers Who Left Their Older Care Recipients in Israel. Home Health Care Serv Q 2014; 33:211-28. [DOI: 10.1080/01621424.2014.956958] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Eckenwiler L. Care worker migration, global health equity, and ethical place-making. WOMENS STUDIES INTERNATIONAL FORUM 2014. [DOI: 10.1016/j.wsif.2014.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Banijamali S, Jacoby D, Hagopian A. Characteristics of Home Care Workers Who Leave Their Jobs: A Cross-Sectional Study of Job Satisfaction and Turnover in Washington State. Home Health Care Serv Q 2014; 33:137-58. [DOI: 10.1080/01621424.2014.929068] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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An exploratory qualitative study on relationships between older people and home care workers in South Korea: the view from family carers and service providers. AGEING & SOCIETY 2013. [DOI: 10.1017/s0144686x13000950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
ABSTRACTAlthough the proportion of older people using home care services has significantly increased in East Asian countries, the issue of the relationships between older people and home care workers in the East Asian context has received scant attention from scholars. This exploratory qualitative study aims to explore these relationships under the new Korean long-term care insurance system. Semi-structured in-depth interviews were conducted with 22 family carers and private-sector home care service providers (home care workers and provider managers). The findings show that while the majority of family carers interviewed reported that their relationships were good, the majority of service providers' responses were more negative. Service providers stated that they experienced a number of difficulties that affected their relationships with older clients, including excessive demands or sexual harassment by the older people in their care, exposure to unsafe working environments, and poor treatment in terms of pay and conditions. The findings suggest that stable and good relationships between home care workers and their clients have not been secured in Korea's long-term care system.
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Chiatti C, Di Rosa M, Melchiorre MG, Manzoli L, Rimland JM, Lamura G. Migrant care workers as protective factor against caregiver burden: results from a longitudinal analysis of the EUROFAMCARE study in Italy. Aging Ment Health 2013; 17:609-14. [PMID: 23418850 DOI: 10.1080/13607863.2013.765830] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of the analysis is to assess the impact of privately employed migrant care workers (MCWs) on the burden of Italian family members who care for a disabled older person. METHODS EUROFAMCARE is a one-year prospective survey carried out to provide evidence on the availability and use of support services by family carers of older people in Europe. In Italy, 990 family caregivers were enrolled and successful follow-ups were completed for 863 subjects. The survey also assessed the level of caregiver burden using the COPE index, which has three sub-sections: 'Positive Value' (PV), 'Quality of Support' (QS) and 'Negative Impact' (NI). We used the one-year change of the COPE-NI as dependent variable and we realised multilevel regression models to estimate the longitudinal predictors of caregivers' burden increase. RESULTS At a cross-sectional level, most burdened caregivers are those caring for a demented relative (COPE-NI = 13.6), with no educational title (14.5) and looking after their own spouses (15.1). Longitudinally those employing an MCW are significantly protected against burden increase (regression coefficient: -1.52; p < 0.01) while those who cannot rely on the support of other family members are exposed to the risk of burden increase (0.991; p < 0.05). Other formal services do not have any protective effect. CONCLUSION Our study suggests that employing an MCW, rather than using formal services, is associated with a reduction of caregiving burden. Further research should assess whether the shift in care responsibilities to the MCWs also implies a transfer of care burden, and understand how these workers can be better supported by existing formal services.
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Affiliation(s)
- Carlos Chiatti
- Scientific Technological Area, National Institute for Health and Science on Ageing, INRCA, Ancona, Italy.
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Jenull BB, Wiedermann W. The Different Facets of Work Stress. J Appl Gerontol 2013; 34:823-43. [DOI: 10.1177/0733464813495472] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 06/03/2013] [Indexed: 11/16/2022] Open
Abstract
Work-related stress has been identified as a relevant problem leading to negative effects on health and quality of life. Using data from 844 nurses, latent profile analyses (LPA) were applied to identify distinct patterns of work stress. Several sociodemographic variables, including nurses’ working and living conditions, as well as nurses’ reactions to workload, were considered to predict respondents’ profile membership. LPA revealed three distinct profiles that can be distinguished by a low, moderate, and higher stress level. Being financially secure is positively related to the low stress profile, whereas working in an urban area and having low job satisfaction increases the chance of belonging to the higher stress profile. Our results can be used as a basis to develop interventions to create a healthy nursing home environment by supporting the balance between family and work, providing access to job resources and optimizing recovery opportunities.
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Berta W, Laporte A, Deber R, Baumann A, Gamble B. The evolving role of health care aides in the long-term care and home and community care sectors in Canada. HUMAN RESOURCES FOR HEALTH 2013; 11:25. [PMID: 23768158 PMCID: PMC3723545 DOI: 10.1186/1478-4491-11-25] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 05/07/2013] [Indexed: 05/20/2023]
Abstract
Health Care Aides (HCAs) provide up to 80% of the direct care to older Canadians living in long-term care facilities, or in their homes. They are an understudied workforce, and calls for health human resources strategies relating to these workers are, we feel, precipitous. First, we need a better understanding of the nature and scope of their work, and of the factors that shape it. Here, we discuss the evolving role of HCAs and the factors that impact how and where they work. The work of HCAs includes role-required behaviors, an increasing array of delegated acts, and extra-role behaviors like emotional support. Role boundaries, particularly instances where some workers over-invest in care beyond expected levels, are identified as one of the biggest concerns among employers of HCAs in the current cost-containment environment. A number of factors significantly impact what these workers do and where they work, including market-level differences, job mobility, and work structure. In Canada, entry into this 'profession' is increasingly constrained to the Home and Community Care sector, while market-level and work structure differences constrain job mobility to transitions of only the most experienced workers, to the long-term care sector. We note that this is in direct opposition to recent policy initiatives designed to encourage aging at home. Work structure influences what these workers do, and how they work; many HCAs work for three or four different agencies in order to sustain themselves and their families. Expectations with regard to HCA preparation have changed over the past decade in Canada, and training is emerging as a high priority health human resource issue. An increasing emphasis on improving quality of care and measuring performance, and on integrated team-based care delivery, has considerable implications for worker training. New models of care delivery foreshadow a need for management and leadership expertise--these workers have not historically been prepared for leadership roles. We conclude with a brief discussion of the next steps necessary to generating evidence necessary to informing a health human resource strategy relating to the provision of care to older Canadians.
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Affiliation(s)
- Whitney Berta
- Institute of Health Policy, Management & Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario, Canada
| | - Audrey Laporte
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
| | - Raisa Deber
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
| | - Andrea Baumann
- School of Nursing, Nursing Health Services Research Unit, McMaster University, Hamilton, Ontario, Canada
| | - Brenda Gamble
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
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Ostbye T, Malhotra R, Malhotra C, Arambepola C, Chan A. Does Support From Foreign Domestic Workers Decrease the Negative Impact of Informal Caregiving? Results From Singapore Survey on Informal Caregiving. J Gerontol B Psychol Sci Soc Sci 2013; 68:609-21. [DOI: 10.1093/geronb/gbt042] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Migrant Live-in Caregivers Providing Care to Canadian Older Adults: An Exploratory Study of Workers’ Life and Job Satisfaction. JOURNAL OF POPULATION AGEING 2012. [DOI: 10.1007/s12062-012-9073-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
The State of Israel provides significant opportunities to study social processes that can enhance our understanding of the aging experience. It has high life expectancy and rapid growth of its older population. With an older cohort that is composed largely of former immigrants and includes a minority Arab population, Israel provides much diversity for gerontological study. Among the unique issues facing older Israelis are the aging of Holocaust survivors, modernization in the Arab sector, and privatization in the kibbutzim. New legislation related to pensions and universal health care is expected to affect aging processes. The development of "supportive communities" offers a new service model. The article notes 2 longitudinal studies of importance-the Israeli component of the Survey of Health, Ageing, and Retirement in Europe and the Jerusalem Longitudinal Cohort Study.
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Affiliation(s)
- Allen Glicksman
- Planning Department, Philadelphia Corporation for Aging, Pennsylvania, PA 19130, USA.
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