Healthy Aging Requires a Healthy Home Care Workforce: the Occupational Safety and Health of Home Care Aides

Quinn, Margaret; Markkanen, Pia; Galligan, Catherine; Sama, Susan; Lindberg, John E.; Edwards, Marilyn

doi:10.1007/s40572-021-00315-7

Cited by 27 publications

(32 citation statements)

References 59 publications

(73 reference statements)

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“…Home-based services are critical to the health and social wellbeing of older adults, people with disabilities, and the chronically ill [1][2][3]. In the USA, these services may be referred to as home health care (HHC) or home care (HC), depending on the degree of medical support provided.…”

Section: Introductionmentioning

confidence: 99%

“It changed everything”: The Safe Home Care qualitative study of the COVID-19 pandemic’s impact on home care aides, clients, and managers

Markkanen

Brouillette

Quinn

et al. 2021

BMC Health Serv Res

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Background Home care (HC) services are crucial to the health and social wellbeing of older adults, people with disabilities, and the chronically ill. Although the HC sector is growing rapidly in the USA, there is high job turnover among the HC aide workforce. HC provides an important alternative to facility-based care, yet it has often been overlooked within the larger health care system: most recently, in COVID-19 pandemic planning. The objective of the study was to characterize qualitatively the impact of the COVID-19 pandemic on three key HC stakeholders: clients, aides, and agency managers. Methods The study included 37 phone interviews conducted during April – November 2020: HC clients (n = 9), aides (n = 16), and agency managers (n = 12). All interviews were audio recorded and transcribed verbatim. Qualitative analysis of the transcripts followed the grounded theory approach. The interview transcriptions were coded line-by-line into hierarchical themes with NVivo 12 software which allowed weighting of themes based on the number of interviews where they were coded. Results Fear of infection and transmission among HC clients and aides were strong themes. Infection prevention and control became the top priority guiding day-to-day business operations at agencies; sourcing adequate personal protective equipment for staff was the most urgent task. HC aides expressed concerns for their clients who showed signs of depression, due to increased isolation during the pandemic. The disappearance of comforting touch – resulting from physical distancing practices – altered the expression of compassion in the HC aide-client care relationship. Conclusions The findings suggest that the pandemic has further increased psychosocial job demands of HC aides. Increased isolation of clients may be contributing to a wider public health problem of elder loneliness and depression. To support the HC stakeholders during the on-going COVID-19 pandemic, for future pandemic planning or other health emergencies, it is important to improve HC aide job retention. This action could also ease the serious care services shortage among the growing population of older adults.

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Section: Introductionmentioning

confidence: 99%

“It changed everything”: The Safe Home Care qualitative study of the COVID-19 pandemic’s impact on home care aides, clients, and managers

Markkanen

Brouillette

Quinn

et al. 2021

BMC Health Serv Res

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“…Research by Nakaishi et al (2013) also focused on the experiences of home care workers and found that while many were experiencing workplace violence, they were generally unaware that their colleagues were also having similar experiences and considered this to be a “part of the job.” These findings are particularly troubling in the context of home care service delivery where individuals work independently and often in isolation from colleagues ( Quinn et al, 2021 ). Creating a culture of consistent reporting is particularly important in home care where providers enter individual homes to provide care in isolation from colleagues who may be helpful in a crisis.…”

Section: Discussionmentioning

confidence: 99%

Spot It, Prevent It: Evaluation of a Rapid Response Algorithm for Managing Workplace Violence Among Home Care Workers

Ruco

Nichol

Edwards

et al. 2022

Workplace Health Saf

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Background: Workplace violence incidents remain pervasive in health care. Home care workers like personal support workers (PSWs) provide services for clients with dementia, which has been identified as a risk factor for workplace violence. The objective of this study was to evaluate whether the implementation of a rapid response algorithm resolved unsafe working conditions associated with responsive behaviors and decreased perception of risk. Methods: A nonexperimental pre- and post-evaluation design was utilized to collect data from PSWs and supervisors. PSWs completed an online survey about their experience with workplace violence and perception of risk. Bi-weekly check-ins were conducted with supervisors to track incidents and their level of resolution in the algorithm. Semi-structured interviews were also conducted to gather in-depth feedback about the algorithm in practice. Findings: We found no difference in risk perception among PSWs pre- and post-implementation. However, PSWs who had been employed for less than 1 year had a significantly higher risk perception. Overall, the algorithm was found to be helpful in resolving workplace violence incidents. Conclusion and Application to Practice: Opportunity exists to further refine the algorithm and ongoing dissemination, and implementation of the algorithm is recommended to continually address incidents of workplace violence. Newly hired PSWs may require additional supports. Ongoing education and training were identified as key mitigation strategies.

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“…In the US, the majority (87%) of approximately 3.5 million home care (HC) providers are women and most are people of color (62%) and immigrants (31%) ( 91 ). Within Canada, this is the work of CAs, personal support workers (PSWs), and related occupations.…”

Section: Care Aidesmentioning

confidence: 99%

Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans

Shroff

2023

Front. Glob. Womens Health

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COVID-19 is catalyzing both crises and opportunities for communities of color. 1 The crisis of high mental and physical morbidities and mortalities exposes persistent inequities while providing opportunities to celebrate the power of rejuvenated anti-racism movements, fueled partly in response to the extremism of ultra-conservative governments, the circumstances to reflect deeply on racism because of forced stay-at-home-orders, and digital technologies primarily driven by youth. In marking this historical moment of longstanding anti-racism and decolonial struggles, I assert the importance of foregrounding women’s needs. In analyzing racism, rooted in colonialism and white supremacy, and its impacts on mental and physical health status, I focus on improving racialized women’s lives within the larger context, concentrating on the determinants of health. I contend that fanning the flames to scathe the racist and sexist foundations of North American society will break new ground for sharing wealth, bolstering solidarity and sisterhood, and ultimately improving Black, Indigenous, and Women of Color (BIWOC) health. Canadian BIWOC earn approximately 59 cents to the dollar earned by non-racialized men, creating vulnerabilities to economic downturns, such as the one Canada is currently in. BIWOC care aides, at the bottom of the healthcare hierarchy, are emblematic of other Black, Indigenous, and People of Color (BIPOC), who face risks of frontline work, low wages, poor job security, unpaid sick days and so forth. To that end, policy recommendations include employment equity initiatives that hire groups of racialized women who consciously express solidarity with each other. Cultural shifts within institutions will be key to providing safe environments. Improving food security, internet access and BIWOC-related data collection linked to community-based programming while prioritizing research on BIWOC will go a long way toward improving BIWOC health. Addressing racism and sexism within the healthcare system, aiming for equitable diagnostic and treatment foci, will require transformative efforts including determined leadership and buy-in from all levels of staff, long-term training and evaluation programs, audited by BIPOC communities.

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Healthy Aging Requires a Healthy Home Care Workforce: the Occupational Safety and Health of Home Care Aides

Cited by 27 publications

References 59 publications

“It changed everything”: The Safe Home Care qualitative study of the COVID-19 pandemic’s impact on home care aides, clients, and managers

“It changed everything”: The Safe Home Care qualitative study of the COVID-19 pandemic’s impact on home care aides, clients, and managers

Spot It, Prevent It: Evaluation of a Rapid Response Algorithm for Managing Workplace Violence Among Home Care Workers

Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans

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