Importance of Experience for Older Home Care Workers in Facing up to the Constraints of Work

Abstract

Home care workers (HCWs) are at risk from injury. A case study was undertaken in a local community health center in order (1) to identify the constraints that introduce risk into the work of HCWs, and (2) to study the strategies they apply, depending on their age, to reduce the effects of those constraints. Observation and semistructured interviews were the main sources of data. Analysis shows that HCWs aged 45 or over sometimes adopt different postures from those used by their younger colleagues. During physical care, the HCWs also carry out screening and social support tasks that are not recognized in the organization of their work. Older workers develop strategies that help them save time, refine their screening and support methods, protect themselves against accidents, and react properly in emergencies or dangerous situations. Because the changes that can be made in patients' homes are limited, the expertise of experienced HCWs is essential. The organization of work must maintain a certain flexibility to allow the workers to use their strategies.

A systematic review of observational studies of adult home care

“…The included studies used various terms to describe their observation methods (Table 1). These were participant observations (Casado-Mejía & Ruiz-Arias, 2016; Kalman & Andersson, 2014;Rabiee & Glendinning, 2011;Tufte & Dahl, 2016), observations (Cloutier, David, Prevost, & Teiger, 1999;Czuba, Sommerich, & Lavender, 2012) and field observations (Cataldo, Kielmann, Kielmann, Mburu, & Musheke, 2015;Glasdam, Henriksen, Kjaer, & Praestegaard, 2013;Nielsen & Jørgensen, 2016;Roberts, Philip, Currie, & Mort, 2015;Swedberg, Chiriac, Tornkvist, & Hylander, 2012Uys, 2002Uys, , 2003. The term ethnography was also used in one study (Cataldo et al, 2015).…”

“…The social and personal interaction schedule recorded types of interactions that took place, such as 'humour' and 'reassurance touch', as well as whether these interactions were instigated by home-care worker or client (Roberts et al, 2015). Guided methods of observation employed a semi-structured plan to guide field work (Casado-Mejía & Ruiz-Arias, 2016;Cloutier et al, 1999;Glasdam et al, 2013;Kalman & Andersson, 2014;Swedberg, Chiriac, Tornkvist, & Hylander, 2012Uys, 2002Uys, , 2003. For example, in one study, researchers were guided to focus their observations on three key elements: 'the relationship between people', 'mutual satisfaction' and 'body position' (Casado-Mejía & Ruiz-Arias, 2016).…”

“…These were the impact of the All but two studies (Kalman & Andersson, 2014;Sundler et al, 2016) triangulated observations with other sources of data. These included interviews (Cataldo et al, 2015;Cloutier et al, 1999;Glasdam et al, 2013;Nielsen & Jørgensen, 2016;Roberts et al, 2015;Uys, 2002), focus/discussion groups (Czuba et al, 2012;Tufte & Dahl, 2016) & Glendinning, 2011;Swedberg et al, 2012Swedberg et al, , 2013. One paper reported audio-recording staff onsite with their employer and in staff meetings (Uys, 2003).…”

“…TA B L E 2 Quality appraisal of included studies using the Critical Appraisal Skills Programme Qualitative Checklist, Section A -Validity Czuba et al, 2012;Uys, 2002Uys, , 2003. In two of these studies, these methods were used to quantify how much time home-care workers were engaged in activities that were physically demanding during visits (Cloutier et al, 1999;Czuba et al, 2012). In two other papers, the frequency or timing of visits was analysed (Uys, 2002(Uys, , 2003.…”