The emotional labour of health-care assistants in inpatient dementia care

Bailey, Simon; Scales, Kezia; Lloyd, J.; Schneider, Justine; Jones, Rob

doi:10.1017/s0144686x13000573

Cited by 44 publications

(100 citation statements)

References 33 publications

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“…It involves consciously suppressing inner emotions to enable working effectively. The phenomenon of "emotional labour" is widely reported among intensive care professionals (Sorensen and Iedema, 2009;Ryan and Seymour, 2013), health care assistants caring for dying cancer patients (Herber and Johnston, 2013;Lovatt et al, 2015); healthcare assistants in inpatient dementia services (Bailey et al, 2015); palliative care nurses (Skilbeck and Payne, 2003) and hospice staff (Sabo, 2008;Slocum-Gori et al, 2011). More recently, Colomer and de Vries (2016) and de Witt and Ploeg (2016) acknowledged that care home workers' emotional bonds with residents with dementia sometimes contributed to feeling physically, mentally and emotionally drained.…”

Section: Introductionmentioning

confidence: 99%

Perceived needs for support among care home staff providing end of life care for people with dementia: a qualitative study

Vandrevala

Samsi

Rose

et al. 2016

Int J Geriat Psychiatry

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Objective: The aim of the current exploratory study was to investigate the impact for care home staff of working with people with dementia at the end of life and to explore how they cope with this aspect of their work. With UK policy encouraging death in the place of residence, rather than hospital, more people with dementia are dying in care homes.Method: A qualitative approach was employed; 20 care home staff working in five English care homes were interviewed. Thematic Analysis was used to analyse the data.Results: Care home staff found the external demands on them and difficulties associated with interacting with people with dementia sometimes challenging, stressful and anxietyprovoking, particularly as residents approached end of life. Emotional aspects of caring for dying residents were sometimes heightened by close attachments with residents and their families. Staff were able to recognise these unmet needs and identified a need for further training and emotional support to manage these stressors.Conclusions: This study revealed rich and complex understanding of the practice dimensions of caring for people with dementia at the end of life and the impact these have on staff. There is a need to develop effective psychosocial interventions that focus on emotional support for care home staff. There will be challenges in providing this in employment settings that are generally low paid, low status, have high turnover and are reliant on temporary or migrant staff, where training is not rewarded, mandatory or culturally valued. 4 IntroductionCare homes are increasingly caring for frail older people at the end of their lives, and older people with cognitive impairment or dementia are more likely to die in care homes than in other settings (Moriarty, Rutter, Ross & Holmes, 2012; National End-of-life Care Intelligence Network, 2013). In recent years in England, there are increasing ambitions to avoid premature and unnecessary moves to hospital in the last weeks of life (Murtagh et al. 2012).Current government policy encourages people to 'die in place' (Department of Health, 2013; Leadership Alliance for the Care of Dying People, 2014); consistent with wishes of many families (Bayer, 2006). Research has focused on ways in which care home staff make end-oflife care decisions (e.g. Goodman et al., 2010; Moriarty, Rutter, Ross & Holmes, 2012).However, there is a need to understand the impacts on care home staff of caring for dying residents who have dementia in order to better support these workers.In England, care home staff are among the lowest paid employees (Resolution Foundation, 2015). Staff working in care homes are often under pressure in their work and experience both psychological and physical strain, including injuries and depression (Walsh, 2006;Zimmerman et al., 2005). There is high staff turnover in some care homes (Franklin, 2014) and staff working with people with dementia are less likely to be trained than other care workers (Hussein and Manthorpe 2011).Furthermore, staff working with...

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Section: Introductionmentioning

confidence: 99%

Perceived needs for support among care home staff providing end of life care for people with dementia: a qualitative study

Vandrevala

Samsi

Rose

et al. 2016

Int J Geriat Psychiatry

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“…Preferred levels of informality or formality among patients and families likely vary (Bailey, Scales, Lloyd, Schneider, & Jones, ). Further, not all dying patients and their families may wish to share their emotions with care providers, preferring more everyday, humorous or optimistic conversations (Skilbeck & Payne, ).…”

Section: Discussionmentioning

confidence: 99%

Caring about dying persons and their families: Interpretation, practice and emotional labour

Funk

Peters

Roger

2018

Health Soc Care Community

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The importance of emotional support for dying persons and their families has been well established, yet we know less about how care workers understand emotional processes related to death and dying, or how these understandings are connected to care practices and emotional labour at the end of life. The aim of this study was to explore how healthcare workers interpret and respond to emotional needs of dying persons and their families. Qualitative data were collected between 2013 and 2014 through in-depth, in-person interviews with 14 nurses and 12 healthcare aides in one Western Canadian city. Transcripts were analysed using an inductive, interpretive thematic coding approach and the analytic lens of emotional labour. Dominant interpretive frames of a "good death" informed participants' emotionally supportive practice. This included guiding patients and families to "open up" about their emotions to activate the grief process. There was concern that incomplete grieving would result in anger being directed towards care staff. The goal of promoting emotional sharing informed the work of "caring about." Although palliative philosophies opened up moral and professional space for "caring about" in the context of organisational norms which often discouraged these practices, the tension between the two, and the lack of time for this work, may encourage surface expressions rather than authentic emotional care.

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“…Three postgraduate researchers worked as health care assistants in separate dementia wards for several months in 2009. The enquiry sought to understand this little-researched workforce and it produced the expected academic outputs (Bailey, Scales, Lloyd, Schneider, & Jones, 2015;Lloyd, Schneider, Scales, Bailey, & Jones, 2011;Schneider et al, 2014). More than half a million words of field notes were subsequently entrusted to the writer, Tanya Myers, whose personal experience of dementia and extensive reading around the subject together with her professional skills shaped the script.…”

Section: The Workmentioning

confidence: 99%

Evaluation of the impact on audiences of Inside Out of Mind, research-based theatre for dementia carers

Schneider

2016

Arts & Health

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The emotional labour of health-care assistants in inpatient dementia care

Cited by 44 publications

References 33 publications

Perceived needs for support among care home staff providing end of life care for people with dementia: a qualitative study

Perceived needs for support among care home staff providing end of life care for people with dementia: a qualitative study

Caring about dying persons and their families: Interpretation, practice and emotional labour

Evaluation of the impact on audiences of Inside Out of Mind, research-based theatre for dementia carers

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