Our study identifies numerous HSW safety concerns, each requiring tailored interventions and strategies. Where multiple concerns intersect, the complexity and precarious nature of the home care workspace is revealed. The identification of mitigating and intensifying factors points to future interventions.
In the provision of care to older clients, home support workers regularly confront, avert, and manage crises. Semistructured interviews were conducted to explore the nature, type, and management of crises from the perspective of home support workers (N = 118) of older persons in British Columbia, Canada. The delivery of home health care occurs within a context of unpredictability related to scheduling, time constraints, variability of client need, and changing work environments. These events are experienced by 91% of home support workers and range from a serious medical incident (e.g., fall, death) to an interpersonal dilemma (e.g., client refusal of service, argument between worker and family member). Home support workers use a variety of strategies to manage these incidents. The analysis of crises enables us to better understand how agency and care policies may be more responsive to circumstances that challenge care work in home health settings.
Important risk factors for hip fracture can be identified from routinely collected data; these could be used to identify at-risk clients for further investigation and prevention strategies.
Client perspectives of home support (i.e., assistance with daily activities that help to maintain a safe and supportive home) have not been considered in relation to personhood: "a standing or status that is bestowed upon one human being, by others, in the context of relationship and social being." Personhood and positive person work interactions conceptually guided our secondary analysis of data from a generic qualitative study including 82 semi-structured interviews with older adult home support clients in British Columbia, Canada. Findings revealed clients value a "focus on the person," "preservation of autonomy," and interactions characterized by recognition, validation, collaboration, and negotiation. Individuals involved in the delivery of home support services are in a key position to support the personhood of older adult clients.
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