Global Journal of Health Science, Vol. 1, No. 2, October 2009, all in one file.

Abstract

By means of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, EMBASE and Ageline (AARP) database searches, the author presents a review of the literature addressing residential care aides-their roles, working environments, work satisfaction, and factors affecting recruitment and retention. Using the method of qualitative metasummary, eight broad themes emerged: job dissatisfaction, low wages, attrition and retention difficulties, threats to personal safety, the experience of hierarchy (devaluation and domination), the importance of relationships and collegial support, excessive workloads and inadequate training. Heavy reliance on American research is a limitation, but there appears to be general agreement across eight countries that residential care aide work can be arduous, demanding and demoralizing. At the same time, given the constraints that most aides work under, many aides care greatly about their clients and are very concerned about the quality of care that they are able to provide. Their voices, however, remain relatively overlooked or ignored.Keywords: Nurse Aide, Metasummary, Role, Work environment, Work satisfaction, Recruitment, Retention, Long term care BackgroundOver the past three decades, Canada has experienced a dramatic increase in the number of persons living beyond age 65. In 2000, life expectancy at age 65 reached 16.8 years for males and 20.5 years for females, an increase of 0.3 years and 0.2 years respectively compared with 1999 (Statistics Canada, 2002, p.52). By the year 2030, Canada's aging population is predicted to form nearly one-quarter of Canada's entire population (Statistics Canada, 2002). The change in life expectancy is anticipated to bring many economic, social, political and health care challenges but the greatest of these will be the challenge to provide quality long term nursing care to the increasing population of persons who will require it. Over the past decade, there have been dramatic shifts in staffing patterns in long term care facilities in Canada and in other countries. Nurse aides are being employed in escalating numbers. In Canada, this increase is said to be related to three important factors: the need to control health care costs, a current and projected shortage of regulated health care professionals and an ageing population which requires new approaches to health-care delivery (Canadian Nurses Association -CNA, 2008, p. 2). In the United States, aides now provide 90% of the care to residents who live in long term care facilities (Castle, 2007; Friedman, Daub, Cresci, & Keyser, 1999; Riggs, & Rantz, 2001).In long term care institutions, aides provide basic resident care. This includes but is not limited to answering calls for assistance, assisting in all activities of daily living (bathing, dressing and grooming, serving meals and feeding residents), taking measurements such as resident's weight, blood pressure, temperature and pulse, collecting urine and stool specimens, administering suppositories and enemas, administ...