‘Going the extra mile’ for older people with dementia: Exploring the voluntary labour of homecare workers

Turner, Nicola; Schneider, Justine; Pollock, Kristian; Travers, Cheryl; Perry-Young, Lucy; Wilkinson, Samantha

doi:10.1177/1471301218817616

Cited by 9 publications

(12 citation statements)

References 17 publications

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“…The attribution of such ‘fictive kinship’ highlights the importance of the emotional as well as practical support, provided by HCWs, and of their role in a network of care extending beyond the immediate family (Sims-Gould and Martin-Matthews, 2008). However, family care-givers rarely expressed interest in the pay and conditions of the staff who provided such critical support and appeared to lack awareness of the logistical constraints they experienced in juggling family life with part-time, casual labour (Turner et al ., 2018).…”

Section: Discussionmentioning

confidence: 99%

What do family care-givers want from domiciliary care for relatives living with dementia? A qualitative study

et al. 2020

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In the current ecology of care, social, rather than medical, support is critical in enabling frail older people to live at home. This paper reports findings from a qualitative study about how home care workers (HCWs) support persons with dementia living in the community. Semi-structured qualitative interviews were carried out in England with 14 family care-givers (FCGs) recruited from a single private home care provider. A thematic analysis of the data was undertaken using the constant comparative method. In every instance, it was FCGs who initiated domiciliary care for the person with dementia, highlighting ambiguity about who is the ‘client’. Rather than focusing on the HCWs’ work in undertaking practical tasks and personal care, respondents prioritised HCWs as companions, providing emotional and social support for their relatives. From an organisational perspective, respondents valued the capacity of the provider to deliver a consistent, personal, reliable and punctual service. These attributes were important in supporting their relative's agency and dignity. Respondents described HCWs engaging in skilled and sensitive communication with clients but considered ‘character’ and ‘innate’ caring abilities to be more important than those derived from training. The results highlight the need to acknowledge the family, rather than the individual client, as the functioning unit of care, and to recognise the highly skilled communicative and emotional work undertaken by HCWs.

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Section: Discussionmentioning

confidence: 99%

What do family care-givers want from domiciliary care for relatives living with dementia? A qualitative study

et al. 2020

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“…The reflective diary part of the study, reported in this article, was used as a method to gather illustrative data in relation to all these questions, to create an opportunity for diarists to reflect on the meaning and implications of their practice, and to give them a voice in the wider research study. 15,16 This article specifically shares the diary method, that is, the design of the diary, the recruitment of the diarists, the diary training, and home care workers' responses to keeping diaries in this way.…”

Section: The Diary Methodsmentioning

confidence: 99%

“…However, there is a high degree of correspondence between the content of the diaries and the data from other strands of the study, particularly the observations and interviews with home care workers. 15,16 Although they were ultimately personal and reflective accounts, the diaries were written for the purpose of the study and consequently had an anticipated audience in mind and some filtering may well have taken place. 48 The entries are not just contemporaneous records of home care workers' experiences or timely reflections on their work, as the process of keeping diaries appears to have influenced the diarists' appraisals of their role as well as their self-presentation as a home care worker.…”

Section: Limitationsmentioning

confidence: 99%

“…12 Although diaries have been used to explore spousal and family interpersonal caring, 13,14 prior to our study, diary methods have been absent in the investigation of paid home care workers. 15,16 This article aims to explore the use of a reflective diary method with home care workers, specifically those caring for people with dementia. Employing diaries uniquely in this way can provide insights into how these workers carry out and experience their role.…”

Section: Introductionmentioning

confidence: 99%

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Using a Reflective Diary Method to Investigate the Experiences of Paid Home Care Workers Caring for People With Dementia

Travers

Schneider

Perry-Young

et al. 2019

Home Health Care Management & Practice

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This article reports on the use of an innovative reflective diary method with paid home care workers caring for people with dementia. It examines the key features of the diary design, recruitment and training of participants, diarists’ approaches and responses to diary-keeping, and evaluates the use of diaries in this context. Following training, 11 volunteers (all female) employed by a U.K.-based home care organization kept diaries of their experiences of caring for those with dementia. Using specially designed diaries, they wrote about their visits to clients for a period of approximately 4 months and were remunerated for up to 16 extra hours at their usual hourly rate of pay. Overall, home care workers engaged well with the process, keeping regular, lengthy, timely, and reflective diary entries. Diary-keeping provided a means for these workers to express their emotions about their work, while enhancing their self-insight and care practices. We demonstrate the feasibility of diaries for research with this occupational group and conclude that the written reflexivity employed in diaries can document, enrich, and improve the work of these caregivers.

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“…Making a positive difference to people's lives, maintaining good relationships, and having autonomy and support from the organisation have been found to contribute to high levels of job satisfaction (Ryan et al., 2004). Often HCWs spend extra time with clients or do tasks, which are outside their job description, a type of volunteerism working beyond their specified role (Schneider et al., 2019; Turner et al., 2018). However, this may be due to a perceived lack of clarity defining the HCW job role (D’Astous et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Home‐care workers' experiences of assisting people with dementia with their personal care: A qualitative interview study

Backhouse

Ruston

2021

Health Social Care Comm

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Home-care workers are increasingly caring for clients living with dementia. Workers usually have limited dementia training and are low paid and often lone working.Little is known about how home-care workers assist people with dementia with their personal care. We aimed to explore the experiences of home-care workers and the knowledge and skills they rely on when providing personal care to people with dementia. In 2020, we conducted 17 semi-structured, face-to-face interviews with home-care workers in the East of England. Analysis was inductive and thematic. Two key themes were present in the data: 'structural conditions' and 'clients' dementia-related characteristics'. For each of these, we examined the challenges faced by home-care workers and the strategies they used to manage these challenges. Challenges included time allocation for visits, completing care plan tasks, lone working, communication and understanding, refusals of care, and client behaviours.To mitigate these challenges, home-care workers utilised system support, time management, training and experience and enacted a caring relationship, thought about their approach, and used distraction and communication skills. Workers relied on skills such as, relationship building, team working, observation, communication, decision making and interpersonal sensitivity. They drew on knowledge about the person, the person's needs, their own abilities, company policies and procedures and their role and responsibilities as a home-care worker. Home-care workers had more scope to mitigate client-based challenges by adapting care within client interactions, than to manage structural challenges where there was a limit to what workers could do. Despite a commissioning focus on time-and task-based care, when caring for people with dementia, home-care workers used interaction as a way to bring the person along and complete care activities. Home-care services should acknowledge the importance of interactions with people with dementia within home care and support their workers to develop interpersonal sensitivity.

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‘Going the extra mile’ for older people with dementia: Exploring the voluntary labour of homecare workers

Abstract: (2018)'Going the extra mile' for older people with dementia: Exploring the voluntary labour of homecare workers. Dementia.

Cited by 9 publications

References 17 publications

What do family care-givers want from domiciliary care for relatives living with dementia? A qualitative study

What do family care-givers want from domiciliary care for relatives living with dementia? A qualitative study

Using a Reflective Diary Method to Investigate the Experiences of Paid Home Care Workers Caring for People With Dementia

Home‐care workers' experiences of assisting people with dementia with their personal care: A qualitative interview study

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