Qualitative Insights into the Working Conditions of Personal Support Workers in Long-Term Care in the Context of a Person-Centered Communication Training Intervention

Abstract

The current study reports on qualitative insights into the working conditions of personal support workers (PSWs) in long-term care (LTC) homes within the context of a person-centered communication training intervention. PSWs ( N = 39) employed at one of four LTC homes in southwestern Ontario, Canada, participated in a series of 1-hour focus groups before, during, and after a 2-week person-centered communication training program for formal caregivers of persons living with dementia (PLWD). Textual data from focus group conversations were coded and organized into themes following an interpretive description research design. Three overarching themes emerged related to the working conditions of PSWs in LTC: (1) dementia care is complex, (2) there is a lack of trained staff to provide person-centered dementia care, and (3) residents' families are not appropriately situated in residents' care circles. Four overarching themes emerged related to the impact of those working conditions: (a) PSW occupational burnout, (b) poor resident care, (c) frustrated and disengaged families, and (d) PSW job attrition. These findings offer LTC employers and administrators opportunities to ameliorate working conditions to better support person-centered dementia care. [ Research in Gerontological Nursing, 14 (5), 245–253.]

Quality home care for persons living with dementia: Personal support workers' perspectives in Ontario, Canada

“…Inadequate client information left care providers unprepared to be sensitive to client needs (Denton et al., 2002; Roelands et al., 2005; Ryan et al., 2004; Savundranayagam et al., 2020; Storch et al., 2014). Care providers also identified a need for better training opportunities to increase knowledge in dementia‐specific care and interpersonal communication (Foster et al., 2019; Jansen et al., 2009; Low et al., 2013; Polacsek et al., 2020; Roelands et al., 2005; Savundranayagam et al., 2021).…”

“…These working conditions make it difficult for PSW to provide person‐centered care (Savundranayagam et al., 2021). Person‐centered care encourages healthcare providers to recognise persons with dementia as individuals with unique life histories and preferences (Dawson et al., 2015; Downs & Collins, 2015; Edvardsson et al., 2010; Kitwood, 1997; Sutherland & Wiersma, 2016).…”

Interventions for mitigating occupational stress for professional dementia caregivers in residential aged care: A systematic review with meta-analysis

“…While agitation, apathy and depressive behaviours can be distressing for caregivers ( Feast et al, 2016 ), positive relationships with clients ( Quinn et al, 2009 ), the working environment ( Savundranayagam et al, 2021 ), and organisational culture and support ( Chamberlain et al, 2017 ) may moderate or buffer the effects of stress. In addition, one of the greatest predictors of burnout may be low self-efficacy ( Duffy et al, 2009 ).…”

Language-Based Strategies that Support Person-Centered Communication in Formal Home Care Interactions with Persons Living with Dementia

“…Communication interactions can consequently become task-focused, directive, and patronizing (Vasse et al, 2010). Formal caregivers recognize the need for dementia-specific caregiver training (Breen et al, 2021; Flöjt et al, 2014; Morgan et al, 2016; Savundranayagam et al, 2021). Equipping PSWs with evidence-based communication practices that complement the communication abilities of the person living with dementia while accommodating for their communication challenges is necessary.…”