“Time is more important than anything else”: tensions of time in the home care of older adults in Ireland

McDonald, Anne; Lolich, Luciana; Timonen, Virpi; Warters, Austin

doi:10.1332/239788219x15622468259858

Cited by 17 publications

(25 citation statements)

References 17 publications

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“…Some chose home care work after having worked in institutional settings, preferring the one-on-one, the reduced stress of not having to rush, and the autonomy to create their own schedules and manage their own workflow, all aspects related to having time. The importance of having time to provide care reflects the recent findings of McDonald, Lolich, and Warters (2019), who found that time was essential to providing quality person-centered care. In our study, those who experienced disempowering aspects of the job identified mostly structural aspects of empowerment, including access to support, resources, information and opportunity.…”

Section: Discussionmentioning

confidence: 80%

The Role of Empowerment in Home Care Work

Kusmaul

Butler

Hageman

2020

Journal of Gerontological Social Work

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The home care industry experiences similar problems with the recruitment and retention of direct care workers (DCWs) as those faced by institutions, and it is important to identify strategies to help retain and grow this important workforce. The empowerment of DCWs has been shown to be an effective strategy for increasing job satisfaction and decreasing turnover in nursing homes, but has not been studied in home care. Using Kanter's organizational theory of empowerment, including structural empowerment (structure of opportunity, access to resources, access to information, and access to support) and psychological empowerment (meaning, competence, self-determination or autonomy, and impact) this study examined whether home care workers (HCWs) feel empowered in carrying out their jobs. An exploratory, qualitative study of 12 HCWs, recruited from two states in the United States, found high levels of both structural and psychological empowerment among research participants, as well as a number of disempowering aspects of their job. Findings suggest ways to support elements of the work that HCWs find empowering and decrease elements that contribute to job dissatisfaction and turnover.

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Section: Discussionmentioning

confidence: 80%

The Role of Empowerment in Home Care Work

Kusmaul

Butler

Hageman

2020

Journal of Gerontological Social Work

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“…It would be useful to note findings from research such as that from the European Foundation for the Improvement of Living and Working Conditions (2020) 4 which has shown that working from home does not always result in decreased working times, and for remote working to be sustainable, challenges such as overtime working need to be addressed, an issue that is especially pertinent for those combining work and caring. Time is really important to family carers, and in addition to considering how to make extra time available to family carers through workplace measures, it could be worth considering how certain issues around time could potentially be addressed through the reconfiguration of health and social care services (McDonald et al, 2019) 5 . Time taken up in this sphere has knock-on effects for working time.…”

Section: Open Peer Reviewmentioning

confidence: 99%

The invisible workforce during the COVID-19 pandemic: Family carers at the frontline

et al. 2020

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This is an open letter to acknowledge the essential and increasingly challenging role unpaid family carers are playing in the COVID-19 pandemic. The letter is written by members of the CAREWELL team, a HRB-funded project that aims to promote health and self-care behaviours among working family carers. Family carers provide care to family and friends in the community who need support due to old-age, disability and chronic illness. In many cases, family carers are supporting those who are considered most at risk in this pandemic meaning carers must reduce their own risk of infection in order to protect their dependent family members. The temporary reduction of some home care services, as well as school and creche closures, means that family carers are providing increased levels of care with little or no support. At a time when both worlds of work and care have been dramatically transformed, we wish to shed light on those who are currently balancing paid employment with a family caregiving role. We argue that there is much to be learned from the recent work restrictions that could benefit employees, including working family carers, beyond this pandemic. We also wish to build on the potential positives of a transformed society and encourage policy makers and employers to focus on what is currently being implemented, and to identify which measures could be used to create a bedrock of policies and practices that would offer robust and effective support to family carers. It is hoped that family carers will receive greater recognition for the significant role they play in society, providing essential care and alleviating the strain on health and social care systems, both during and post the COVID-19 pandemic.

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“…With this participant, multiple professional services in addition to daily personal support were involved, resulting in more than one visit on some days. HC visits have previously been reported as intrusive and disruptive to one’s normal routine, and described as an invasion of space and time [ 45 ]. Shared-decision making is preferred by clients and may have mitigated this burden pre-emptively [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

A qualitative study of home care client and caregiver experiences with a complex cardio-respiratory management model

et al. 2021

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Background Home care clients are typically older and have some degree of medical, physical, cognitive or social conditions that require formal or informal support to promote healthy aging in the community. Home care clients contribute a significant proportion of health service use, including emergency department visits. The DIVERT-CARE trial introduced a cardio-respiratory management model to improve client motivation, symptoms and rates of unwarranted health service use. Our objective was to explore the perceptions and experiences of individuals who participated in the DIVERT-CARE self-management support and education intervention. Methods A qualitative study was nested within a pragmatic randomized control trial and conducted following a 15-week multi-component cardio-respiratory intervention. A phenomenological descriptive design was employed using thematic analysis. Post-intervention, clients and their caregivers were invited to participate in a semi-structured telephone interview. Interview questions were designed to elicit the experience with the intervention components. Results A total of 29 interviews were completed from June 2018 to March 2020 from participants in Ontario, Newfoundland, and British Columbia. Three themes were identified; self-care trajectory and burden of responsibility, learning and behaviour change, and feeling connected pre-emptively to care providers, the information and medical advice, and connection through the therapeutic relationship. Conclusions Home care clients experience unique challenges in managing cardio-respiratory related chronic disease. Home-based interventions fostered a therapeutic relationship of connectedness while equipping clients with necessary knowledge and skills. These results inform recommendations for community nursing, and home-based self-management supports for older community-residing individuals.

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“Time is more important than anything else”: tensions of time in the home care of older adults in Ireland

Cited by 17 publications

References 17 publications

The Role of Empowerment in Home Care Work

The Role of Empowerment in Home Care Work

The invisible workforce during the COVID-19 pandemic: Family carers at the frontline

A qualitative study of home care client and caregiver experiences with a complex cardio-respiratory management model

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