Work schedules of home care workers for the elderly in France: Fragmented work, deteriorating quality of care, detrimental health impact

Abstract

Objective: Like most Western countries, France is faced with rapid changes in how social welfare and care regimes are being organized. Home care for the elderly has been closely affected by such trends. This study will analyse the consequences of such developments on work schedules and working conditions of female home care workers. Methods: We carried out 55 biographical interviews with experienced female home care workers employed by six associations as well as 13 interviews with representatives of those associations. Results: The findings reveal an increase in time pressure linked to a reduction in care time per care recipient as well as the fragmentation of care work. These conditions negatively affect the provision of quality care as well as care workers' physical and mental well-being and blur the distinction between workers' professional and home lives. Conclusions: The negative impacts observed call for a change in perspective in relation to how home care work for fragile, elderly people is organized. Our research bears out the necessity of drawing on the experience of the most highly-qualified care workers and entrusting them with the autonomy needed to manage the care time allotted to each care recipient.

On the Move and Working Alone: Policy Implications of the Experiences of Unionised Newfoundland and Labrador Homecare Workers

“…Research on the restructuring of home care in Europe suggests that home care workers have experienced work intensification, but do not face job insecurity. 55 Common OHS issues described by workers in this research are similar to those found in other studies including musculoskeletal disorders, 7,29,31,32 workplace violence and harassment, 7,9,12,23,[33][34][35]58,59 a lack of risk assessment, 7 problematic access to workers' compensation, 7 and potential or actual vehicle accidents. 7,36,37 While there is no other research, that examines home care workers' complex daily E-RGM, a recent study of immigrant workers in the Greater Toronto Area describes the challenges associated with daily extended E-RGM.…”

“…Likewise, home care workers in Europe, North America, and Australia are more likely to be women, tend to be older, and earn a low income. 7,54,55 As with other research on the working conditions of home care workers, 4,24 unionized home care workers in this study experienced irregular earnings, job insecurity, and limited social wages. Research on the restructuring of home care in Europe suggests that home care workers have experienced work intensification, but do not face job insecurity.…”

“…The stress related to a lack of time to provide quality care is a common finding in research on home care restructuring in Western countries. 1,13,[53][54][55]…”

Homecare user needs from the perspective of the patient and carers: a review

“…31,62 The other three studies focused on the fast-changing environment and its impact on formal caregiving. Fragmentation of care, characterized by increasing time pressures, pressures on care resources, and increased demand, was experienced by care workers as "being on the verge", [114][115][116] ie, increasingly feeling that they are being pushed to the limits of their capabilities and increasingly working against their professional standards, with concerns for the delivery of quality care.…”

Satisfaction and difficulties of French professional home caregivers in supporting older people with Alzheimer's disease or alcohol misuse

“…For Dibié‐Racoupeau, Estingoy, and Chavane (), professionals struggle with older people, consciously or unconsciously, in a confusing situation and in clashing roles that require both mothering and complicit empathy. Moreover, because some alcohol misuse situations are sometimes associated with social isolation, close contact with pets, an accumulation of rubbish in homes and aggressive behaviour by the older person, makes sure these people stay in their homes to the end of their lives in good conditions (Doniol‐Shaw & Lada, ). In this close relationship, they admit to having concerns and feelings of anger, compassion and rejection towards the person.…”