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\"2029: In Japan, ... childbirth rates are at a critical low and the elderly are living increasingly long lives. This population crisis has precipitated a mass immigration of foreign medical workers from all over Asia--as well as the development of refined artificial intelligence to step in where humans fall short. In Tokyo, Angelica Navarro, a Filipina nurse who has been working in Japan for the last five years, is the caretaker for Sayoko Itou, an intensely private woman about to turn 100 years old ... But one day Sayoko receives a present from her son: a cutting-edge robot caretaker that will educate itself to anticipate Sayoko's every need. Angelica wonders if she is about to be forced out of her much-needed job by an inanimate object--one with a preternatural ability to uncover the most deeply buried secrets of the humans around it. While Angelica is fighting back against the AI with all of her resources, Sayoko is becoming more and more attached to the machine. The old woman is hiding many secrets of her own--and maybe now she's too old to want to keep them anymore\"-- Provided by publisher.
Book
The Caring Self
According to the Bureau of Labor Statistics, there were approximately 1.7 million home health aides and personal and home care aides in the United States as of 2008. These home care aides are rapidly becoming the backbone of America's system of long-term care, and their numbers continue to grow. Often referred to as frontline care providers or direct care workers, home care aides-disproportionately women of color-bathe, feed, and offer companionship to the elderly and disabled in the context of the home. InThe Caring Self, Clare L. Stacey draws on observations of and interviews with aides working in Ohio and California to explore the physical and emotional labor associated with the care of others.
Aides experience material hardships-most work for minimum wage, and the services they provide are denigrated as unskilled labor-and find themselves negotiating social norms and affective rules associated with both family and work. This has negative implications for workers who struggle to establish clear limits on their emotional labor in the intimate space of the home. Aides often find themselves giving more, staying longer, even paying out of pocket for patient medications or incidentals; in other words, they feel emotional obligations expected more often of family members than of employees. However, there are also positive outcomes: some aides form meaningful ties to elderly and disabled patients. This sense of connection allows them to establish a sense of dignity and social worth in a socially devalued job. The case of home care allows us to see the ways in which emotional labor can simultaneously have deleterious and empowering consequences for workers.
eBook
Become a home health aide
\"Examines the necessary training and everyday work of a home health aide\"-- Provided by publisher.
Book
Safety and Health Support for Home Care Workers: The COMPASS Randomized Controlled Trial
Objectives. To determine the effectiveness of the COMmunity of Practice And Safety Support (COMPASS) Total Worker Health intervention for home care workers. Methods. We randomized 16 clusters of workers (n = 149) to intervention or usual-practice control conditions. The 12-month intervention was scripted and peer-led, and involved education on safety, health, and well-being; goal setting and self-monitoring; and structured social support. We collected measures at baseline, 6 months, and 12 months, which included workers’ experienced community of practice (i.e., people engaged in a common activity who interact regularly for shared learning and improvement). Implementation occurred during 2013 and 2014 in Oregon. Results. In an intent-to-treat analysis, relative to control, the intervention produced significant and sustained improvements in workers’ experienced community of practice. Additional significant improvements included the use of ergonomic tools or techniques for physical work, safety communication with consumer–employers, hazard correction in homes, fruit and vegetable consumption, lost work days because of injury, high-density lipoprotein cholesterol, and grip strength. Consumer–employers’ reports of caregiver safety behaviors also significantly improved. Conclusions. COMPASS was effective for improving home care workers’ social resources and simultaneously impacted both safety and health factors.
Journal Article
The senator's wife : a novel
\"After a tragic chain of events led to the deaths of their spouses two years ago, DC philanthropist Sloane Chase and Senator Whit Montgomery are finally starting to move on. The horrifying ordeal drew them together, and now they're ready to settle down again--with each other. As Sloane returns to the world of White House dinners and political small talk, this time with her new husband, she's also preparing for an upcoming hip replacement--the latest reminder of the lupus she's managed since her twenties. With their hectic schedules, they decide that hiring a home health aide will give Sloane the support and independence she needs postsurgery. And they find the perfect fit in Athena Karras. Seemingly a godsend, Athena tends to Sloane and even helps her run her charitable foundation. But Sloane begins to deteriorate--a complication, Athena explains, of Sloane's lupus. As weeks go by, Sloane becomes sicker, and her uncertainty quickly turns to paranoia as she begins to suspect the worst. Why is Athena asking her so many probing questions about her foundation--as well as about her past? And could Sloane be imagining the sultry looks between Athena and her new husband?\"--Page 4 of cover
Book
Effectiveness of the Labour Inspection Authority’s regulatory tools for work environment and employee health: study protocol for a cluster-randomised controlled trial among Norwegian home-care workers
IntroductionThere is a need to evaluate whether, and to what degree, labour inspections or other regulatory tools have the desired effects on psychosocial, organisational and mechanical work environment, and employee health. The Norwegian Labour Inspection Authority (NLIA) uses different tools and strategies to enforce compliance with occupational safety and health (OSH) legislation. The aim of the present study is to evaluate the effects of labour inspections and other regulatory tools employed by the NLIA. The home-care service is one of the fastest growing occupations and a prioritised area for the NLIA, hence the present study will investigate regulatory tools in this sector.Methods and analysisThe research project has been designed as a longitudinal, cluster-randomised, controlled trial and will be conducted among Norwegian home-care workers. The objective of the research project is to evaluate the effects of the NLIA’s regulatory tools (inspection and guidance) on: (1) compliance with OSH legislation and regulation; (2) psychosocial, organisational and mechanical work environment; (3) employee health in terms of musculoskeletal and mental health complaints; and (4) sickness absence. Public home-care services have been randomised to three intervention groups and one control group. Home-care services in the intervention groups will receive one of three intervention activities from the NLIA: (1) inspection from the Labour Inspection Authority; (2) guidance through an online interactive risk-assessment tool; and (3) guidance on psychosocial, organisational and mechanical work environment through workshops. The interventions will be performed at the organisational level (home-care service), and the effects of the interventions on the working environment and health complaints will be measured at the individual level (home-care employees).Ethics and disseminationThis project has been approved by the Regional Committees for Medical and Health Research Ethics (REC) in Norway (REC South East) (2018/2003/REK sør-øst C), the Norwegian Center for Research Data (566128), and will be conducted in accordance with the World Medical Association Declaration of Helsinki. The results will be reported in international peer-reviewed journals.Trial registration numberNCT03855163.
Journal Article
High workload and its connection to health-related quality of life among in-home care workers in northern Sweden during the Covid-19 pandemic
Background
The main aim of this study is to investigate the connection between a high workload and health-related quality of life among in-home care workers in northern Sweden during the COVID-19 pandemic. We also investigate whether social support and control at work can prevent poor health due to high workload.
Methods
A cross-sectional survey was conducted during the pandemic, with 629 (response rate 33 per cent) of an estimated 1,900 in-home care workers responding. Results were compared with a nearly identical survey conducted prior to the pandemic in which 1,154 (response rate 58 per cent) of an estimated 2000 in-home care workers responded. Psychosocial factors were measured using QPSNordic and health-related quality of life using EuroQol 5 Dimensions (EQ-5D). EQ-5D responses were translated into quality-adjusted life year (QALY) scores. Propensity scores were used with absolute risk differences.
Results
During the pandemic, staff with high workload had a statistically significantly (6.2%) lower QALY score (confidence interval 2.2%–10.3%) compared to staff with a normal workload. This was also the case for the usual activities and the anxiety/depression dimensions of EQ-5D. These risk differences were greater, but not statistically significant, during the pandemic than before. The combination of a normal workload and a high degree of control over one’s work appeared to protect against a low QALY score, while social support at work did not seem to be protective.
Conclusions
High workload is related to poorer health-related quality of life. This is mainly attributable to anxiety/depression. In-home care organisations need to manage workload better to prevent poor health among staff during strained situations such as a pandemic. The results of our study indicate that in-home care organisations should increase their readiness to promote opportunities for staff to maintain a high degree of control over their work, in order to counteract variations in workload that ultimately appear to have a negative impact on HRQoL.
Journal Article
In-home work environment for home care workers in Northern Sweden before and during the Covid-19 pandemic
Background
The in-home work environment is the main work environment for home care workers, but it has only been sparsely studied. Our aim was to investigate the in-home work environment for home care workers by exploring challenges that arise regardless of a pandemic and by investigating Covid-19–specific challenges.
Methods
Two cross-sectional studies were conducted, one before (2017) and one during the pandemic (2021/2022) in three Swedish regions (Jämtland/Härjedalen, Västerbotten and Västernorrland), in which 1,154 (58%) out of 2,000 and 629 (33%) of 1,900 invited home care workers participated, respectively. Participants responded to a questionnaire asking about 10 problems associated with the in-home work environment as well as Covid-19–related challenges. Comparisons were conducted between regions and between study years using univariable analyses.
Results
Daily problems with the in-home work environment were common before the pandemic, and they increased statistically significantly during the pandemic for, among other things, non-ergonomic beds (29% vs. 37%), impractical bathrooms (40% vs. 50%), indoor smoking (24% vs. 31%), and pets (19% vs. 25%). There were major concerns about the risk of getting infected with Covid-19 for both staff (42%) and the home care recipients (50%). There were statistically significant differences between regions, e.g. many problems were more common in the Västerbotten region than in the other two regions during the pandemic, while challenges with protective equipment was most common in the Västernorrland region.
Conclusions
In-home work environment problems are common for home care workers and worsen in a more strained situation. Efforts are needed to strengthen the work environment for home care workers.
Journal Article
Heart Failure Training and Job Satisfaction
Background: Home care workers (HCWs), who include home health aides and personal care attendants, frequently care for adults with heart failure (HF). Despite substantial involvement in HF care, prior qualitative studies have found that HCWs lack training and confidence, which creates challenges for this workforce and potentially for patient care. Herein, we quantified the prevalence of HF training among HCWs and determined its association with job satisfaction.Methods: We conducted a cross-sectional survey of agency-employed HCWs caring for HF patients across New York, NY from 2018-2019. HF training was assessed with, “Have you received prior HF training?” Job satisfaction was assessed with, “How satisfied are you with your job?” The association between HF training and job satisfaction was determined with robust poisson regression.Results: 323 HCWs from 23 agencies participated; their median age was 50 years (IQR: 37,58), 94% were women, 44% were non-Hispanic Black, 23% were Hispanic, 78% completed ≥ high school education, and 72% were foreign-born. They had been caregiving for a median of 8.5 years (IQR: 4,15) and 73% had cared for 1-5 HF patients. Two-thirds received none/a little HF training and 82% felt satisfied with their job. In a fully adjusted model, HCWs with some/a lot of HF training had 14% higher job satisfaction than those with none/a little HF training (aPR 1.14; 95% CI 1.03-1.27).Conclusions: The majority of HCWs have not received HF training. HF training was associated with higher job satisfaction, suggesting that HF training programs may improve HCWs’ experience caring for this patient population. Ethn Dis. 2020;30(4):575-582; doi:10.18865/ed.30.4.575
Journal Article
“We just get paid for 12 hours a day, but we work 24”: home health aide restrictions and work related stress
Background
Home-bound patients in New York State requiring long-term care services have seen significant changes to their benefits due to turmoil in the Managed Long Term Care (MLTC) market. While there has been research conducted regarding the effect of MLTC challenges on beneficiaries, the impact of MLTC regulatory changes on home health aides has not been explored.
Methods
Qualitative interviews were conducted with formal caregivers, defined as paid home health aides (HHAs) (
n
= 13) caring for patients in a home-based primary care program in the New York City metropolitan area. HHAs were asked about their satisfaction with the home based primary care program, their own job satisfaction, and whether HHA restrictions affect their work in any way. Interviews were audio-recorded, transcribed, and analyzed.
Results
Two main themes emerged: (1) Pay, benefits and hours worked and (2) Concerns about patient well-being afterhours
.
HHAs are working more hours than they are compensated for, experience wage stagnation and loss of benefits, and experience stress related to leaving frail clients alone after their shifts end.
Conclusions
HHAs experience significant job-related stress when caring for frail elderly patients at home, which may have implications for both patient care and HHA turnover. As government bodies contemplate new policy directions for long-term care programs which rely on HHAs the impact of these changes on this vulnerable workforce must be considered.
Journal Article