Residential structures for older people

the relation between care quality and employment quality

Keywords: nursing homes, care workers, working conditions, job quality, quality care, care work

Abstract

The aim of this article is to analyse how working conditions from care workers interfere daily in the care provided in older people homes, in Portugal, and what solutions should be implemented in order to dignify care and the care worker profession. This paper is based on 150 questionnaires and 40 semi-structured interviews with care workers, in 16 Portuguese care homes, in one council in the metropolitan area of Lisbon. Findings revealed that excessive workloads and poor working conditions, coupled with high staff turnover and poor training and pay have consequences not only the quality of the care that these care workers can offer, but also their physical and mental health, job satisfaction. The high demand for social care, due to the ageing of the Portuguese population, will require better working conditions, professionalisation and the dignification of care work.

References

Abrantes, M. (2012) “A densidade da sombra: trabalho doméstico, género e imigração” (In the depth of shadows: domestic work, gender and immigration), Sociologia, Problemas e Práticas, n.º 70, 91-110.

Anderson, B. (2012) “Who needs them? Care work, migration and public policy”, Cadernos de Relaciones Laborales, vol. 30, nº 1, 45-61.

Bauer, G., Rodrigues, E., Leichsenring (2018) Working conditions in long-term care in Austria: the perspective of care professionals, European Centre for Social Welfare Policy and Research.

Campbell, S., Roland, O., Buetow, S. (2000) “Defining quality of care”, Social Science & Medicine, 51(11), 1611-1625.

Cangiano, A., Shutes, I. (2010) “Ageing, Demand for care and the role of migrant care workers in the UK”, Population Ageing, 3, 39-57.

Colombo, F., Nozal. A.L., Mercier, J., Tjadens, F. (2011) “Help wanted? Providing and paying for long-term care”, OECD Health Policy Studies, OECD Publishing, Paris.

Corbin, J. (1992) “Le soin: cadre théorique pour un cheminement interactif”, Revue Internationale d´action communautaire, vol.28 (68), 39-49.

Donabedian, A. (1980) Explorations in quality assessment and monitoring, AnnArbor, MI: Health Administration Press.

Drennan, J., Lafferty, A., Treacy, M., Fealy, G., Phelan, A., Lyons, I., Hall, P. (2012) Older people in residential care settings: Results of a national survey of staff–resident interactions and conflicts, Dublin: University College Dublin and National Centre for the Protection of Older People.

Eurofound (2019) Quality of health and care services in the EU, Publications Office of the European Union, Luxembourg.

Figueiredo, M.C., Suleman, F., Botelho, M.C. (2018) “Workplace Abuse and Harassment: The Vulnerability of Informal and Migrant Domestic Workers in Portugal”, Social Policy & Society, 17(1), 65–85.

Filipova, A.A. (2011) “Ethical climates in for-profit, nonprofit, and government skilled nursing facilities: managerial implications for partnerships”, JONA’S Healthcare Law, Ethics, and Regulation, 13(4),125-31.

Gabinete de Estratégia e Planeamento (2018) Carta Social, Gabinete de Estratégia e Planeamento, Ministério da Solidariedade, Emprego e Segurança Social, Lisboa.

Gil, A P. M., (2010) “Heróis do quotidiano: dinâmicas familiares na dependência”, no âmbito do protocolo entre a Fundação Calouste Gulbenkian & Fundação para a Ciência e Tecnologia, ISBN 978-972-31-1314-3.

Gil, A.P. (2018) “Care and mistreatment – two sides of the same coin? An exploratory study of three Portuguese care homes”, International Journal of Care and Caring, 2 (4), 551-73.

Gil, A.P. (2019a) “Quality procedures and complaints: nursing homes in Portugal”, The Journal of Adult Protection, Vol. 21 No. 2: 126-143. https://doi.org/10.1108/JAP-09-2018-0018.

Gil, A.P, Moniz, A., São, José São (2019b) Technologies in care for older people - EPTA report 2019, https://eptanetwork.org/images/documents/minutes/EPTA_report_2019.pdf

Gil, A.P., Capelas, L. (2019c) “Elder mistreatment in Portuguese care homes: intersections with organisational and professional factors – a mixed methods study”, 4th Transforming Care Conference – Copenhagen Changing priorities: The making of care policy and practices, Copenhague, Denmark. Copenhague, Denmark: http://www.transforming-care.net/wp-content/uploads/2019/06/BoA-master-7.pdf.

Gil, A.P. (2020) “Os cuidados familiares à luz da teoria da ambivalência sociológica: “Os dois lados da moeda” in Quartilho, M. (org.) Psiquiatria Social e Cultural: Diálogos e Convergência, Imprensa da Universidade de Coimbra, DOI https://doi.org/10.14195/978-989-26-1928-6.399-420

Guberman, N., Maheu, P., Maillé, C. (1992) “Women as family caregivers: why do they care”, The Gerontologist, vol. 32, nº 5, 607-617.

Hayes, L.J.B. (2017) Stories of care: a labour of law – Gender and class at work. London: Palgrave.

Hussein, S., Manthorpe, J., Stevens, M. (2011) “Social care as first work experience in England: a secondary analysis of the profile of a national sample of migrant workers”, Health and Social Care in the Community, 19 (1), 83-97.

Hussein, S. (2017) “Job demand, control and unresolved stress within the emotional work of long-term care in England”, International Journal of Care and Caring, 2 (1), 89-107.

International Labour Office (ILO) (2018) Care work and care jobs for the future of decent work, International Labour Office, Geneva.

Kane, R.A., Kling, K.C., Bershadsky, B., Kane, R.L., Giles, K., Degenholtz, H.B., Liu, J., Cutler, L.J., (2003) “Quality of life measures for nursing home residents”, Journal of Gerontology, 58A (3), 240-248.

King-Dejardin, A. (2019) The social construction of migrant care work - At the intersection of care, migration and gender, International Labour Office, Geneva.

Maheu, P., Guberman, N. (1992) “Familles, personnes adultes dépendantes et aide « naturelle »: Entre le mythe et la réalité”, Revue Internationale d´action communautaire, vol.28, 51-62.

Noelker, L.S., Harel, Z., (2001) “Humanizing long-term care: forging a link between quality of care and quality of life” in L.S. Noelker, Z. Harel (eds), Linking Quality of Long-Term Care and Quality of Life, Canada: Springer Publishing Company.

Organisation for Economic Co-operation and Development (2013) “A good life in old age? Monitoring and improving quality in long-term care”, OECD Health Policy Studies, OECD Publishing.

Organisation for Economic Co-operation and Development (2016) “Long-term care data: Progress in data collection and proposed next steps”, DELSA/HEA/HD 3, Directorate for Employment, Labour and Social Affairs Health Committee, Paris.

Organisation for Economic Co-operation and Development (2017) Health at a glance 2017, OECD indicators: Paris.

Organisation for Economic Co-operation and Development (2019) Health at a glance 2019, OECD indicators: Paris.

Patton, M.Q. (2002) Qualitative research and evaluation methods, Thousand Oaks, CA: Sage.

PORDATA (2019) Database of Contemporary Portugal, Francisco Manuel dos Santos Foundation, Lisbon.

Rodrigues, R. (2017) “Cuidados de longa duração para idosos no contexto europeu: múltiplas soluções para um problema comum?” in Ferreira, P., Cabral, M., Moreira, A. (eds.), Envelhecimento na Sociedade Portuguesa – Pensões, Família e Cuidados, Imprensa de Ciências Sociais, Lisboa, 165-179.

Scheil-Adlung, X. (2015) “Long-term care protection for older persons: A review of coverage deficits in 46 countries”, Extension of Social Security Working Paper nº 50, International Labour Office: Geneva.

Scheil-Adlung, X. (2016) “Health Workforce: A Global Supply Chain Approach. New Data on the Employment Effects of Health Economies in 185 Countries”, Extension of Social Security Working Paper nº 55, International Labour Office: Geneva.

Shulmann, K., Gasior, K., Fuchs, M., Leichsenring, K. (2016) “The view from within: ‘Good’ care from the perspective of care professionals – lessons from an explorative study”, Policy Brief 2, European Centre, Vienna.

Theobald, H. (2017) “Care workers with migrant backgrounds in formal care services in Germany: a multi-level intersectional analysis”, Internationl Journal of Care and Caring, 1 (2), 209-226.

Timonen, V., Lolich, L. (2019) “The poor carer: ambivalent social construction of the home care worker in elder care services”, Journal of Gerontological Social Work, 21,1-21.

Towers, A-M., Smith, N., Palmer, S. Welch, E., Netten A. (2016) “The acceptability and feasibility of using the Adult Social Care Outcomes Toolkit (ASCOT) to inform practice in care homes”, BMC Health Services Research, 516-523, BMC.

Tronto, J. (2010) “Creating caring institutions: Politics, plurality and purpose”, Ethics and Social Welfare, 4, 2, 158-171.

Tronto, J. (2013) Caring democracy: markets, equality, and justice, New York: New York University Press.

Twigg, J., Atkin, K. (1994) Carers perceived: policy and practice in informal care, Buckingham, Pen University Press.

Wiskow, C., Albreht, T., Pietro, C. (2010) How to create an attractive and supportive working environment for health professionals, World Health Organization Euro, Copenhagen.

World Health Organization (2016) “Health workforce requirements for universal health coverage and the Sustainable Development Goals”, Human Resources for Health Observer Series No. 17, World Health Organization.

World Economic Forum (2020) Jobs of tomorrow – mapping opportunity in the new economy, WEF: Geneve.

Zúñiga, D., Ausserhofer, M., Simon, C. S., Schwendimann, R. (2015) L‘enquête SHURP Follow-Up 2015. Universität Basel.

Published
2020-06-26
Section
Dossier Articles