Who is looking after mom and dad? Unregulated workers in Canadian long-term care homes

Canadian Journal on Aging

Volumn 34, Issue 1, 2014, Pages 47-59

  Estabrooks, Carole A ^a   Squires, Janet E ^b   Carleton, Heather L ^a   Cummings, Greta G ^a   Norton, Peter G ^c  

^a UNIVERSITY OF ALBERTA   (Canada)

^b OTTAWA HOSPITAL RESEARCH INSTITUTE   (Canada)

^c UNIVERSITY OF CALGARY   (Canada)

Author keywords

aging; care aides; long term care; nursing homes; personal care workers; unregulated healthcare workforce

Indexed keywords

AGED; BURNOUT; CANADA; CAREGIVER; EDUCATION; FEMALE; FRAIL ELDERLY; HEALTH CARE QUALITY; HOME FOR THE AGED; HUMAN; JOB SATISFACTION; LICENSING; LONG TERM CARE; MALE; MANPOWER; NURSING HOME; NURSING STAFF; REGISTER; STANDARDS; STATISTICS AND NUMERICAL DATA; VERY ELDERLY;

AGED; AGED, 80 AND OVER; BURNOUT, PROFESSIONAL; CANADA; CAREGIVERS; FEMALE; FRAIL ELDERLY; HOMES FOR THE AGED; HUMANS; JOB SATISFACTION; LICENSURE; LONG-TERM CARE; MALE; NURSING HOMES; NURSING STAFF; QUALITY OF HEALTH CARE; REGISTRIES;

EID: 84961289094     PISSN: 07149808     EISSN: 17101107     Source Type: Journal    
DOI: 10.1017/S0714980814000506     Document Type: Article

References (72)

1. Association of Canadian Community Colleges (ACCC). (2012). Canadian educational standards for personal care providers: Environmental scan. Ottawa, ON : Author.
2. Alzheimer's Association. (2013). Alzheimer's facts and figures. Retrieved 2 April 2013, from http://www.alz.org/alzheimers-disease-facts-and-figures.asp.
3. Alzheimer Society of Canada. (2010). Rising tide: The impact of dementia on Canadian society. Toronto, ON : Author.
4. Baughman, R. A., & Smith, K. E. (2012). Labor mobility of the direct care workforce: Implications for the provision of long-term care. Health Economics, 21 (12), 1402-1415.
5. Baum, D. J. (1977). Warehouses for death: The nursing home industry. Don Mills, ON : Burns & MacEachern.
6. BC Care Aide and Community Health Worker Registry. (2013). BC care aide and community health worker registry. Retrieved 5 April 2013, from http://www.cachwr.bc.ca.
7. Berta, W., Laporte, A., Deber, R., Baumann, A., & Gamble, B. (2013). The evolving role of health care aides in the longterm care and home and community care sectors in Canada. Human Resources for Health, 11, 25.
8. Bostick, J. E. (2004). Relationship of nursing personnel and nursing home care quality. Journal of Nursing Care Quality, 19 (2), 130-136.
9. Bostick, J. E., Rantz, M. J., Flesner, M. K., & Riggs, C. J. (2006). Systematic review of studies of staffing and quality in nursing homes. Journal of the American Medical Directors Association, 7 (6), 366-376.
10. Boström, A. M., Squires, J. E., Mitchell, A., Sales, A. E., & Estabrooks, C. A. (2012). Workplace aggression experienced by frontline staff in dementia care. Journal of Clinical Nursing, 21 (9-10), 1453-1465.
11. British Columbia Office of the Ombudsperson. (2009). The best of care: Getting it right for seniors in British Columbia (Part 1). Vancouver, BC : Author.
12. British Columbia Office of the Ombudsperson. (2012). The best of care: Getting it right for seniors in British Columbia (Part 2). Vancouver, BC : Author.
13. Canadian Institutes of Health Research. (2010). Turning the tide: A Canadian strategy for international leadership in the prevention and early treatment of Alzheimer's disease and related dementias. Ottawa, ON : Author.
14. Canadian Nurses Association. (2005). Unregulated health workers: A Canadian and global perspective. Ottawa, ON: Author.
15. Carr, A. (2003). Adult measures of quality of life. Arthritis and Rheumatism, 49 (5S), S113-S133.
16. Chappell, N. L., & Novak, M. (1992). The role of support in alleviating stress among nursing assistants. The Gerontologist, 32 (3), 351-359.
17. Cummings, G. G., Spiwek, T., Hewko, S., Cooper, S., Lynch, S., & Huynh, H. (2013). Shining a light on the unregulated healthcare aide workforce. Edmonton, AB: CLEAR Outcomes, Faculty of Nursing, University of Alberta.
18. Doupe, M., Brownell, M., St. John, P., Strang, D. G., Chateau, D., & Dik, N. (2011). Nursing home adverse events: further insight into highest risk periods. Journal of the American Medical Directors Association, 12 (6), 467-474.
19. Doupe, M., St. John, P., Chateau, D., Strang, D., Smele, S., Bozat-Emre, S., & Dik., N. (2012). Profiling the multidimensional needs of new nursing home residents: Evidence to support planning. Journal of the American Medical Directors Association, 13 (5), 487.e9-487.e17.
20. Dunn, F. (2005). Report of the Auditor General on seniors care and programs. Edmonton, AB : Auditor General.
21. Estabrooks, C., Hutchinson, A., Squires, J., Birdsell, J., Cummings, G., Degner, L., & Norton, P. G. (2009). Translating Research in Elder Care: An introduction to a study protocol series. Implementation Science, 4 (51), 1-8.
22. Estabrooks, C. A., Squires, J. E., Adachi, A. M., Kong, L., & Norton, P. G. (2008). Utilization of Research in Acute Care Settings in Alberta (AKUTE) Technical Report. Edmonton, AB : Faculty of Nursing, University of Alberta.
23. Estabrooks, C. A., Squires, J. E., Cummings, G. G., Teare, G. F., & Norton, P. G. (2009). Study protocol for the Translating Research in Elder Care (TREC): Building context-An organizational monitoring program in long-term care project (project one). Implementation Science, 4 (52), 1-13.
24. Feng, Z., Grabowski, D. C., Intrator, O., Zinn, J., & Mor, V. (2008). Medicaid payment rates, case-mix reimbursement, and nursing home staffing 1996-2004. Medical Care, 46 (1), 33-40.
25. Fredriksen-Goldsen, K. I., & Bonifas, R. P. (2013). Long-term care: The global impact on women. In M. B. Goldman, R. Troisi & K. M. Rexrode (Eds.), Women and Health (2nd ed., pp. 1515-1526). Boston, MA : Academic Press.
26. Fujisawa, R., & Colombo, F. (2009). The long-term care workforce: Overview and strategies to adapt supply to a growing demand. Paris, France : Organisation for Economic Co-operation and Development (OECD).
27. Gruber-Baldini, A., Stuart, B., Zuckerman, I., Hsu, V. D., Boockvar, K. S., Zimmerman, S., & Magaziner, J. (2009). Sensitivity of nursing home cost comparisons to method of dementia diagnosis ascertainment. International Journal of Alzheimer's Disease, Article ID 780720.
28. Health Association Nova Scotia. (2012). Nova Scotia continuing care assistant program. Retrieved 20 November 2012, from http://www.novascotiacca.ca.
29. Hirdes, J. P., Mitchell, L., Maxwell, C. J., & White, N. (2011). Beyond the 'iron lungs of gerontology': Using evidence to shape the future of nursing homes in Canada. Canadian Journal on Aging, 30 (3), 371-390.
30. Houttekier, D., Cohen, J., Bilsen, J., Addington-Hall, J., Onwuteaka-Philipsen, B. D., & Deliens, L. (2010). Place of death of older persons with dementia: A study in five European countries. Journal of the American Geriatrics Society, 58 (4), 751-756.
31. Hyde, H. A. (1981). Report and recommendations-Alberta Nursing Home Review Panel. Edmonton, AB : Alberta Nursing Home Review Panel.
32. Ikegami, N., Morris, J. N., & Fries, B. E. (1997). Low-care cases in long-term care settings: Variation among nations. Age and Ageing, 26 (Suppl 2), 67-71.
33. Institute of Medicine. (2001). Improving the quality of long-term care. Washington, DC : National Academy Press.
34. Janes, N., Sidani, S., Cott, C., & Rappolt, S. (2008). Figuring it out in the moment: A theory of unregulated care providers' knowledge utilization in dementia care settings. Worldviews on Evidence-Based Nursing, 5 (1), 13-24.
35. Josefsson, K., Sonde, L., Winblad, B., & Robins Wahlin, T. B. (2007). Work situation of registered nurses in municipal elderly care in Sweden: A questionnaire survey. International Journal of Nursing Studies, 44 (1), 71-82.
36. Kerr, M. S., Laschinger, H. K., Severin, C. N., Almost, J. M., & Shamian, J. (2005). New strategies for monitoring the health of Canadian nurses: Results of collaborations with key stakeholders. Nursing Leadership, 18 (1), 67-81.
37. Kontos, P. C., Miller, K.L., Mitchell, G. J., & Cott, C. A. (2011). Dementia care at the intersection of regulation and reflexivity: A critical realist perspective. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 66B (1), 119-128.
38. Leiter, M. P., & Maslach, C. (2009). Nurse turnover: The mediating role of burnout. Journal of Nursing Management, 17 (3), 331-339.
39. Long-Term Care Task Force Ontario. (2012). An action plan to address abuse and neglect in long-term care homes. Ontario, Canada : Long-Term Care Task Force on Residential Care and Safety.
40. Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behaviour, 2 (2), 99-113.
41. Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach burnout inventory: Manual (3rd ed.). Palo Alto, CA : Consulting Psychologists Press.
42. McGilton, K. S., Hall, L.M., Wodchis, W. P., & Petroz, U. (2007). Supervisory support, job stress, and job satisfaction among long-term care nursing staff. Journal of Nursing Administration, 37 (7/8), 366-372.
43. McGregor, M. J., Tate, R. B., Ronald, L. A., McGrail, K. M., Cox, M. B., Berta, W., & Broemeling, A. M. (2010). Trends in long-term care staffing by facility ownership in British Columbia, 1996 to 2006. Health Reports, Statistics Canada, 21 (4), 27-33.
44. Mitchell, S. L., Teno, J. M., Miller, S. C., & Mor, V. (2005). A national study of the location of death for older persons with dementia. Journal of the American Geriatrics Society, 53 (2), 299-305.
45. Erratum appears in Journal of the American Geriatrics Society 2005; 53:741
46. Mor, V., Zinn, J., Gozalo, P., Feng, Z., Intrator, O., & Grabowski, D. C. (2007). Prospects for transferring nursing home residents to the community. Health Affairs, 26 (6), 1762-1771.
47. Morgan, D. G., Cammer, A., Stewart, N. J., Crossley, M., D'Arcy, C., Forbes, D. A., & Karunanayake, C. (2012). Nursing aide reports of combative behavior by residents with dementia: Results from a detailed prospective incident diary. Journal of the American Medical Directors Association, 13 (3), 220-227.
48. Morgan, D. G., Semchuk, K. M., Stewart, N. J., & D'Arcy, C. (2002). Job strain among staff of rural nursing homes: A comparison of nurses, aides, and activity workers. Journal of Nursing Administration, 32 (3), 152-161.
49. Morgan, D. G., Stewart, N. J., D'Arcy, C., Forbes, D., & Lawson, J. (2005). Work stress and physical assault of nursing aides in rural nursing homes with and without dementia special care units. Journal of Psychiatric and Mental Health Nursing, 12 (3), 347-358.
50. Morgan, J. C., Dill, J., & Kalleberg, A. L. (2013). The quality of healthcare jobs: Can intrinsic rewards compensate for low extrinsic rewards? Work, Employment & Society, 27 (5), 802-822.
51. Moss, F. E., & Halamandaris, V. J. (1977). Too old, too sick, too bad: Nursing homes in America. Germantown, MD : Aspen Systems.
52. National Advisory Council on Aging. (2005). NACA demands improvement to Canada's long term care institutions: press release. Retrieved 20 November 2012, from http://www.phac-aspc.gc.ca/seniors-aines/archive/archive2005-e.htm.
53. OECD. (2005). Long-term care for older people. Paris, France : Organization for Economic Co-Operation and Development Publishing.
54. OECD. (2013). Good life in old age. Paris, France: Organization for Economic Co-Operation and Development Publishing.
55. PHI National. (2011). Who are direct-care workers? Retrieved 27 November 2012, from http://phinational.org/sites/phinational.org/files/clearinghouse/NCDCW-0904-Fact-Sheetfinal.pdf.
56. Potter, S. J., Churilla, A., & Smith, K. (2006). An examination of full-time employment in the direct-care workforce. Journal of Applied Gerontology, 25 (5), 356-374.
57. PSW Registry Ontario. (2013). Ontario personal support worker registry. Retrieved 5 April 2013, from http://www.pswregistry.org/.
58. Pyper, W. (2004). Employment trends in nursing. Ottawa, ON : Statistics Canada.
59. Rose, M. (2003). Good deal, bad deal? Job satisfaction in occupations pations. W ork, Employment & Society, 17 (3), 503-530.
60. Schaufeli, W. B., Leiter, M. P., & Maslach, C. (2009). Burnout: 35 years of research and practice. Career Development International, 14 (3), 204-220.
61. Squires, J., Estabrooks, C., Scott, S., Cummings, G., Hayduk, L., Kang, S., & Stevens, B. (2013). The influence of organizational context on the use of research by nurses in Canadian pediatric hospitals. BMC Health Services Research, 13 (351), 1-10.
62. Squires, J. E., Hutchinson, A. M., Bostrom, A.-M., Deis, K., Norton, P. G., Cummings, G. G., & Estabrooks, C. (2012). A data quality control program for computer-assisted personal interviews. Nursing Research and Practice, Article ID 303816.
63. Statistics Canada. (2004). Employment trends in nursing. Ottawa, ON : Author.
64. Statistics Canada. (2010). Population projections for Canada, provinces and territories, 2009-2036. Ottawa, ON : Minister of Industry, Canada.
65. Statistics Canada. (2013 a). Table 075-0008-Historical statistics, immigration to Canada, by country of last permanent residence, annual (persons). Retrieved 30 August 2013, from http://www5.statcan.gc.ca/cansim/a05?lang=eng&id=0750015.
66. Statistics Canada. (2013 b). Table 075-0015-Historical statistics, origins of the population, every 10 years (persons). Retrieved 30 August 2013, from http://www5.statcan.gc.ca/cansim/a05?lang=eng&id=0750015.
67. Statistics Canada. (2013 c). Table 075-0022-Historical statistics, country of birth of other British-born and foreignborn population, every 10 years (foreign-born persons unless otherwise noted). Retrieved 30 August 2013, from http://www5.statcan.gc.ca/cansim/a05?lang=eng&id=0750015.
68. Stevens, M. (2008). Workload management in social work services: What, why and how? Practice: Social Work in Action, 20 (4), 207-221.
69. Tolson, D., Rolland, Y., Andrieu, S., Aquino, J. P., Beard, J., Benetos, A., & Morley, J.E. (2011). International Association of Gerontology and Geriatrics: A global agenda for clinical research and quality of care in nursing homes. Journal of the American Medical Directors Association, 12 (3), 184-189.
70. Vladeck, B. C. (1980). Unloving care: The nursing home tragedy. New York, NY : Basic Books.
71. Ware, J., Kosinski, M., Dewey, J., & Gandek, B. (2001). How to score and interpret single-item health status measures: A manual for users of the SF-8 health survey. Lincoln, RI : QualityMetric.
72. Ware, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item short-formhealth survey: construction of scales and preliminary tests of reliability and validity. Medical Care, 34 (3), 220-233.