Abstract
BackgroundThere is lack of adequate training and policy support for employed care workers (CWs) employed in the South African (SA) older persons’ sector. Existing literature neglects the influence of training and policy support on CWs’ experiences in long-term care (LTC) for older adults in residential care facilities (RCFs). We investigated the ways in which CWs’ experiences are rooted in the lack of adequate training and policy support.MethodsQualitative data was collected through focus group (FG) interviews with 32 CWs employed in RCFs in the City of Cape Town. Data was also collected using semi-structured interviews with representatives of five RCFs for older adults and four training organisations providing CW training in the City of Cape Town, South Africa.ResultsDespite some positive caregiving experiences, CWs face role ambiguity and experience care work as a ‘career-less job’. They also face poor employment conditions, negative interpersonal relations at work, and role overload. They are not coping with the demands of LTC due to role overload, and lack of basic caregiving skills, coping skills and socio-emotional support. Their motivation to cope and provide quality care is hamstrung by their experiences of role ambiguity, poor employment conditions, negative interpersonal relations at work, and lack of career growth opportunities.ConclusionsFindings suggest that CWs’ experiences derive from the policy and structural context of caregiving. Policy inadequacies and lack of structural support create conditions for adverse conditions which negatively impact on CWs motivation and ability to cope with the demands of LTC. Lack of policy implementation presents structural barriers to quality LTC in the older persons’ sector. Implementation of policies and systems for professionalising care work is long overdue.
Highlights
There is lack of adequate training and policy support for employed care workers (CWs) employed in the South African (SA) older persons’ sector
Focus Group Interviews (FGIs) were held with CWs recruited through residential care facilities (RCFs)
Role ambiguity and career growth CWs’ role expectations do not align with their actual scope of work. They are generally regarded as nonmedical social care personnel in the South African primary care system, but they understood their role in primary care as more or less part of the nursing profession
Summary
There is lack of adequate training and policy support for employed care workers (CWs) employed in the South African (SA) older persons’ sector. Nurses experience their work as highly complex and unpredictable [4, 6, 7] They have difficulty defining and limiting their roles because they have all-embracing roles [5, 6]. CWs face the challenge of developing and consolidating their professional role in LTC [8, 9] They define their role in terms of what they are not allowed to do, nursing work [7]. South African literature indicates that CWs in private homes may be task-shifting upwards, doing more nursingtype care [10] They are required to provide holistic care, including performing nursing tasks such as providing antiretroviral and tuberculosis treatment [11]. There is need to examine of the roles of the LTC workforce to ensure greater coherence and clearer roles, responsibilities and accountability [4, 5]
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