Long-term Care Workers Research Articles

Impact of increased long-term care insurance payments on employment and wages in formal long-term care

This paper examines the effect of raising Long-term care insurance (LTCI) payments on employment and wages of workers in the long-term care (LTC) industry. Specifically, I use the change in the regional premium in 2012 as an exogenous shock to the insurance fee schedule: the change in the unit price of LTCI service ranges from a decrease of 2.8% to an increase of 4.2%. I find no increase in the number of employees in the establishments, registered under the LTCI scheme, in municipalities where the regional premium increased. The earnings and working hours of LTC workers did not increase, either.

Contradictions in information technology mediated work in long-term care: An activity theoretic ethnographic study

BackgroundThe growing demand for aged care services coupled with a global shortage of skilled nursing staff has hindered long-term care facilities’ ability to provide necessary services to their residents. Healthcare information technology is expected to mitigate this challenge by streamlining nursing work, while also improving quality of care and productivity. ObjectivesThis study set out to examine how nurses and care workers work, the role of information technology (IT) in their work and what contradictions they face in their IT mediated work. DesignEthnographic study informed by six components of activity theory: subject, object, tool, rule, community and division of labor. SettingEight care units in two long-term care facilities in Australia. ParticipantsEleven staff from two long-term care facilities including registered nurses (n = 2), endorsed enrolled nurses (n = 5) and personal care workers (n = 4) participated in this study. MethodsParticipants were shadowed during morning shifts (6:30 am to 3:00 pm). A total of 24 morning shifts were observed over four months. Field notes were created based on observational data and informal interviews, in addition to document review. ResultsThrough the lens of activity theory, the work activity system of nurses and care workers in the long-term care facilities consisted of the subject (nurses and care workers), their object (resident care), tools used for work including IT, rules of work, community, and division of labor. These components interacted through work processes; therefore, a “process” component was added in the activity system. Special attention was given to the role of IT as the conduit of information in the work processes. Although IT helped track medication rounds, automated documentation and communication among the staff, it introduced contradictions. Seven contradictions involving IT were identified, including contradictions within the IT tool, between the IT tool and the object of work, between the subjects and documentation rules, between the work activity system using paper records and the system using IT, and between the activity system within the long-term care facility and the pharmacists’ work activity system outside the facility. ConclusionsActivity theory provided a theoretic framework to model the work activity system of nurses and care workers. Information technology played an important role in supporting information flow in this system, however it also caused contradictions.

Care For America's Elderly And Disabled People Relies On Immigrant Labor.

As the US wrestles with immigration policy and caring for an aging population, data on immigrants' role as health care and long-term care workers can inform both debates. Previous studies have examined immigrants' role as health care and direct care workers (nursing, home health, and personal care aides) but not that of immigrants hired by private households or nonmedical facilities such as senior housing to assist elderly and disabled people or unauthorized immigrants' role in providing these services. Using nationally representative data, we found that in 2017 immigrants accounted for 18.2percent of health care workers and 23.5percent of formal and nonformal long-term care sector workers. More than one-quarter (27.5percent) of direct care workers and 30.3percent of nursing home housekeeping and maintenance workers were immigrants. Although legal noncitizen immigrants accounted for 5.2percent of the US population, they made up 9.0percent of direct care workers. Naturalized citizens, 6.8percent of the US population, accounted for 13.9percent of direct care workers. In light of the current and projected shortage of health care and direct care workers, our finding that immigrants fill a disproportionate share of such jobs suggests that policies curtailing immigration will likely compromise the availability of care for elderly and disabled Americans.

PNS75 THE QUALITY OF CARE WORKERS IN LONG-TERM CARE INSTITUTIONS IN ZHEJIANG PROVINCE, CHINA

This paper aimed to explore the quality of care workers in long-term care (LTC) institutions in Zhejiang Province, including demographic characteristics, knowledge, attitude, and practice (KAP). In addition, to find related factors to improve quality of care workers. A cross-sectional survey was conducted from April to June in 2016 in Zhejiang. Ten LTC institutions was randomly selected using a cluster random sampling method, including four institutions in Xihu District and six institutions in Lanxi County. Totally 84 caregivers were interviewed face-to-face with a unified questionnaire. Multiple linear regression were used to find the related factors to KAP. Structural equation modeling was conducted to explore the pathways among KAP and influencing factors. The study found that most of care workers in Zhejiang Province were middle-aged female with diploma below middle school. There are many care workers hadn’t received any pre-job training. Their salary was low although they undertook high-intensive work. The average knowledge, attitude, and practice score was 17.11 ± 3.34, 48.15 ± 3.71 and 5.58 ± 1.36, their full score was 23, 65 and 7, respectively. Education and working years had positive effect on knowledge and practice score, pre-job training had positive effect on attitude score. What's more, we found that nursing knowledge could affect nursing practice through nursing attitude. The quality of care workers in Zhejiang Province was low. Continuous and regular elderly care training should be provided for the care workers to improve their ageing-care knowledge and hence the quality of elderly care.

Improving Job Quality for Direct Care Workers

The prevalence of low wage work is a major challenge for American labor markets and health care is an industry in which many of these low wage workers are found. This paper provides data documenting these facts and then discusses strategies for upgrading job quality for long-term care workers who constitute the majority of low wage employees in health care occupations. In addition the paper briefly discusses approaches for upgrading the employment opportunities of low wage employees who are in the health industry but in jobs that are not health care specific.

Drivers of participation in Facebook long-term care groups: Applying the use and gratification theory, social identification theory, and the modulating role of group diversity.

Facebook long-term care groups have been established by long-term care workers, and few studies have explored the related drivers of participation from the perspective of caregivers. This study applied a mixed-methods approach; the qualitative component conducted a pilot study to explore the drivers of participation in Facebook long-term care groups and found that the use and gratification theory provides a valid approach for explaining these drivers. Subsequently, the quantitative component, based on the use and gratification theory, proposed a conceptual model to examine the effect of these drivers on the social identity of these groups as well as the modulating effects of extraversion and group diversity in terms of age and educational background. The results showed that the most important social identification-related driver underlying participation in these groups was self-discovery. In addition, the relationship among these drivers and social identification was found to be modulated by extraversion, age, and educational background.

Relationships between social support, job autonomy, job satisfaction, and burnout among care workers in long-term care facilities in Hawaii

ABSTRACTThis study examined the effects of social support, job autonomy, and job satisfaction on burnout among long-term care workers in Hawaii, USA. Data were collected from 170 care workers working at long-term care facilities in Hawaii. The study variables included demographic data, burnout, social support, job autonomy, and job satisfaction. The study findings support the association between social support, job autonomy, job satisfaction, and burnout among care workers at long-term care facilities. Social support, job autonomy, and job satisfaction were negatively and significantly associated with the level of burnout of care workers in Hawaii. Furthermore, the findings suggest the need to develop policy and practice considerations for reducing burnout risks among care workers in order to improve quality of care.

Impact of Increased Long-Term Care Insurance Payments on Employment and Wages in Formal Long-Term Care

This paper examines the effect of raising Long-term Care Insurance (LTCI) payments on employment and wages of workers in the long-term care (LTC) industry. Specifically, I use the change in the regional premium in 2012 as an exogenous shock to the insurance fee schedule: the change in the unit price of LTCI service ranges from a decrease of 2.8% to an increase of 4.2%. I find no increase in the number of employees in the establishments, registered under the LTCI scheme, in municipalities where the regional premium increased. The earnings and working hours of LTC workers did not increase, either.

The Impact of Job Satisfaction and Social Support on Overturn Intention among Long-Term Care Workers

The Purpose of this research study is to find the impact of job satisfaction and social support on overturn intention among long-term care workers. For this purpose, the sample was comprised of 373 long-term care workers from October 1 st in 2017 to February in 2017. T-test and Anova, and multiple regression were used to analysis the data. This research study indicated that long-term care workers who were a high level of job satisfaction and social support from supervisor had a high mean score on turnover intention. Participants who finished university and who worked less six than months had a high mean score in turnover intentions than others. Also, working year, job satisfaction, and supervisor’s social support were significant predictors for overturn intention among long-term care workers. Based on this research result, the implications of social work practice and social policy are discussed..

The Effects of Psychological Capital on Job Satisfaction and Organizational Citizenship Behavior in Long-term Care Worker

The Effects of Psychological Capital on Job Satisfaction and Organizational Citizenship Behavior in Long-term Care Worker

A STUDY OF DIFFERENCES IN VIEWS OF HIRING FOREIGN CARE WORKERS BETWEEN ADMINISTRATORS AND CARE WORKERS

AbstractIn 2017, to address the shortage of long-term care workers, the Japanese government drastically changed policies for permitting foreigners to fill these jobs. This included creating a new immigration status, “Kaigo”(long-term-care) and adding a new job category to “Ginou-Jissyu”(technical-intern-training) immigration status. This study examined differences in views of hiring foreign care workers and these policy options between administrators and Japanese care workers at long-term-care institutions for older adults before these policy changes were in place as a way of understanding receptivity towards them. A nationwide survey was conducted during September to October of 2014. Structured questionnaires were sent to 3,932 randomly selected institutions, and a total of 722 responses were obtained from administrators(response rate:18.4%) and 586 responses(14.9%) from Japanese care workers. Preliminary analyses revealed that there were statistically significant differences between administrators and care workers in views of hiring foreign care workers(p<.001), language proficiency needs(p<.001) and ability to provide quality care(p<.05), and the three policy options proposed at the time(p<.01). For example, administrators agreed more with hiring foreign care workers and were less concerned with Japanese language skills than care workers. Moreover, administrators agreed more with creating a new immigration status and adding a new job category to “Ginou-Jissyu” immigration status than care workers. Given the recent policy enactment, it is suggested that administrators need to be aware of these differences in order not to accelerate already higher turnover rates of Japanese care workers and to pay attention to if and how the new policies are changing care workers views.

Job strain, time strain, and well-being: A longitudinal, person-centered approach in two industries

The notion of constellations is central to many occupational health theories; empirical research is nevertheless dominated by variable-centered methodologies. Guided by the job demands-resources framework, we use a person-centered longitudinal approach to identify constellations of job demands and resources (task-based and time-based) over time that predict changes in well-being. We situate our research in two dissimilar, but growing, industries in the United States—information technology (IT) and long-term care. Drawing on data collected over 18 months, we identify five patterned, stable constellations of job demands/resources using group-based multi-trajectory modeling: (1) high strain/low hours, (2) high strain/low hours/shift work, (3) high strain/long hours, (4) active (high demands, high control), and (5) lower strain (lower demands, high control). IT workers are overrepresented in the lower-strain and active constellations, whereas long-term care providers are more often in high-strain constellations. Workers in the lower-strain constellation experience increased job satisfaction and decreased emotional exhaustion, work-family conflict and psychological distress over 18 months. In comparison, workers in high-strain job constellations fare worse on these outcomes, as do those in the active constellation. Industrial contexts matter, however: Compared with long-term care workers, IT workers' well-being is more at risk when working in the “high strain/long hours” constellation. As the labor market continues to experience structural changes, scholars and policy makers need to attend to redesigning the ecological contexts of work conditions to promote workers' well-being while taking into account industrial differences.

Moderating Effects of Resilience on the Relationship Between Emotional Labor and Burnout in Care Workers.

The aim of the current study was to investigate the moderating effects of resilience on the relationship between emotional labor and burnout among care workers in long-term care (LTC) hospitals. Participants were 126 care workers from five different LTC hospitals in Busan, South Korea. A set of self-reported questionnaires was administered to assess general characteristics, emotional labor, resilience, and burnout of participants. Data were analyzed using descriptive statistics, t tests, one-way analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression. The final multivariate regression model was statistically significant and accounted for 36% of the variance in burnout. Emotional labor was significantly associated with burn-out (β = 0.25, p = 0.001). Resilience had a significant moderating effect on the relationship between emotional labor and burnout (β = -0.16, p = 0.033). To alleviate burnout in care workers, emotional labor should be recognized as a significant mental health problem and management interventions should be developed. [Journal of Gerontological Nursing, 44(10), 30-39.].

Effects of Emotional Labor on Burnout in Long-term Care Hospital Care Workers

Effects of Emotional Labor on Burnout in Long-term Care Hospital Care Workers

The worksite heart health improvement project’s impact on behavioral risk factors for cardiovascular disease in long-term care: A randomized control trial

BackgroundLong-term care workers are at high risk for cardiovascular disease, in part because of their poor health habits. ObjectiveThe purpose of this study is to test the impact of the Worksite Heart Health Improvement Project (WHHIP) on subjective behavioral cardiovascular risk factors over time among long-term care staff. DesignThe WHHIP was a 12-month cluster randomized control trial conducted in four long-term care facilities. The exercise, nutrition, and stress management intervention lasted 9-months and was implemented during paid work time. Setting and participantsNinety-eight long-term care workers consented to participate in the study. MethodsSurvey data included: mood, dietary salt intake, dietary fat intake, sleep quality, and sleep duration. ResultsA significant positive short-term intervention effect at 9-month (p = .037) and long-term effect at 12-month for mood (p = .039) was found, signifying reduction in mood symptoms in the treatment group over time. The intervention group also showed longer sleep time (p = .016) and better sleep quality (p = .046) at 12-months. The intervention group had less dietary sodium intake at 9-months (p = .036); yet, this was not maintained over time. ConclusionThe WHHIP demonstrated the ability to improve participants’ mood, sleep and sodium intake over time. Lessons learned particularly the challenges faced implementing the WHHIP and the solutions recommended provide critical insights to strengthen future programs with this population.

A Study on the Development of a Career Model for In-home Long-term Care Workers

A Study on the Development of a Career Model for In-home Long-term Care Workers

A Phenomenological Study of the Work Environment in Long-Term Care Facilities for the Older Adults.

Attempts to meet the increasing demand for long-term care (LTC) services have been hindered by acute staff shortages and high turnover. Distinct from previous studies, a descriptive phenomenological approach with van Kaam's controlled explication method was adopted in this study, to delineate how attributes of the LTC work environment shape the workforce crisis. Individual interviews were conducted with 40 LTC workers from 10 facilities in Hong Kong. The results suggest that the work environment in LTC facilities is not only characterized by organization- and job-related attributes that influence staff outcomes but also is a socially constructed concept with derogatory connotations that can influence staff recruitment and retention. Concerted efforts from facility administrators and policy makers are needed to improve the quality of the work environment. Future initiatives should focus on developing a vision and strategic plan to facilitate the rise of the LTC sector as a profession.

Not just “sweet old ladies” – Challenges in voluntary work in the municipal long-term care services

Introduction: The Norwegian government is addressing the need for increased voluntary work in the municipal care sector. Several reforms over the last decades have transferred important care tasks to the municipalities, as it is a political aim for people to live longer in their own homes. Despite important structural changes in the provision of public care services, less attention has been devoted to the investigation of how voluntary work interacts with the overall development of care tasks within municipal care services. This paper aims to discover how the contribution of volunteers matches the current needs of service recipients and the daily work of professional staff and, additionally, to discover what level of volunteer competence and qualifications are considered necessary when cooperating with staff.Method: Eight case studies addressing opportunities and barriers to voluntary work in long-term care were carried out. Our study included participants from both voluntary organisations and long-term care.Results: Volunteers were considered to fill important functions and gaps by providing social support, offering activities and by communicating with the service recipients. However, the poor health of service recipients risked putting undue strain on volunteers. Volunteers need to have personal qualifications, such as good observation and communication skills, in order to function well and be useful in their role as volunteers.Discussion: Care is seen as a complex task requiring time, effort, and technical and social skills. Relational care is not easily distinguished from the overall care needs of service recipients. Service recipients in the municipalities are seen as increasingly frail and have complex health needs. With the expected increase in the number of elderly with dementia in the future, we may need to question whether volunteers are equipped to take on such advanced health problems.

Relationships between work outcomes, work attitudes and work environments of health support workers in Ontario long-term care and home and community care settings

BackgroundOur overarching study objective is to further our understanding of the work psychology of Health Support Workers (HSWs) in long-term care and home and community care settings in Ontario, Canada. Specifically, we seek novel insights about the relationships among aspects of these workers’ work environments, their work attitudes, and work outcomes in the interests of informing the development of human resource programs to enhance elder care.MethodsWe conducted a path analysis of data collected via a survey administered to a convenience sample of Ontario HSWs engaged in the delivery of elder care over July–August 2015.ResultsHSWs’ work outcomes, including intent to stay, organizational citizenship behaviors, and performance, are directly and significantly related to their work attitudes, including job satisfaction, work engagement, and affective organizational commitment. These in turn are related to how HSWs perceive their work environments including their quality of work life (QWL), their perceptions of supervisor support, and their perceptions of workplace safety.ConclusionsHSWs’ work environments are within the power of managers to modify. Our analysis suggests that QWL, perceptions of supervisor support, and perceptions of workplace safety present particularly promising means by which to influence HSWs’ work attitudes and work outcomes. Furthermore, even modest changes to some aspects of the work environment stand to precipitate a cascade of positive effects on work outcomes through work attitudes.

Experiences of a Mass Interinstitutional Relocation for Long-Term Care Staff

ABSTRACTThis research explored long-term care (LTC) staff perceptions and experiences of working in LTC and providing care to residents following a mass interinstitutional relocation. In-depth, semistructured interviews were conducted with 63 LTC workers. Thematic analyses revealed three overarching themes related to how staff members perceived their relationships with other staff members following relocation. The first theme, post-relocation relationships between staff members, included the subthemes “Staff are segregated from each other” (physical distance) and “We were a family” to “barely say hi” (psychological distance). The second theme, post-relocation stress, has two subthemes: “Staffing is our big issue” and consequences of stress: absenteeism and leave. The third theme is recommendations for improving and managing staff relationships post-relocation. Relationships among staff members are integral to working in LTC and providing care to residents following a mass interinstitutional relocation. Recommendations for improving staff relationships and morale are suggested.