Elderly Care Staff Research Articles

Collaborative learning in gerontological clinical settings: The students' perspective

This study deals with student nurses' experiences of collaborative learning in gerontological clinical settings where aged people are involved as age-experts in students' learning processes. The data were collected in 2012 using the contents of students' reflective writing assignments concerning elderly persons' life history interviews and the students' own assessments of their learning experiences in authentic elder care settings. The results, analyzed using qualitative content analysis, revealed mostly positive learning experiences. Interaction and collaborative learning activities in genuine gerontological clinical settings contributed to the students' understanding of the multiple age-related and disease-specific challenges as well as the issues of functional decline that aged patients face. Three types of factors influenced the students' collaborative learning experiences in gerontological clinical settings: student-related, patient-related and learning environment-related factors. According to the results, theoretical studies in combination with collaboration, in an authentic clinical environment, by student nurses, elderly patients, representatives of the elder care staff and nurse educators provide a feasible method for helping students transform their experiences with patients into actual skills. Their awareness of and sensitivity to the needs of the elderly increase as they learn.

Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people

ABSTRACTObjectives: Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal aging and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training program for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness.Method: Single group pre-test–post-test design.Results: The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up.Conclusions: The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomized controlled trail is needed to investigate the effectiveness of the program. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved.

Can organizational justice mitigate the negative effects of shift work and fixed-term employment?

The present study examined whether organizational justice moderates the association of shift work and employment type with patient-related stress, stress symptoms, and musculoskeletal symptoms. Cross-sectional survey data from 1270 Finnish female elderly care staff aged 18–69 years was used. Analyses of covariance were used to examine the associations adjusted for age,marital status, education, and tenure. Organizational justice was associated with lower levels of patient-related stress, stress symptoms, and musculoskeletal symptoms. Organizational justice mitigated stress symptoms related to working night shift and three shifts. In addition, organizational justice mitigated the patient-related stress associated with working on fixed-term contracts. Organizational justice was also able to alleviate musculoskeletal symptoms associated with working on permanent contracts. Thus, we found evidence for organizational justice being able to mitigate the negative effects of shift work and employment type. Promoting organizational justice in organizations with shift work and lots of fixed-term contracts is of importance.

Why are they leaving? Causes of actual turnover in the Danish eldercare services

To investigate reasons for actual turnover among eldercare staff and to investigate changes in job design that could prevent turnover. Many Western countries have difficulties in recruiting healthcare staff to provide care for an ageing population. Knowledge on the causes of turnover among healthcare staff is therefore important. In a prospective cohort study (n=7025) baseline characteristics were compared for employees who respectively quit, retired and worked in eldercare at follow-up. Additionally, a survey was conducted among those employees who left their jobs during follow-up. Employees who quit their jobs (n=461) primarily stated that psychosocial work conditions caused them to quit, whereas retirees (n=265) primarily stated reasons related to health and physical job demands. Improvements in the time available for the contact with the elderly, increased skill discretion and improved social relations could prompt employees to reconsider quitting or retiring. Work in eldercare has some 'core' aspects that appear desirable to employees who quit or retired. Building on those aspects offers a strategy for enhanced recruitment potential. To reduce turnover managers should improve psychosocial work conditions in eldercare and ensure that physical demands do not exceed the capacities of employees.

Being perceived as a ‘visitor’ in the nursing staff's working arena – the involvement of relatives in daily caring activities in nursing homes in an urban community in Sweden

It is both complex and difficult for relatives when a loved one moves into a nursing home and many relatives are not prepared for the realities these new situations entail. Little attention has been paid to scrutinising the involvement of relatives in patient care, particularly in relation to the structures and routines of nursing homes or to the staff's reasoning concerning their involvement. To describe, from a gender perspective, how nursing staff's routines and reasoning act to condition the involvement of relatives in nursing homes. Focused ethnographic fieldwork was conducted in a medium-sized urban community in central Sweden in three different nursing homes. The nursing staff assigns a certain code of conduct to all relatives they perceived as 'visitors' in their working arena. This code of conduct was related to the routines and subcultures existing among the nursing staff and stemmed from a division of labour; the underlying concept of 'visitor' predetermined the potential for relatives' involvement. This involvement is explicitly related to the general gendered characteristics that exist in the nursing staff's perception of the relatives. The study's limitations are primarily concerned with shortcomings associated with a research presence during the fieldwork. The discussion focuses on the dimensions of power structures observed in the nursing home routines and the staff's reasoning based on their gendered assumptions. We argue that it is important to develop mechanisms that provide opportunities for nursing staff in elderly care to reflect on these structures without downplaying the excellent care they provide. We stress the importance of further exploring these issues concerning relatives and their involvement in nursing homes to facilitate the transition from informal caregiver to 'visitor'.

Does psychological well‐being mediate the association between experiences of acts of offensive behaviour and turnover among care workers? A longitudinal analysis

To investigate whether the psychological well-being of care workers in the Danish eldercare services mediated the association between experiences of acts of offensive behaviour and actual turnover. Research suggests that experiences of acts of offensive behaviour are associated with risk of turnover. However, little is known about the longitudinal associations between experiences of different types of offensive behaviour (threats, violence, bullying, and unwanted sexual attention) and risk of actual turnover. A prospective cohort study. The study was conducted among employees in the eldercare services in Denmark. Employees aged 55 or more and non-care staff were excluded from the study. Employees who were working in eldercare at baseline (2005) and no longer worked in eldercare at follow-up (2006) were interviewed through questionnaires. Respondents to this questionnaire were coded as cases of turnover (N=608) and were compared with employees who had not changed jobs during follow-up (N=4330). Data on experiences of acts of offensive behaviour and well-being were measured at baseline. Data were analysed using logistic regression analysis. Frequent and occasional experiences of bullying and threats and occasional experiences of unwanted sexual attention at baseline entailed a significantly increased risk of turnover at follow-up. Further analyses showed that psychological well-being significantly reduced the risk of turnover and that well-being partially mediated the association between bullying and turnover and fully mediated the association between threats, unwanted sexual attention, and turnover. Prevention of threats, unwanted sexual attention and - especially - bullying may contribute towards improving well-being and reducing turnover among eldercare staff.

Personality Characteristics of Staff in Elderly Care—A Cross-Cultural Comparison

Communication and interaction between carers and residents in elderly and dementia care can be challenging and demanding. The carer's personality, one factor shaping this interaction, seems to have been neglected in the literature. This article looks at cross-cultural comparisons of staff in elderly and dementia care with individuals from the general population matched by age and gender. Compared to individuals in the general population, elderly and dementia care staff are usually slower tempered, more stoic and reflective, tolerant to monotony, and more systematic. They also have more optimistic attitudes in situations that might worry most people, and more confidence in social situations and in the face of danger and uncertainty.

The Association of Ownership Type With Job Insecurity and Worry About Job Stability

This study examined whether the ownership type is associated with job insecurity and worry about job stability and whether the type of employment contract, positive leadership, and fair management moderated these associations. Survey data from 1249 Finnish female elderly care staff aged 18 to 69 years were used. Job insecurity and worry about job stability were highest in not-for-profit sheltered homes. However, positive leadership and fair management were able to mitigate this insecurity and worry. Job insecurity was highest among fixed-term employees in public sheltered homes or not-for-profit nursing homes. Thus, promoting good leadership and fair management would be of importance.

Return to work among employees with long-term sickness absence in eldercare

This study investigates whether psychosocial work characteristics and work-related psychological states predict return to work (RTW) after long-term sickness absence among eldercare staff. We followed 9947 employees in a national register on payment of sickness-absence compensation for 1 year and found that 598 employees had absence periods of 8 or more consecutive weeks. Using Cox regression analysis, these 598 employees were followed for a year after onset of sickness absence to investigate associations between baseline questionnaire data on psychosocial work characteristics and work-related psychological states on the one side and 'risk' of RTW on the other. The results showed that none of the psychosocial work characteristics, emotional demands, role conflicts, quality of leadership and influence, were significantly associated with RTW. Of the two work-related psychological states, affective organizational commitment and experience of meaning at work, the results showed that sickness-absent employees who experienced low meaning at work at baseline had a significantly reduced 'risk' of RTW when compared with employees who experienced high meaning at work. No significant associations were found for affective organizational commitment. The results imply that experience of meaning at work must be considered an important work-life resource, as it enhances the capacity of sickness-absent employees to RTW after extended sickness-absence periods.

Acts of offensive behaviour and risk of long-term sickness absence in the Danish elder-care services: a prospective analysis of register-based outcomes

To investigate associations between acts of offensive behaviour (threats, violence, bullying, and unwanted sexual attention) and risk of long-term sickness absence for eight or more consecutive weeks among female staff in the Danish elder-care services. These associations were investigated using Cox regression analysis. Data consisted of a merger between Danish survey data collected among 9,520 female employees in the Danish elder-care services and register data on sickness absence compensation. Compared to unexposed employees, employees frequently exposed to threats (HR = 1.52, 95% CI:1.11-2.07), violence (HR = 1.54, 95% CI:1.06-2.25), and bullying (HR = 2.33, 95% CI:1.55-3.51) had significantly increased risk of long-term sickness absence when adjusting for age, job function, tenure, BMI, smoking status, and psychosocial work conditions. When mutually adjusting for the four types of offensive behaviours, only bullying remained significantly associated with risk of long-term sickness absence (HR = 2.26, 95% CI: 1.50-3.42). No significant associations were found between unwanted sexual attention and risk for long-term sickness absence. Results indicate that prevention of threats, violence, and bullying may contribute to reduced sickness absence among elder-care staff. The results furthermore suggest that work organizations must be attentive on how to handle and prevent acts of offensive behaviour and support targets of offensive behaviours.

Evaluation of an intervention programme based on empowerment for eldercare nursing staff

This study evaluated the impact of an intervention programme at individual, worksite, and organizational level, for eldercare nursing staff at 12 eldercare units. The project aimed at empowering auxiliary nurses and nursing assistants, thus promoting good working conditions, health and well-being of eldercare staff, and improving their evaluation of the quality of nursing care. Questionnaire responses from the nursing staff (n=200) before and after an 18-month intervention programme evaluated the effects using ANOVA, repeated measures for the statistical analyses. Although the improvements were limited, the intervention seemed to impact on work conditions and on the perceived quality of nursing rather than on the health and well-being of staff. Work at nursing homes or at home-care was shown to modify the outcome due to different needs and priorities for work unit improvements. Staff turnover and multiple reorganizations are discussed as inhibiting factors for performance as well as for the evaluation of workplace interventions. The sharing of power between occupational groups or organizational levels must be carefully considered. The study emphasizes the importance of involving the middle management in early project planning and decisions.

Community Elder-Care in Tasmania

SUMMARY Adult caregivers (n = 184; M age = 43.9 years old) working at a non-profit, eldercare program at five geographically diverse sites located in the self-contained, island state of Tasmania, Australia, completed a set of self-report measures. Results across the five sites indicated that respondents experienced a relatively strong sense of self-efficacy toward making a difference in their local community. However, there were significant differences (controlling for social desirability) when comparing caregivers from rural northern (n = 45) with urban southern (n = 139) communities, with rural caregivers claiming stronger sense of common mission with others, reciprocal responsibility to help others, and caregiver satisfaction, plus lower disharmony with other members and caregiver stress in helping the elderly than urban caregivers. Implications suggest that community self-efficacy may be high among eldercare staff, but their sense of community and caregiving perceptions may reflect geographic differences, especially in Tasmania.

Staff satisfaction with work, perceived quality of care and stress in elderly care: psychometric assessments and associations

To evaluate validity and reliability of three questionnaires measuring 'work satisfaction', 'patient care' and 'staff health' for staff in elderly care and to study the relationship between staff members' satisfaction with work and perceived stress. Increased workload, difficulties in recruiting and retaining nurses are reported in elderly care. Valid and reliable instruments measuring staffs' perceptions of work are needed. A convenience sample of 299 staff answered the questionnaires. Factor analysis of 'work satisfaction' gave eight factors, 'patient care' four factors and 'staff health' two factors, explaining 52.2%, 56.4% and 56.8% of the variance. Internal consistency was mostly satisfactory. Multiple regression analysis revealed a model that explained 41% of the variance in perceived stress symptoms. There was support for the instruments' validity and reliability. Older age, higher scores/satisfaction with workload, cooperation, expectations and demands, personal development and lower scores on internal motivation contributed to less stress.

Mentoring relationships of eldercare staff in Australia: Influence on service motives, sense of community, and caregiver experiences

Employees (76 women, 15 men; mean age = 44.61 years old; SD = 10.84) of a nonprofit eldercare program completed measures of public service motives, community self-efficacy, sense of community with coworkers, and caregiver satisfaction and stress. Participants also identified whether they had a mentor in their life, someone with more experience who provided support and guidance to them. Employees with mentors (n = 47) compared to those without a mentor (n = 44) indicated (controlling for social desirability) (1) significantly stronger motives to help others as boosting self-esteem, understanding of social problems, and reflection of one's values; (2) significantly stronger beliefs in a common mission and a desire to be supportive of peers; and (3) less caregiver stress in helping older adults. Limitations and implications are discussed. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 245–252, 2005.

Supported living in residential homes for the elderly: impact on patients and elder care workers

To enable older people with severe and persistent mental illness to live in the community, the Dutch mental health sector has developed a program for supported living in residential homes for the elderly. It provides for the permanent stationing of mental health workers (MHWs) in elder care facilities to support both the resident patients and the elder care staff. The authors examined associations between the number of MHW staff and the degree to which (1) patients were integrated into the community and (2) elder care workers had developed effective working alliances with their patients. Participants included 110 patients participating in 18 supported living programs in the Netherlands. Community integration was assessed in face-to-face interviews with the patients about their perceived influence over daily life, involvement in social activities, and social network size. The quality of the worker-patient relationship was assessed using the Dutch Working Alliance Questionnaire for Community Care, completed by the elder care worker primarily responsible for each patient. After differentiation of the MHW staff into medically trained and nurse-trained professionals, associations with outcome measures were found only for the nurse-trained staff. The more hours of nurse-trained staff capacity per patient, the more influence perceived by the patients, and the more directiveness shown by the elder care workers in their contacts with patients. The impact of supported living programs in residential homes for the elderly appears to be determined in part by the caseloads of the on-site MHWs.

Assault most common in elderly care wards

Study shows elderly care staff more than twice as likely to be assaulted as A&E staff