Weighing obligations to home care workers and Medicaid recipients

2017 ◽  
Vol 26 (2) ◽  
pp. 418-424
Author(s):  
Paul C Treacy ◽  
Douglas MacKay
Keyword(s):  
Home Care ◽  
Minimum Wage ◽  
People With Disabilities ◽  
Home Care Services ◽  
Certified Nursing Assistants ◽  
Department Of Labor ◽  
Home Health Aides ◽  
Care Services ◽  
Care Workers ◽  
Home Care Workers

In June 2016, a US Department of Labor rule extending minimum wage and overtime pay protections to home care workers such as certified nursing assistants and home health aides survived its final legal challenge and became effective. However, Medicaid officials in certain states reported that during the intervening decades when these protections were not in place, their states had developed a range of innovative services and programs providing home care to people with disabilities—services and programs that would be at risk if workers were newly owed minimum wage and overtime pay. In this article, we examine whether the Department of Labor was right to extend these wage protections to home care workers even at the risk of a reduction in these home care services to people with disabilities. We argue that it was right to do so. Home care workers are entitled to these protections, and, although it is permissible under certain conditions for government to infringe workers’ occupational rights and entitlements, these conditions are not satisfied in this case.

scholarly journals Impacts of a Care Robotics Project on Finnish Home Care Workers’ Attitudes towards Robots

2020 ◽  
Vol 17 (19) ◽  
pp. 7176
Author(s):  
Teemu Rantanen ◽  
Teppo Leppälahti ◽  
Jaakko Porokuokka ◽  
Sari Heikkinen
Keyword(s):  
Home Care ◽  
Elderly Care ◽  
Test Group ◽  
Home Care Services ◽  
Two Dimensions ◽  
Control Group ◽  
Care Services ◽  
Care Robots ◽  
Care Workers ◽  
Home Care Workers

Technological advances in elderly care have been rapid, and the introduction of robots in care will be a topical issue in the near future. There has been little research into the possibility of influencing care workers’ attitudes towards robots by project activities, and how to make the change easier for work communities. This study focuses on a robotics project that took place in elderly and home care services in one municipality in Finland (total of 45 care workers). During the project, four robotics workshops and one extended pilot session were implemented. The study follows quasi-experimental settings, and it included two measurements (before and after project activities) and a control group, but no randomization. The data were collected by questionnaires and were analyzed statistically. The project under study brought about minor positive changes in home care workers’ attitudes towards the usefulness of care robots. In the final measurement, the difference between the test group and the control group was significant in the two dimensions of positive attitudes. The research supports the hypothesis that project activities can be used to influence home care workers’ attitudes towards robots. This can also facilitate the introduction of care robots in home care services. However, the construction of a technology-positive care culture is a long-term process, which requires training and development, technological development and strong strategic management at various levels.

Fears come true: the experiences of older care recipients and their family members of live-in foreign home care workers

2009 ◽  
Vol 21 (4) ◽  
pp. 779-786 ◽  
Author(s):  
Liat Ayalon
Keyword(s):  
Home Care ◽  
Qualitative Interviews ◽  
Family Members ◽  
Home Care Services ◽  
Care Recipient ◽  
Care Services ◽  
Care Recipients ◽  
Care Workers ◽  
Home Care Workers ◽  
Care Worker

ABSTRACTBackground: Foreign home care services provided to frail older adults by individuals from the developing world are a global phenomenon. This study evaluated the challenges associated with live-in foreign home care from the perspective of older care recipients and their family members.Methods: Qualitative interviews were conducted with 23 family members and seven older care recipients. Interviews were analyzed thematically.Results: Three main themes were identified: (i) the intense fears associated with witnessing the decline of the older care recipient and the subsequent employment of a foreign home care worker; (ii) actual negative experiences within this caregiving setting; and (iii) the ways in which family members and older care recipients coped with these challenging experiences.Conclusions: The key to this caregiving arrangement is the establishment of trust. Yet, many care recipients experienced violations of trust that resulted in abuse and neglect, which served to further intensify fears and concerns about this caregiving arrangement. The same coping methods used to maintain this arrangement, despite fears and concerns, are the ones responsible for maintaining the older care recipient in an abusive situation.

scholarly journals Working with colleagues and other professionals when caring for people with dementia at the end of life: home care workers’ experiences

2019 ◽  
Vol 3 (4) ◽  
pp. 567-583
Author(s):  
Jill Manthorpe ◽  
Tushna Vandrevala ◽  
Ruth Abrams ◽  
Kritika Samsi
Keyword(s):  
Home Care ◽  
Home Care Services ◽  
Care Staff ◽  
Structured Interviews ◽  
Care Services ◽  
People With Dementia ◽  
Care Workers ◽  
Informal Practices ◽  
Home Care Workers ◽  
Care Agency

Caring for people with dementia often necessitates inter-professional and inter-agency working but there is limited evidence of how home care staff work as a team and with professionals from different agencies. Through analysis of semi-structured interviews, we explored the experiences of home care workers (n = 30) and managers of home care services (n = 13) in England (2016‐17). Both groups sought to collaboratively establish formal and informal practices of teamwork. Beyond the home care agency, experiences of interacting with the wider health and care workforce differed. More explicit encouragement of support for home care workers is needed by other professionals and their employers.

scholarly journals The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study

2020 ◽  
pp. 107755872096090
Author(s):  
Nancy Dudley ◽  
Jacqueline Miller ◽  
Mary Lou Breslin ◽  
Susan A. Chapman ◽  
Joanne Spetz
Keyword(s):  
Home Care ◽  
Home Care Services ◽  
Health Maintenance ◽  
Study Approach ◽  
Care Services ◽  
Care Workers ◽  
Evidence Based Guidelines ◽  
Home Care Workers ◽  
The Impact

The objective of this study was to explore how home care workers and the agencies that employ them interact with their state’s nurse practice act in the provision of care. Using a qualitative case study approach, we selected four states with varying levels of restrictiveness in their nurse delegation regulations. We conducted interviews ( N = 45) with state leaders, agency leaders, and home care workers to learn how these policies affect the home care workforce’s ability to perform care tasks for their clients in order to allow clients to remain in their own homes. We found that increased training and input from registered nurses is needed to identify appropriate health maintenance tasks to delegate to home care workers and support development of training strategies. The federal government could support the development of evidence-based guidelines for training and competency testing as well as for appropriate delegation of health maintenance tasks.

scholarly journals Fortunate and fearful: emotions evoked by home-care policies for older people in Ireland

2020 ◽  
Vol 2 (1) ◽  
pp. 61-78
Author(s):  
Luciana Lolich ◽  
Virpi Timonen
Keyword(s):  
Home Care ◽  
Home Care Services ◽  
System Level ◽  
Service Users ◽  
Care Providers ◽  
Term Care ◽  
Care Services ◽  
Care Workers ◽  
Care Policies ◽  
Care Package

This article examines the emotions of fear and feeling fortunate experienced by key actors in home-care services in Ireland. We take a relational approach to emotions; that is to say, an understanding that emotions are produced in social interactions and play an essential part in how people engage with, and respond to, long-term care policies. The study involved focus groups and in-depth interviews with 104 participants. Our findings show that the most vulnerable participants – service users and care workers on precarious contracts – feel fortunate or fearful about outcomes that had, or would have, a direct impact on them: respectively, having a good carer and obtaining job satisfaction, or losing a home-care package and not having enough work. Professionals were more likely to speak about luck and fear, not in relation to what could happen to them directly but in relation to the fate of service users and care workers. The unregulated home-care services in Ireland have influenced actors to construe their own and others’ participation in the system as increasingly individualised, where desired outcomes depend on one’s good luck or strong personal relationships. For the system to work properly trust needs to be present not only at the micro level of individual relationships but also at a system level. This could lead to a decline in emotions that centre on feeling fortunate and fearful, and an increase in expressions of trust and a sense of control by both care providers and care recipients.

scholarly journals Home health aides’ experiences of their occupational health: a qualitative meta-synthesis

2020 ◽  
Author(s):  
Sunniva Grønoset Grasmo ◽  
Ingeborg Frostad Liaset ◽  
Skender Elez Redzovic
Keyword(s):  
Occupational Health ◽  
Home Care ◽  
Home Care Services ◽  
Home Health ◽  
Working Environment ◽  
Major Health Problem ◽  
Positive Effects ◽  
Home Health Aides ◽  
Care Services ◽  
Key Concepts

Abstract Objective: The need for home care services is rapidly growing due to an increasing elderly population, earlier discharge from hospital and clients’ preference of being treated at home. While this need increases, there is high sickness absence among home health aides, and research show that home health aides have one of the highest probabilities of being granted a disability pension. A high prevalence of musculoskeletal disorders has been reported in occupations with physically demanding work, and this aspect is a major health problem among home health aides. Studies have shown that home health aides find their work stressful, physically demanding and exhausting. The objectives of this study were to summarise peer-reviewed literature on how home health aides experience their occupational health and conduct an ethnographic meta-synthesis with the aim of identifying and describing key concepts across studies. Methods: A qualitative ethnographic meta-synthesis was used to develop new insights into home health aides’ occupational experiences. By using this method, we directed attention to the interpretation of studies, development of concepts and expansion and specification of theories that concern these concepts. The first author conducted searches in the electronic databases CINAHL, MEDLINE and PsycINFO. Results: This meta-synthesis includes 27 articles. The review of these sources identified four key concepts as important to gain an understanding of occupational health among home health aides: exposure to physical demands , physical environmental factors , organisational conditions of employment and psychosocial working environment . Conclusion: The findings in this synthesis are consistent with previous research showing that occupational health among home health aides is a complex phenomenon. Specifically, physical, psychosocial and psychological exposure aspects have potential negative and positive effects on home health aides’ occupational health. In order to increase employee’s well-being, create a healthier workplace that provides well-functioning and high-quality home care services and cope with future health challenges, more investigations into the organisation of home care are needed.

scholarly journals What constitutes ‘good’ home care for people with dementia? An investigation of the views of home care service recipients and providers

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anita M. Y. Goh ◽  
Meg Polacsek ◽  
Sue Malta ◽  
Colleen Doyle ◽  
Brendan Hallam ◽  
...  
Keyword(s):  
Home Care ◽  
Care Service ◽  
Home Care Services ◽  
Dementia Care ◽  
Trial Registration ◽  
Care Providers ◽  
Family Carers ◽  
People With Dementia ◽  
Care Workers ◽  
Home Care Workers

Abstract Background Our objective was to explore what people receiving and providing care consider to be ‘good’ in-home care for people living with dementia. Methods We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke’s six-step approach. Results Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers’ understanding of dementia and its impact; 2) Home care workers’ demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers’ knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. Conclusions It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. Trial registration ACTRN 12619000251123.

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