Relationship-Based Care Work, Austerity and Aged Care

Home care and aged care in English-speaking countries around the globe have enthusiastically taken up a model of work known as ‘relationship-based care’ (RBC). Part of the popularity of RBC is because it does not challenge austerity, underfunding, and extensive managerialism. Instead it works within and through them to foster caring connections between patients, staff, and families, and is able to do so because workers are willing to self-sacrifice for clients. Drawing on case study data collected using a ‘rapid ethnography’ methodology in two large Australian aged care organisations, this article explores workers’ experience of work and contributes to Bolton’s typology of emotion management in the relationship-based care endeavour. Our typology includes: (1) austerity-linked sacrifice; (2) official discourse; (3) faux control; and (4) compulsory time philanthropy. The article contributes to debates on care work, relationship-based care, emotional labour, and emotion management and working in the context of austerity and managerialism.

The Role of Relationship-Based Care in Developing Empathy Through Vulnerability: Visual Cues for Conversation and Change

Empathy is a word that is showing up in conversations across health-care organizations as we explore how to establish relationships with our patients to improve quality of care. According to researcher Brene' Brown, empathy is a connection with the heart, and cannot be expressed without touching our own vulnerability. In an increasingly complex and demanding health-care environment, with patient volumes and acuities impacting workflow and prioritization, it is important to explore vulnerability not only as a concept present in patient populations and our individual experiences as health-care professionals, but also as an unspoken and changing element in the entire clinical milieu. In a health-care world where focus is necessarily placed on quantitative metrics and outcomes, addressing concepts such as vulnerability can create a real challenge. Fear is an inherent by-product of vulnerability. As an aid to conversation and culture revision, this article presents a series of diagrams showing how focusing on the three relationships of Relationship-Based Care (RBC) (care for self, care for colleagues, and care for patients and families) can help shrink the fear associated with vulnerability. Fear initiates and perpetuates protective behaviors to keep us from feeling the uncertainty of vulnerability; those behaviors work against the development and nurturing of the RBC relationships. The three relationships of RBC provide a structure with which to explore vulnerability, allowing their principles and practices to help us open our hearts and lead us to the empathy we seek when serving our patients, ourselves, and each other.