Doing ‘whatever they can imagine’: social task shifting in directly funded home care

Directly funded home care provides funds to individuals to arrange their own services. We ask, what is unique about being a directly funded home care worker? Our qualitative case study in Manitoba, Canada, included an online survey of 95 directly funded workers and interviews with 13 key informants, 24 clients and/or family managers, and 23 workers. Framed by feminist and disability care theories, we found ‘social task shifting’, that is: work that keeps households running and supports socialising; front-line worker involvement in care administration; and blurred relationships. Some directly funded workers are empowered by social task shifting, though the expectations can feel limitless.

The prioritisation of choice in eldercare: the case of Ireland

In recent decades, there has been a prioritisation of choice in eldercare in many Western countries. In many policy documents, choice is framed as giving older adults the choice to be cared for at home. The article draws on secondary sources to trace the impact of a logic of choice in eldercare in Ireland. It situates the analysis within the re-conceptualisation of care as a commodity and the home-care worker as the most ‘efficient’ option. The article examines the limitations of choice and questions whether choice should be the most important aspect of care in old age.

Work Postures When Assisting People at the Toilet

The aim of our study was to analyze home care workers’ movement patterns and back postures, relating them to risks while helping an ambulatory care recipient to and from the toilet in a homelike environment. We found that severe risks of unpredictable movements with exposed postures could explain many injuries. Because of high-risk injuries, we suggest decreasing the time when the care recipient stands and the home care worker helps with clothing and personal hygiene. We also suggest the development of support in front of the recipient to prevent her or him from falling forward.

A triadic perspective on elder neglect within the home care arrangement

ABSTRACTThe present study evaluates a conceptual model of elder neglect within the home care arrangement that takes into consideration the older adult, his or her family members, and the home care worker. Data from 223 complete care-giving units, which consist of an older adult, a family member and a home care worker, were analysed using structural equation modelling. Overall, 31.5 per cent of the older adults, 18 per cent of the care workers and 32.3 per cent of the family members reported at least one type of elder neglect. The proposed model showed a reasonable fit to the data. There was an inverse effect from type of home care to family member's burden and elder neglect, with live-in (around the clock) care being associated with lower levels of family member burden and elder neglect compared with live-out Israeli home care (provided for several hours per week). The amount of informal assistance provided by family members was inversely related to the amount of burden reported by home care workers, with greater informal assistance being associated with lower levels of worker burden. The findings call for the important role of formal home care by demonstrating a potentially protective effect for live-in migrant home care. The study also emphasises the shared burden between formal and informal sources of care.