Margaret Denton

Job stress and job dissatisfaction of home care workers in the context of health care restructuring.

Changes in the social organization of home care work due to health care restructuring have affected the job stress and job dissatisfaction of home care workers. This article reports the results of a survey of 892 employees from three nonprofit home care agencies in a medium-sized city in Ontario, Canada. Survey results are complemented by data from 16 focus groups with 99 employees. For the purposes of this study, home care workers include both office workers (managers, supervisors, coordinators, office support staff, and case managers) and visiting workers (nurses, therapists, and visiting homemakers). Focus group participants indicated that health care restructuring has resulted in organizational change, budget cuts, heavier workloads, job insecurity, loss of organizational support, loss of peer support, and loss of time to provide emotional laboring, or the “caring” aspects of home care work. Analyses of survey data show that organizational change, fear of job loss, heavy workloads, and lack of organizational and peer support lead to increased job stress and decreased levels of job satisfaction.

Nursing Generations in the Contemporary Workplace

Preserving a viable workforce is contingent upon recruiting and retaining more young people and persuading older workers to remain with the organization. The success of these efforts may depend on offering appropriate incentives to workers in different age cohorts. Although only limited research has been carried out on the topic, findings have consistently shown that the workforce consists of generational groups with different attributes and priorities. This mixed-methodology study uses survey and focus group results to explore some of the differences among age cohorts of nurses in three Canadian hospitals. The research revealed significant differences in career commitment; affective, normative, and continuity commitment to the organization; job satisfaction; stress and emotional exhaustion; depersonalization; personal accomplishment; and propensity to leave the hospital. This article concludes with recommendations for policies that address the needs of nurses of different ages.

The Linkages between Informal and Formal Care of the Elderly

The purpose of this paper is to report research findings from a study of the nature of the relationship between informal and formal care of the elderly. There are several explanations for the link between informal and formal care: the task specific model, the compensatory model, the substitution model, the supplementary model, and the complementary model (which combines both the compensatory and supplementary functions of formal care). These explanations were evaluated using data from the 1985 General Social Survey for those aged 65 and older who have functional disabilities. Data were analysed using logistic regression analysis. The findings show support for the complementary function of formal care. The data indicate that formal care compensates for the absence of a spouse or child and, in a minority of cases, supplements work of the spouse or child caregiver for personal care tasks and to a lesser extent housework. Of these two, the compensatory effect of formal care appears to be more prevalent than the supplemental effect.

The Gender Wealth Gap: Structural and Material Constraints and Implications for Later Life

ABSTRACT Wealth is an important measure of economic well-being, because while income captures the current state of inequality, wealth has the potential for examining accumulated and historically structured inequality. This presentation documents the extent of gender inequality in wealth for Canadian women and men aged 45 and older. The analysis uses data from the 1999 Canadian Survey of Financial Security, a large nationally representative survey of household wealth in Canada. Wealth is measured by total net worth as measured by total assets minus debt. We test two general hypotheses to account for gender differences in wealth. The differential exposure hypothesis suggests that women report less wealth accumulation because of their reduced access to the material and social conditions of life that foster economic security. The differential vulnerability hypothesis suggests that women report lower levels of wealth because they receive differential returns to material and social conditions of their lives. Support is found for both hypotheses. Much of the gender differences in wealth can be explained by the gendering of work and family roles that restricts womens ability to build up assets over the life course. But beyond this, there are significant gender interaction effects that indicate that women are further penalized by their returns to participation in family life, their health and where they live. When women do work, net of other factors, they are better able to accumulate wealth than their male counterparts.

Perceived Participation in Decision-Making in a University Setting: The Impact of Gender

This analysis of responses to a 1988 survey of full-time faculty at a medium-sized university in central Canada indicates that women were less likely than men to perceive themselves as participating in university decision-making, even with controls for other relevant variables. Academic rank, visible or ethnic minority status, and membership in networks were also influential. No significant effect was found for the possession of a Ph.D., the amount of teaching experience, the possession of tenure, having a mentor, or the proportion of women in the divisions faculty.

Market-Modelled Home Care in Ontario: Deteriorating Working Conditions and Dwindling Community Capacity

The closure of a non-profit, unionized home support agency in Hamilton in 2002 offers an illuminating case study of the local impacts of Ontarios contractual approach to home care. A survey of the 317 support workers who were laid off revealed that only 38 percent stayed in the home-care sector; most were absorbed by for-profit, non-unionized agencies where their employment conditions deteriorated. These findings are at odds with the long-established connection between quality of home-care employment and quality of home-care service. They have implications for developing criteria for dispersing public funds in mixed economies of community care, and for conceptualizing the capacity-building responsibilities of governments in their coordination.

Occupational Health Issues Among Employees of Home Care Agencies

The purpose of this paper is to explore occupational health issues among employees of home care agencies. Results of a survey of 892 office and visiting employees of three not-for-profit home care agencies and focus group discussions show that employees of home care agencies experience high levels of stress, tiredness and exhaustion. This work-related stress is most acutely felt by those in managerial occupations, nurses and therapists. When compared to findings from the Canadian National Population Health Survey, employees of home care agencies are found to be significantly more likely than all working women to suffer from allergies, asthma, arthritis or rheumatism, back problems, high blood pressure, migraine headaches, and work-related injuries in the past year. Many employees of home care agencies suffer pain or discomfort in several body locations. Visiting employees of home care agencies suffer from sprains or strains, dislocations, fractures, and bruises as a result of lifting or moving clients, bending or straining, accidental falls, repetitive motion injuries, and motor vehicle accidents. Home care office staff suffer from repetitive strain injuries and respiratory illness. Implications for policy and research are discussed.

Market-Modelled Home Care: Impact on Job Satisfaction and Propensity to Leave

Responding to increasing health-care costs, deficit financing and the aging of the population, many OECD nations are exploring new cost-efficient health-care models. One such model, designed to manage the homebased health-care system through the application of quasi-market principles has been adopted by the province of Ontario. Findings from a case study of 835 Ontario home-care workers indicate that a market-modelled approach to health-care restructuring may be leading to decreased levels of job satisfaction and a greater propensity to leave among workers in the home-care sector.

Older Adults' Awareness of Community Health and Support Services for Dementia Care

The article examines where older adults seek help in caring for a parent with dementia and the factors associated with their identification of community health and support services as sources of assistance. The authors conducted telephone interviews, using random digit dialing, of 1,152 adults aged 50 and over in the city of Hamilton. Respondents received a vignette that raised issues related to parental dementia. In identifying support sources, over 37 per cent of respondents identified their physician, 33 per cent identified informal support such as family and neighbors, and 31 per cent identified home health services. Only 18 per cent identified community support services. Female participants having higher levels of education were more likely to identify their physician as a source of support. Knowing where to find information about community support services was associated with an increased likelihood of mentioning physicians and home health services as sources of assistance. L’article examine où les personne agées peuvent chercher l’aide pour prendre soin d’un parent avec démence et les facteurs associés à leur identification des services de santé et de soutien communautaires comme des sources d’aide. Les auteurs menées des entrevues téléphoniques, à l’aide de numérotation de chiffres aléatoires, de 1,152 adultes âgés de 50 et plus dans la ville de Hamilton. À déterminer les sources de soutien, plus 37 pour cent des répondants a identifié leur médecin, 33 pour cent a identifié un soutien informel comme la famille et voisins et 31 pour cent a identifié des services de santé maison. Seulement 18 pour cent a identifié des services de soutien communautaires. Participants femmes ayant des niveaux plus élevés de scolarité étaient plus susceptibles d’identifier leur médecin comme une source de soutien. Savoir où trouver renseignements sur services de soutien communautaires était associée à une probabilité accrue de mentionnant des médecins et des services de santé maison comme sources d’aide.

Identifying research priorities in long term care homes.

Concerns about the quality of care in long term care (LTC) homes range from inadequate daily care to understaffing and insufficient funding. LTC decision makers are challenged to keep up with the changing demographics of residents admitted to LTC who have increasingly complex care needs. Decisions regarding LTC policies and procedures need to be informed by research that identifies the most effective and efficient care practices. This study solicited feedback from LTC decision makers in Ontario, Canada, regarding research priorities to guide improvement in the quality of care in LTC homes. Representatives from 134 LTC homes responded (53.6% response rate). Nine thematic areas of research were identified: delivery of care; staffing; organization and structure of homes; funding; indicators, standards, policies, and procedures; managing difficult behaviors; education; safety; and infectious disease control. It is anticipated that these themes will steer research down a path that is responsive to the information needs of practitioners in LTC homes.