Geriatrics and Gerontology

Biography

Biography: Elizabeth Andersen

Abstract

In Canada, over the past decade, care aides’ assistive and caring roles have expanded considerably due to dramatic shifts in staffing patterns in nursing homes. These shifts are due in part to tremendous health care cost pressures faced by federal and provincial governments and in part to new approaches to health care delivery. In contemporary approaches, the presence of Registered Nurses in long-term care facilities has diminished, while care aides are employed in escalating numbers. Care aides have become the most central or the most accessible/available service providers to residents. In many facilities, teams of care aides who used provided care to all residents have been abolished. Newer approaches favor consistent (non-rotating) assignment of residents to care aides. In theory, consistent assignments foster closer, more intimate relationships between care aides and nursing home residents and facilitate familiarity between care aides and families of residents. This ethnographic study is a portrayal of care aides’ thoughts and feelings about their consistent assignments. Experiential data were collected from 22 care aides working in five nursing homes in a western Canadian city. The data were analyzed utilizing constant comparison to identify common themes. Care aides who were consistently assigned to residents described working without reference to each other. Some described losing contact with residents/families not assigned to them. Others described feeling overwhelmed, isolated, and confined by this mode of assignment and described a strong need for collegial fellowship and friendship. Experienced care aides stressed the importance of shared tasks, interchangeable tasks, and joint decisions, and indicated that a return to teamwork would help them to moderate or buffer the effects of stressful events and/or work environments.