Long-Term Care Personal Support: "There's a System at Work"

Abstract

<p>The purpose of this research is to examine front line practices in long-term care (LTC) facilities and the conditions which variously preserve, enhance and constrain workers' efforts to provide personalized and identity supporting work with older adults deemed cognitively impaired. This interest derived from my experience as a student in a longterm care facility setting and matured through subsequent years of practice experience with cognitively impaired older adults.</p> <p>A modified form of institutional ethnography was employed to explore how personal support work in long-term care settings was "socially organized" by local and extra-local forces (Campbell & Gregor, 2002). A qualitative study was conducted, involving semistructured interviews with personal support workers employed in long-term care facilities. Participants were recruited from two, non-profit long-term care facilities in Southern Ontario. While small, this sample of front line experience can illuminate current practices in long-term care and stimulate conceptualization of its challenges and possibilities.</p> <p>A predominant theme in the findings is the constraint of 'time', which is exacerbated by factors, such as: staff shortages; Ministry standards, and demands of care; and performing underappreciated and undervalued tasks. Participants' accounts of their work with cognitively impaired older adults revealed their commitment to personalize care. Participants also described how they strove to negotiate time and organizational constraints in order to facilitate identity-supporting work. Lastly, participants offered suggestions for proposed changes to the organizational culture of long-term care and to improving their work conditions.</p> <p>In conclusion, the possibilities of organizational change efforts aimed at enhancing personalized care are considered, along with their policy and resource implications.</p>