Teaming up for long-term care: Recognizing all long-term care staff contribute to quality care.

When looking to promising international approaches to improve quality care in long-term care, it is necessary to avoid cherry-picking specific dimensions ignoring the integrated nature of what makes these approaches promising in the first place. In looking at promising Scandinavian or Green House models, attention is often paid to the size of facility. This often overlooks the importance of higher level of staffing, mix, and compensation of direct care staff and the integration of dietary, laundry, and housekeeping staff to care teams.

Leadership for quality in long-term care.

Leadership in long-term care is a burgeoning field of research, particularly that which is focused on enabling point of care staff to provide high-quality and responsive healthcare. In this article, we focus on the relatively important role that leadership plays in enabling the conditions for high-quality long-term care. Our methodological approach involved a rapid in-depth ethnography undertaken by an interdisciplinary team across eight public and non-profit long-term care homes in Canada, where we conducted over 1,000 hours of observations and 275 formal and informal interviews with managers, staff, residents, family members and volunteers.

Is there a future for nursing homes in Canada?

The high rates of nursing home deaths in the wake of COVID-19 have led to calls for their elimination and their replacement by home care. Based on years of research in Canada and abroad, this article argues that nursing homes are not just necessary, they provide significant benefits for those living in, working in, and visiting in them. In developing this argument, the article begins by setting out why long-term residential care is necessary before moving on to consider the benefits of such care, benefits that go beyond the clinical.

"Careworkers don't have a voice:" epistemological violence in residential care for older people.

Drawing on feminist epistemologies, this paper attends to the way the reductionist assumptions have shaped the organization of nursing home carework in manners that are insufficient to the needs of relational care. This paper is informed by a study involving nine focus groups and a survey of Canadian residential care workers (141 RNs, 139 LPNs and 415 frontline careworkers). Four major themes were identified.

Structural violence in long-term, residential care for older people: comparing Canada and Scandinavia.

Canadian frontline careworkers are six times more likely to experience daily physical violence than their Scandinavian counterparts. This paper draws on a comparative survey of residential careworkers serving older people across three Canadian provinces (Manitoba, Nova Scotia, Ontario) and four countries that follow a Scandinavian model of social care (Denmark, Finland, Norway, Sweden) conducted between 2005 and 2006. Ninety percent of Canadian frontline careworkers experienced physical violence from residents or their relatives and 43 percent reported physical violence on a daily basis.

Lifting the 'violence veil': examining working conditions in long-term care facilities using iterative mixed methods.

We conducted a mixed-methods study-- the focus of this article--to understand how workers in long-term care facilities experienced working conditions. We surveyed unionized care workers in Ontario (n = 917); we also surveyed workers in three Canadian provinces (n = 948) and four Scandinavian countries (n = 1,625). In post-survey focus groups, we presented respondents with survey questions and descriptive statistical findings, and asked them: "Does this reflect your experience?" Workers reported time pressures and the frequency of experiences of physical violence and unwanted sexual attention, as we explain.

Qualitative research and the politics of knowledge in an age of evidence: developing a research-based practice of immanent critique.

This paper offers an expository discussion of an approach to qualitative health research we call immanent critique. The central analytic move of immanent critique, as we have practiced it, is to explore how claims that are internal to authoritative discourse are experienced by those who have been excluded from their formulation. This paper contributes to the discussion of the politics of qualitative research methods in an age of evidence.