Ageing International

, Volume 41, Issue 1, pp 62–78 | Cite as

Comparing Nursing Home Assistive Personnel in Five Countries

  • Katherine LaxerEmail author
  • Frode F. Jacobsen
  • Liz Lloyd
  • Monika Goldmann
  • Suzanne Day
  • Jacqueline A. Choiniere
  • Pauline Vaillancourt Rosenau


Assistive personnel are the primary caregivers in long-term residential care (LTRC) in industrialized countries. Our goal is to describe and compare the work-related characteristics of assistive personnel in LTRC in five countries (Canada, Germany, Norway, U.K., and U.S), which may reflect how various societies view their responsibility to aging populations and the workers who care for them. OECD and national statistical databases are used to assess and compare the work context for assistive personnel. Analysis of the statistical data is informed by on-site observations in nursing homes with reputations for high quality, close readings of these organizations’ documents and records, and interviews with LTRC staff. Pay is generally low and the work required of assistive personnel is often demanding in all countries studied. While most assistive personnel have completed high school, formal certification requirements vary considerably. Professionalization is increasing in Norway with its high school major in eldercare, and in Germany, which has a 2-year certificate program. Financial compensation for assistive personnel in Norway and Canada is greater than in the other countries. Union membership for assistive personnel ranges from very high in Canada to negligible in the U.S. Some countries studied have training programs of only a few months duration to prepare assistive personnel for highly demanding jobs. However, in Germany and Norway, training aims to professionalize the work of assistive personnel for the benefit of workers, employers, and residents. There are high rates of part-time and/or casual work among assistive personnel, associated with reduced employment-related benefits, except in Germany and Norway, where these benefits are statutory for all. Data suggest that unionization is protective for assistive personnel, however union coverage data were not available for all countries. The need to improve the qualifications and training of assistive personnel was observed to be a national priority everywhere except in the U.S. Compensation is relatively low in the U.K., the U.S. and Germany, despite the important jobs performed by assistive personnel. Finally, to improve future research, statistical mapping of this critical component of the labour force in LTRC should be a greater priority across high-income countries.


Long-term residential care Human resources Comparative Assistive personnel Care aides Nursing homes 



This article is based, in part, on data obtained from the MCRI project, “Re-Imaging Long-Term Residential Care: An International Study of Promising Practices,” funded by the Social Sciences and Research Council of Canada – Major Collaborative Research Initiative.

Compliance with Ethical Standards

Conflict of interest

Authors of this research declare that they have no conflict of interest.

Informed Consent

As there is no person or personal data appearing in the paper, there is no one from whom a permission should be obtained in order to publish personal data.

Ethical Treatment of Experimental Subjects (Animal and Human)

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Katherine Laxer
    • 1
    Email author
  • Frode F. Jacobsen
    • 2
  • Liz Lloyd
    • 3
  • Monika Goldmann
    • 4
  • Suzanne Day
    • 5
  • Jacqueline A. Choiniere
    • 6
  • Pauline Vaillancourt Rosenau
    • 7
  1. 1.School of Health Policy and Management, Faculty of HealthYork UniversityTorontoCanada
  2. 2.Center for Care Research - Western NorwayBergen University CollegeBergenNorway
  3. 3.University of BristolBristolUK
  4. 4.TU Dortmund University, Social Research CentreDortmundGermany
  5. 5.Re-Imaging Long-term Residential CareYork UniversityTorontoCanada
  6. 6.School of NursingYork UniversityTorontoCanada
  7. 7.Management, Policy, and Community Health DivisionUniversity of Texas Health Science Center at Houston - School of Public HealthHoustonUSA

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