Balancing the Tension in Long-Term Residential Care
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Although high income countries increasingly emphasize care at home, long-term residential care is and will remain the place where some of our most vulnerable live and work. Based on over 500 interviews with the entire range of actors in long-term residential care, intensive observations by interdisciplinary teams of at least 12 in 27 different sites in six countries and on background documents that take context into account, this paper explores tensions in long-term residential care. It argues that recognizing and balancing these tensions is critical to care and constitute promising practices. However, multiple pressures are shifting the balances in these tensions, with for-profit, chain ownership and the increasing pressure to emphasize clinical care among the most powerful forces.
KeywordsNursing homes Social care Risk Equity Regulations
Compliance with Ethical Standards
Conflict of Interest
Pat Armstrong declares no conflict of interest.
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 research received ethics approval from York University as well as from specific homes studied, where this was required.
- Armstrong, P., Banerjee, A., Szebehely, M., Armstrong, H., Daly, T., & Lafrance, S. (2009). They deserve better: The long-term care experience in Canada and Scandinavia. Ottawa: Canadian Centre for Policy Alternatives.Google Scholar
- Armstrong, P., Armstrong, H., & Daly, T. (2012). The thin blue line: Long-term care as an indicator of equity in welfare states. Canadian Woman’s Studies, 29(3), 49–60.Google Scholar
- Association of Workers Compensations Boards of Canada (2013). 2012 Injury Statistics. http://awcbc.org/?page_id=14.
- Bostock L., & Humphries, R. (2011). At a glance 45: Social Care and Clinical commissioning for people with long-term conditions. London: Scie. http://www.scie.org.uk/publications/ataglance/ataglance 45.asp.
- Cameron, W. B. (1963). Informal Sociology. A casual introduction to sociological thinking. New York: Random House.Google Scholar
- Canadian Institute for Health Information (CIHI) (2014). Drug Use Among Seniors on Public Drug Programs in Canada. 2012 Ottawa: CIHI https://secure.cihi.ca/free_products/Drug_Use_in_Seniors_on_Public_Drug_Programs_2012_EN_web.pdf.
- Chouinard, V., Hall, E., & Wilton, R. (Eds.). (2010). Towards enabling geographies: ‘disabled’ bodies and minds in Society and space. Farnham: Ashgate Press.Google Scholar
- Esping-Andersen, G. (1990). The three worlds of welfare capitalism. Cambridge: Polity Press.Google Scholar
- Finch, J., & Groves, D. (Eds.). (1983). A labour of love: Women, work and caring. London: Routledge.Google Scholar
- Fukui, H., Arai, A., & Toyoshima, K. (2012). Efficacy of music therapy in treatment for the patients with Alzheimer’s Disease. International Journal of Alzheimer's Disease. 2012 Article ID 531646, 6, doi: 10.1155/2012/531646.
- Gerard, M. N. (2010). A diagnosis of conflict: Theoretical barriers to integration in mental health services & their philosophical undercurrents. Philosophy, Ethics, and Humanities in Medicine, 5(4). doi: 10.1186/1747-5341-5-4.
- Goffman, E. (1961). Asylums: Essays on the social situation of mental patients and other inmates. New York: Anchor Books.Google Scholar
- Harrington, C. (2013). Understanding the relationship of nursing home ownership and quality in the United States. In G. Meagher, & M. Szebehely (Eds.), Marketization in Nordic Eldercare: A research report on Legislation, Oversight, Extent and Consequences (pp. 229–240). Stockholm: Stockholm University.Google Scholar
- Harrington, C., Choiniere, J., Goldmann, M., Jacobsen, F., Lloyd, L., McGregor, M., Stamatopoulos, V., & Szebehely, M. (2012a). Nursing home staffing standards and staffing levels in six countries. Journal of Nursing Scholarship, 44(1), 88–98. doi: 10.1111/j.1547-5069.2011.01430.x.CrossRefGoogle Scholar
- Harrington, C., Olney, B., Carrillo, H., & Kang, T. (2012b). Nurse staffing and deficiencies in the largest for-profit nursing home chains and chains owned by private equity companies. Health Services Research, 47(1, pt1), 106–128.Google Scholar
- Kamp, A. (2012). The quest for the meaning of work: Competing concepts of meaning. In A. Kamp & H. Hvid (Eds.), Elderly Care in Transition (pp. 51–82). Copenhagen Business School: Copenhagen.Google Scholar
- Lloyd, L., Banerjee, A., Fadnes, F., Harrington, C., & Szehebely, M. (2014). It's a scandal!: Comparing the causes and consequences of nursing home media scandals in five countries. International Journal of Sociology and Social Policy, 34(1–2), 2–18. doi: 10.1108/IJSSP-03-2013-0034.CrossRefGoogle Scholar
- Lowndes, R., Armstrong, P., & Daly, T. (2015). The meaning of “dining”: The social organization of food in LTC. Food Studies: An Interdisciplinary Journal, 4(1), 19–34.Google Scholar
- Marin, A. (2010). Confidential letter to the deputy minister of health and long term care Mr. Rafi Saäd. Toronto: Ontario Ombudsman.Google Scholar
- Messing, K. (1998). One-eyed Science. Occupational health and women workers. Philadelphia: Temple University Press.Google Scholar
- Music and Memory (2014). Alzheimer Society of Toronto’s iPod Project Study Finds Personalized Music Benefits Caregivers, Too. https://musicandmemory.org/?s=Alzheimer+society+of+toronto.
- Næss, A., Kvale Havig, A., & Vabø, M. (2013). Contested spaces – The perpetual quest for change in Norwegian nursing homes. In A. Hujala, S. Rissanen, & S. Vihma (Eds.), Designing Well-being in Elderly Care Homes (pp. 68–85). Helsinki: Aalto University.Google Scholar
- Ontario Ministry of Health and Long-Term Care (2012). Performance improvement and compliance branch inspection protocol. Dining: Observation.Google Scholar
- Ontario Ministry of Health and Long-Term Care. (2014). Home, Community and Residential Care Services Seniors' Care: Long-Term Care Homes. http://www.health.gov.on.ca/en/public/programs/ltc/15_facilities.aspx
- Ringard, A., Sagan, A., Sperre Saunes, I., & Lindahl, A. K. (2013). Norway. Health system review. Health Systems in Transition, 15(1), 1–182. http://www.euro.who.int/__data/assets/pdf_file/0018/237204/HiT-Norway.pdf..
- Sherrington, C. J., Whitney, C., Lord, S. R., Herbert, R. D., Cumming, R. G., & Close, J. C. T. (2008). Effective exercise for the prevention of falls: A systematic review and meta-analysis. Journal of the American Geriatric Society, 56(12), 2234–2243. doi: 10.1111/j.1532-5415.2008.02014.CrossRefGoogle Scholar
- Slama, C. A., & Bergman-Evans, B. (2000). A troubling triangle. An exploration of loneliness, helplessness, and boredom of residents of a veterans home. Journal of Psychosocial Nursing and Mental Health Services, 38(12), 36–43.Google Scholar
- Storm, P. (2013) Care work in Swedish nursing homes. In: A. Hujala, S. Rissanen, & S. Vihma (Eds.), Designing Well-being in Elderly Care Homes (pp. 148–161). Helsinki: Aalto University.Google Scholar
- Szebehely, M. and Meagher, G. (2013). Four Nordic countries-four responses to the international trend of marketisation. In G. Meagher, & M. Szebehely (Eds.), Marketization in Nordic Eldercare: A Research Report on Legislation, Oversight, Extent and Consequences (pp. 241–284). Stockholm: Stockholm University.Google Scholar
- The King’s Fund (2014) Commission on the Future of Health and Social Care in England. A new settlement for health and social care Interim Report (K. Barker, Chair) London: The King’s Fund. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/commission-interim-new-settlement-health-social-care-apr2014.pdf..