Ageing International

, Volume 43, Issue 1, pp 53–73 | Cite as

Cleaning and Caring: Contributions in Long-term Residential Care

  • Beatrice Müller
  • Pat Armstrong
  • Ruth Lowndes


Cleaning and cleaners make three main contributions to long-term residential care. While cleaning in hospitals has received considerable research attention, much less attention has been paid to connecting cleaning and cleaners with the specific nature of long-term care and resident needs. In this article we explore three critical contributions cleaning and cleaners make to the quality of care in nursing homes. This work is central to infection control. It is also important in maintaining the appearance of the home; in making it home-like, welcoming, and safe. Much less visible is the significant part cleaners play in supporting relational care. Based on ethnographic studies in six countries, we argue that the extent to which cleaners and cleaning promote quality care and worker health is related to the division of labour, team work, training, equipment, and some autonomy.


Long-term care Care work Elder care Care homes Cleaning Relational care Division of labour Ethnography Feminist political economy Training Qualification Staffing levels 


Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflict of interest.

Informed Consent

We did obtain written, informed consent from all participants interviewed in this study. All interviews were audio recorded and transcribed verbatim. All names have been replaced by pseudonyms in order to maintain anonymity.

Ethical Treatment of Experimental Subjects (Animal and Human)

Ethical approval was obtained for this research from York University Research Ethics Board and in all jurisdictions requiring further ethics approval.


  1. Alamgir, H., & Yu, S. (2008). Epidemiology of occupational injury among cleaners in the healthcare sector. Occupational Medicine, 58(6), 393–399. doi: 10.1093/occmed/kqn028.CrossRefGoogle Scholar
  2. Andersen, B. M., Rasch, M., Hochlin, K., Tollefsen, T., & Sandvik, L. (2009). Hospital-acquired infections before and after healthcare reorganization in a tertiary university hospital in Norway. Journal of Public Health, 31(1), 98–104.CrossRefGoogle Scholar
  3. Armstrong, P. (2013). Puzzling skills. Feminist political economy approaches. Canadian Review of Sociology, 50(3), 256–283.CrossRefGoogle Scholar
  4. Armstrong, P., & Braedley, S. (2013). Troubling care. Critical perspectives on research and practices. Toronto: University of Toronto Press.Google Scholar
  5. Armstrong, P., & Connelly, M. P. (1989). Feminist political economy. An introduction. Studies in Political Economy, 30, 5–12.CrossRefGoogle Scholar
  6. Armstrong, P., Armstrong, H., & Coburn, D. (Eds.). (2001). Unhealthy times: Political economy perspectives on health and Care in Canada. Don Mills: Oxford University Press.Google Scholar
  7. Armstrong, P., Armstrong, H., & Scott-Dixon, K. (2008). Critical to care. The invisible women in health services. Toronto: University of Toronto Press Retrieved from Scholar
  8. Armstrong-Evans, M., Litt, M., McArthur, M., Willey, B., Cann, D., Liska, S., Nusinowitz, S., Gould, R., Blacklock, A., Low, D., & McGeer, A. (1999). Control of transmission of vancomycin-resistant enterococcus faecium in a long-term–care facility. Infection Control and Hospital Epidemiology, 20(5), 312–317. doi: 10.1086/501623.CrossRefGoogle Scholar
  9. Calvet, B., Riel, J., Couture, V., & Messing, K. (2012). Work organisation and gender among hospital cleaners in Quebec after the merger of “light” and “heavy” work classifications. Ergonomics, 55(2), 160–172.CrossRefGoogle Scholar
  10. Chesley, L., & Richards, C. L. (2004). Infections in long-term-care facilities: screen or clean? Infection Control and Hospital Epidemiology, 26(10), 800–801.Google Scholar
  11. Cohen, M.G. (2001). Do comparisons between hospital support workers and hospitality workers make sense - Prepared for Hospital Employees’ Union.
  12. Daly, T., & Szebehely, M. (2012). Unheard voices, unmapped terrain: care work in long-term residential care for older people in Canada and Sweden. International Journal of Social Welfare, 21(2), 139–148.CrossRefGoogle Scholar
  13. Dancer, S. J. (1999). Mopping up hospital infection. Journal of Hospital Infection, 43(2), 85–100. doi: 10.1053/jhin.1999.0616.CrossRefGoogle Scholar
  14. Dancer, S. J., White, L. F., Lamb, J., Girvan, E. K., & Robertson, C. (2009). Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over study. BMC Medicine, 7(1), 28.CrossRefGoogle Scholar
  15. Denton, M., Wilcox, M. H., Parnell, P., Green, G., Keer, V., Hawkey, P. M., Evans, I., & Murphy, P. (2005). Role of environmental cleaning in controlling an outbreak of Acinetobacter Baumannii on a neurosurgical intensive care unit. Intensive & Critical Care Nursing, 21(2), 94–98.CrossRefGoogle Scholar
  16. Feulner, M. (2014). Erst gemeinsam entsteht ein Ganzes. in: Altenheim, 53(6), 16–21.Google Scholar
  17. Fisher, B., & Tronto, J. (1990). Towards a feminist theory of caring. In E. K. Abel, & M. K. Nelson (Eds.), Circles of care: Work and identity in women’s lives. Albany: State University of New York Press.Google Scholar
  18. Friesema, I. H. M., Vennema, H., Heijne, J. C. M., de Jager, C. M., Morroy, G., Kerkhof, J. H. T. C., & van Duynhoven, Y. T. H. P. (2009). Norovirus outbreaks in nursing homes: the evaluation of infection control measures. Epidemiology and Infection, 137(12), 1722–1733. doi: 10.2307/40390507.
  19. Gamperiene, M., Nygård, J. F., Sandanger, I., Wærsted, M., & Bruusgaard, D. (2006). The impact of psychosocial and organizational working conditions on the mental health of female cleaning personnel in Norway. Journal of Occupational Medicine and Toxicology, 1(1), 24. doi: 10.1186/1745-6673-1-24.CrossRefGoogle Scholar
  20. Hayden, M. K., Bonten, M. J. M., Blom, D. W., Lyle, E. A., van Vijver, D. A. M. C., & Weinstein, R. A. (2006). Reduction in Acquisition of Vancomycin-Resistant Enterococcus after enforcement of routine environmental cleaning measures. Clinical Infectious Diseases, 42(11), 1552–1560.CrossRefGoogle Scholar
  21. Huth, E., Krüger, D., & Zorzi, G. (1996). Gesundheitsförderung im Krankenhausbetrieb. Hamburg: Fachhochschule Hamburg.Google Scholar
  22. James, N. (1992). Care = organisation + physical labour + emotional labour. Sociology of Health & Illness, 14(4), 488–509.CrossRefGoogle Scholar
  23. Kumar, R., & Kumar, S. (2008). Musculoskeletal risk factors in cleaning occupation-a literature review. International Journal of Industrial Ergonomics, 38(2), 158–170.CrossRefGoogle Scholar
  24. Kundrapu, S., Sunkesula, V., Jury, L. A., Sitzlar, B. M., & Donskey, C. J. (2012). Daily disinfection of high-touch surfaces in isolation rooms to reduce contamination of healthcare workers’ hands. Infection Control and Hospital Epidemiology, 33(10), 1039–1042. doi: 10.1086/667730.CrossRefGoogle Scholar
  25. Messing, K. (1998). Hospital trash: cleaners speak of their role in disease prevention. Medical Anthropology Quarterly, 12(2), 168–187.CrossRefGoogle Scholar
  26. Messing, K., Chatigny, C., & Courville, J. (1998). “Light” and “heavy” work in the housekeeping service of a hospital. Applied Ergonomics, 29(6), 451–459.CrossRefGoogle Scholar
  27. Orenstein, R., Aronhalt, K. C., McManus, J. E., & Fedraw, L. A. (2011). A targeted strategy to wipe out Clostridium Difficile. Infection Control and Hospital Epidemiology, 32(11), 1137–1139.CrossRefGoogle Scholar
  28. Rampling, A., Wiseman, S., Davis, L., Hyett, A. P., Walbridge, A. N., Payne, G. C., & Cornaby, A. J. (2001). Evidence that hospital hygiene is important in the control of methicillin-resistant Staphylococcus aureus. Journal of Hospital Infection, 49(2), 109–116.CrossRefGoogle Scholar
  29. Sharkey, S. S., Hudak, S., Horn, S., James, B., & Howes, J. (2011). Frontline caregiver daily practices: a comparison study of traditional nursing homes and the green house project sites. Journal of the American Geriatrics Society, 59(1), 126–131.CrossRefGoogle Scholar
  30. Sie, I., Thorstad, M., Andersen, B., & M. (2012). Personal- and environmental hygiene in Norwegian nursing homes. Journal of Nursing Education and Practice, 2(1), 71–81.CrossRefGoogle Scholar
  31. Strausbaugh, L. J., Sukumar, S. R., & Joseph, C. L. (2003). Infectious disease outbreaks in nursing homes: an unappreciated hazard for frail elderly persons. Clinical Infectious Diseases, 36(7), 870–876.CrossRefGoogle Scholar
  32. Toffolutti, V., Reeves, A., McKee, M., & Stuckler, D. (2017). Outsourcing cleaning services increases MRSA incidence: Evidence from 126 english acute trusts. Social Science & Medicine, 174, 64–69. doi: 10.1016/j.socscimed.2016.12.015.
  33. Twigg, J. (2000). Carework as a form of bodywork. Ageing and Society, 20(4), 389–411.CrossRefGoogle Scholar
  34. Valiquette, L., Low, D. E., Pépin, J., & McGeer, A. (2004). Clostridium Difficile infection in hospitals: a brewing storm. Canadian Medical Association Journal, 171(1), 27–29. doi: 10.1503/cmaj.1040957.CrossRefGoogle Scholar
  35. Woods, V., & Buckle, P. (2006). Musculoskeletal ill health amongst cleaners and recommendations for work organisational change. International Journal of Industrial Ergonomics, 36(1), 61–72.CrossRefGoogle Scholar
  36. Wu, H. M., Fornek, M., Schwab, K. J., Chapin, A. R., Gibson, K., Schwab, E., Spencer, C., & Henning, K. (2005). A norovirus outbreak at a long-term-care facility: the role of environmental surface contamination. Infection Control and Hospital Epidemiology, 26(10), 802–810.CrossRefGoogle Scholar
  37. Ye, Z., Mukamel, D. B., Huang, S. S., Li, Y., & Temkin-Greener, H. (2015). Healthcare-associated pathogens and nursing home policies and practices: results from a National Survey. Infection Control & Hospital Epidemiology, 36(7), 759–766. doi: 10.1017/ice.2015.59.CrossRefGoogle Scholar
  38. Zuberi, D. (2013). Cleaning up: how hospital outsourcing is hurting workers and endangering patients. Ithaca: ILR Press, an imprint of Cornell University Press.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.University of VechtaVechtaGermany
  2. 2.York UniversityTorontoCanada

Personalised recommendations