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Care Aides’ Perceptions and Experiences of their Roles and Relationships with Residents in Long-term Care Settings

  • Author / Creator
    Andersen, Elizabeth A
  • The purpose of this study was to explore care aides’ perceptions and experiences of their roles and relationships with residents in long-term care institutions, and how the context, including the organizational philosophy, influenced those perceptions and experiences. The method of exploration was qualitative focused ethnography. Convenience and purposive sampling were used to recruit 22 care aides from five long-term care facilities in a western Canadian city. Data were collected via semi-structured interviews. Data analysis utilized constant comparison to identify themes or patterns within and across participants as well as comparison of new data to data previously analyzed. It emerged that a dominant influence on care aides’ perceptions of their roles and relationships was the way they experienced a model of cultural change called the Eden Alternative®. The Eden Alternative® model aims to increase quality of life for institutionalized persons by restructuring delivery of care and transforming institutional environments into more habitable places to live. However, although the care aides believed in an ideal occupational relational purpose or state, they perceived that the model had been incompletely implemented in their facilities, was incompatible with an existing organizational policy, and had eroded after implementation. Instead of feeling supported and reassured by fellowship, most of the care aides worked with the residents alone and without reference to each other. They emphasized what separated them, rather than what united them. Without a shared purpose and collegial connections they felt a reduced relationship to the larger residential community. Meaningful personal connections with residents no longer assigned to them were lost. They felt overburdened by their expanded responsibilities; they found themselves engaged in conflicts with residents and families; and many felt unsupported by management. As a consequence, they had little time or energy to be compassionate, empathetic partners to the residents permanently assigned to them. This study contributes to the body of knowledge used by registered nurses, nurse educators and nursing home managers/administrators who train and support care aides and may be useful to managers/administrators who make the decisions that shape and affect services provided to residents.

  • Subjects / Keywords
  • Graduation date
    2012-11
  • Type of Item
    Thesis
  • Degree
    Doctor of Philosophy
  • DOI
    https://doi.org/10.7939/R3665P
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
    English
  • Institution
    University of Alberta
  • Degree level
    Doctoral
  • Department
    • Faculty of Nursing
  • Supervisor / co-supervisor and their department(s)
    • Dr. Judith Spiers, Faculty of Nursing
  • Examining committee members and their departments
    • Dr. Kathleen Hunter, Faculty of Nursing, University of Alberta
    • Dr. Pauline Paul, Faculty of Nursing, University of Alberta
    • Dr. Belinda Parke, Faculty of Nursing, University of Alberta
    • Dr. Laurel Strain, Department of Sociology, University of Alberta
    • Dr. Katherine McGilton, External Reader, Senior Scientist Toronto Rehab