Maintaining the ‘caring self’ and working relationships: a critically informed analysis of meaning-construction among paid companions in long-term residential care

• Published in: Ageing and society 2020-07, Vol.40 (7), p.1511-1528
• Main Authors: Funk, Laura M., Outcalt, Linda
• Format: Article
• Language: English
• Subjects: Dementia; Families & family life; Friendship; Insecure; Long term health care; Meaning; Narratives; Nursing homes; Older people; Patient-centered care; Political economy; Privatization; Residential care; Residential institutions; Social identity; Social participation; Social services; Temporary employment; Workers; Workforce planning; Working relationships
• ISSN: 0144-686X; 1469-1779
• DOI: 10.1017/S0144686X19000138

In Canadian residential long-term care, paid companion services are increasingly viewed as helping to meet older adults’ psycho-social needs. Complementing the critique of these services from a political economy perspective, analyses of companions’ talk about their work can illuminate not only why companions stay in devalued and often invisible work, but also how social assumptions and circulating narratives about nursing homes and older adults are implicated in this process. In this article, we draw on in-depth analyses of interviews with both companions and organisational representatives. We interpret companions’ accounts in relation to their need to justify the necessity for their work to their employers (families), to nurture good relationships with the facilities in which they work, and to maintain a sense of identity as a responsible, conscientious and ‘caring self’. In this way, these precarious workers inadvertently reproduce dominant narratives, including those that stigmatise dementia and residential care, and facilitate the privatisation of person-centred, relational care. Organisational representatives generally reproduce similar assumptions about care responsibilities, in a context in which facilities are increasingly challenged to meet a range of resident needs. Discussion highlights tensions around responsibility for psycho-social care in nursing homes, highlighting organisational vested interests in avoiding risk and downloading responsibilities to families and to private, independent and temporary workers.