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Rural Long-term Care Work, Gender, and Restructuring*

Published online by Cambridge University Press:  23 May 2011

Belinda Leach  and
Gillian Joseph
Belinda Leach*
Affiliation:
University of Guelph
Gillian Joseph
Affiliation:
University of Waterloo
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Belinda Leach, Ph.D. College of Social and Applied Human Sciences University of Guelph 50 Stone Rd. East Guelph, ON N1G 2W1 (bleach@uoguelph.ca)
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Abstract

Restructuring – the introduction of changes that alter the way health care is delivered for maximum efficiency and least cost – layered with rurality and with rural gender ideologies and practices, results in rural long-term care settings that have particular consequences for the women working in them, and for the residents and communities that they serve. This research investigated how rurality affects the implementation of patient classification in Ontario long-term care homes. Methods involved interviews and focus groups with front-line long-term care workers, administrators, and key participants. The findings revealed that rural long-term care delivery takes place when a restructured work environment intersects with gender ideologies and practices that take on particular characteristics when developed and sustained in a rural context. These factors shape the labor market and working conditions for rural women. We argue that this produces a uniquely rural experience for long-term care workers and conclude that those implementing classification systems must consider contextual factors as well as practical and financial exigencies.

Résumé

La restructuration – l’introduction de changements qui modifient la façon dont les soins de santé sont délivrés pour optimiser l’éfficacité à moindre coût – s’ajoutant à la ruralité et aux idéologies et pratiques sexistes des milieux ruraux produit des établissements de soins longue durée dont les environnements ne sont pas sans conséquences particulières pour leur personnel féminin et pour les résidents et les communautés qu’ils desservent.

Cette étude avait pour but d’évaluer dans quelle mesure la ruralité affecte la mise en place de la classification des patients dans les foyers de soins longue durée en Ontario. La méthodologie de l’étude comprenait des entretiens et des groupes de travail avec du personnel de soins longue durée directement en contact avec les patients, des administrateurs et des informateurs clés en première ligne. Les conclusions de l’étude ont montré que l’offre des soins de santé de longue durée en milieu rural a lieu lorsqu’un environnement de travail restructuré rejoint les idéologies et pratiques qui prennent des caractéristiques particulières lorsque celles-ci ont été developpées et soutenues dans un contexte rural. Ces facteurs determinent le marché du travail et les conditions de travail des femmes en milieu rural. Nous défendons que ceci produit une expérience rurale unique pour le personnel des soins longue durée, et nous concluons que ceux qui mettent en place les systèmes de classification doivent prendre en compte les facteurs contextuels tout autant que les exigences pratiques et financières.

Keywords

maisons de soins infirmierspersonnel de soins longue duréesexesoins de santé longue durée en milieu ruralle contexte de soinsclassification des patientsvieillissementnursing homescare workgenderrural eldercarecare contextpatient classificationaging
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 30 , Issue 2 , June 2011 , pp. 211 - 221
Copyright
Copyright © Canadian Association on Gerontology 2011

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Footnotes

*

The study was funded by Status of Women Canada’s Policy Research Fund. We thank our co-investigator, Bonnie Hallman and research assistants Nichola Martin and Anita Marcotte for their contributions to the study.

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