Mapping Social Relations of Older Workers' Employment: Using Institutional Ethnography to Explore the Meaning and Organization of Work, Health, and Safety of Aging Workers in the Home Support Sector

Demographic trends both provincially and nationally indicate increasing life expectancy and growing numbers of older adults living with chronic disease and disability. Human resource projections predict that Canada will need to double the number of formal home care workers in order to meet future demands. This demographic change has also resulted in increasing numbers of older adults choosing to remain engaged in the workforce past the traditional age time of retirement. Research on supportive services in the community has identified the issues and challenges of homecare but little has addressed the complex interplay of economic, political, and social factors that have resulted in the health and safety challenges associated with the work provided by home support workers. Using a method of inquiry called Institutional Ethnography, this research explored the meaning of work and health and safety considerations of workers over 50 years old who are providing home support services in Newfoundland. This exploration of health and safety needs and practices, work environments, as well as policies and government systems regulating the employment of workers can be summarized into three threads that describe the everyday work of these aging home support workers: Crossing Boundaries - More Than Just a Job; Making it Work in Unhealthy and Unsafe Work Environments; and Becoming a Home Support Worker: Experience, Orientation, and Training Necessary to do the Work. The findings suggest that decision making practices to engage in risk taking behaviour that impact health and safety in the workplace are influenced by the meaning of work as well as the emotional connections and close, personal relationships with clients. It is anticipated that this research may positively influence the health and safety of aging workers in this sector. This will be achieved through the recommendations for policy and practice that emerged from this research including the development and implementation of a risk assessment tool for home support workers, clear standards on education, orientation, and training, wage parity with the acute care sector, and more clarity on title, roles, and responsibilities of home support workers.