Personal care homes have become increasingly dependent on the employment of immigrant care workers. This qualitative study explored the high concentration of Filipino health care aides in personal care homes from their own perspectives, as well as that of policy stakeholders. In depth interviews were conducted with seven Filipino health care aides working in personal care homes in Winnipeg, Manitoba. Semi-structured interviews with policy stakeholders examined the policy context of the health care aide labour force. The study identified several factors that influenced the migration and employment of Filipino health care aides including: poverty and unemployment, migrant social networks, barriers in the labour market and financial incentives. The lack of regulations for health care aides sustained the flow of immigrant labour and enabled the expansion of social networks. Although their employment decisions were primarily based on financial need, health care aides valued their work and viewed themselves as critical care providers.

Falls among older adults (age 65 years and older) residing in personal care homes (PCHs) are an important health concern. Atypical antipsychotic drugs (AADs) have been shown to be associated with fall risk among older adults. However, previous studies face some methodological limitations that affect the quality, consistency, and comparability of these studies. Therefore, a population-based study was undertaken to examine the effect of AAD use on the risk of falling among older PCH residents. A nested case-control study was conducted using the administrative healthcare records and Minimum Data Set for PCHs (MDS) housed at the Manitoba Centre for Health Policy in the Faculty of Medicine, University of Manitoba. The study period was from April 1, 2005 to March 31, 2007. Cases (n=626) were fallers as recorded in MDS. Using incidence density sampling, each case was matched to four controls on length of PCH stay, age, and sex (n=2,388). Exposure to AADs was obtained from the Drug Program Information Network database. Conditional logistic regression was used to model the effects of AAD use on the risk of falling while accounting for matching and for confounding of other covariates. While the adjusted odds of falling was statistically greater for AAD users versus nonusers (adjusted odds ratio = 1.60, 95% CI 1.10-2.32), this association was type and dose dependent. Compared to nonusers, the odds of falling was greater for quetiapine users, regardless of this drug's dose, and high dose risperidone users. On the other hand, low dose risperidone and olanzapine, irrespective of drug dose, use was not associated with the risk of falling. Furthermore, the effect of AAD use, in general, on the risk of falling was significantly greater for people with wandering problems (adjusted odds ratio = 1.84, 95% CI 1.09-3.09). Despite some methodological limitations, this research has provided some unique findings that enhance our understanding of AAD use as a fall risk factor. Study findings allow policymakers to further develop evidence-based interventions specific to AADs in order to better manage falls in the PCH setting. However, a great deal of research is still needed to address other important unanswered questions.

Personal care homes have become increasingly dependent on the employment of immigrant care workers. This qualitative study explored the high concentration of Filipino health care aides in personal care homes from their own perspectives, as well as that of policy stakeholders. In depth interviews were conducted with seven Filipino health care aides working in personal care homes in Winnipeg, Manitoba. Semi-structured interviews with policy stakeholders examined the policy context of the health care aide labour force. The study identified several factors that influenced the migration and employment of Filipino health care aides including: poverty and unemployment, migrant social networks, barriers in the labour market and financial incentives. The lack of regulations for health care aides sustained the flow of immigrant labour and enabled the expansion of social networks. Although their employment decisions were primarily based on financial need, health care aides valued their work and viewed themselves as critical care providers.

Falls among older adults (age 65 years and older) residing in personal care homes (PCHs) are an important health concern. Atypical antipsychotic drugs (AADs) have been shown to be associated with fall risk among older adults. However, previous studies face some methodological limitations that affect the quality, consistency, and comparability of these studies. Therefore, a population-based study was undertaken to examine the effect of AAD use on the risk of falling among older PCH residents. A nested case-control study was conducted using the administrative healthcare records and Minimum Data Set for PCHs (MDS) housed at the Manitoba Centre for Health Policy in the Faculty of Medicine, University of Manitoba. The study period was from April 1, 2005 to March 31, 2007. Cases (n=626) were fallers as recorded in MDS. Using incidence density sampling, each case was matched to four controls on length of PCH stay, age, and sex (n=2,388). Exposure to AADs was obtained from the Drug Program Information Network database. Conditional logistic regression was used to model the effects of AAD use on the risk of falling while accounting for matching and for confounding of other covariates. While the adjusted odds of falling was statistically greater for AAD users versus nonusers (adjusted odds ratio = 1.60, 95% CI 1.10-2.32), this association was type and dose dependent. Compared to nonusers, the odds of falling was greater for quetiapine users, regardless of this drug's dose, and high dose risperidone users. On the other hand, low dose risperidone and olanzapine, irrespective of drug dose, use was not associated with the risk of falling. Furthermore, the effect of AAD use, in general, on the risk of falling was significantly greater for people with wandering problems (adjusted odds ratio = 1.84, 95% CI 1.09-3.09). Despite some methodological limitations, this research has provided some unique findings that enhance our understanding of AAD use as a fall risk factor. Study findings allow policymakers to further develop evidence-based interventions specific to AADs in order to better manage falls in the PCH setting. However, a great deal of research is still needed to address other important unanswered questions.

The case study examined physical and social privacy for nine residents residing in personal care homes in Winnipeg, Manitoba, Canada. The study explored how residents’ well-being and quality of life was affected by the privacy afforded to them in various room accommodations. The case study explored residents’ social location, room preference, safety and security, communication with family, interaction with staff, and interaction with roommates. The study found that residents benefit from having access to locks for doors; specialized units for cognitively impaired residents; private health assessment rooms; phasing out multi-bed room; use of room barriers; privacy for intimacy; access to private lounges for visiting; and private room with a public telephone. The study assists health care providers and students in health fields in becoming aware of privacy issues. The study may be useful in assisting residents to prepare for adjustment to a personal care home.

Purpose: to understand the tasks that health care aides (HCAs) are responsible for in a nursing home setting, and to understand which of these tasks HCAs feel are more important. Methods: In Phase 1, focus groups were conducted to validate the list of tasks and ensure HCAs could differentiate between them, according to task urgency, quality of care, and quality of life. During Phase 2, HCAs participated in a Delphi process to reach consensus on the relative importance of these tasks. Results: Participants reached consensus that 12 of 31 tasks were highly important according to task urgency. Of these, 10 were from the medical domain (e.g., skin care). Similar results were reached for the other definitions of importance. Conclusions: This study provides a framework for classifying HCA tasks into three domains (medical, social and indirect). Irrespective of the definition of importance used, medical tasks are consistently deemed as more important. / October 2016

This qualitative exploratory research study examined the experiences of older women (over age 55) whose husbands had been admitted to a personal care home (PCH) in Winnipeg, Manitoba within the previous twelve (12) months. In-depth, semi-structured, one-on-one interviews were conducted with six (6) women. Socialist feminist and feminist caregiving theoretical frameworks along with narrative analysis were used gain insight into the participants’ needs surrounding their experiences of the admission. Findings include the fact that changes in women’s formal and informal supports began occurring years before their husbands’ admissions. The all-encompassing role as caregiver for their families continued to be central in their lives even after the admission. While women met their material and emotional needs through a range of formal and informal services, the participants were more likely to see needs met through informal means. Themes emerging from the research included those of guilt, entitlement, obligation, and reciprocity.

This qualitative exploratory research study examined the experiences of older women (over age 55) whose husbands had been admitted to a personal care home (PCH) in Winnipeg, Manitoba within the previous twelve (12) months. In-depth, semi-structured, one-on-one interviews were conducted with six (6) women. Socialist feminist and feminist caregiving theoretical frameworks along with narrative analysis were used gain insight into the participants’ needs surrounding their experiences of the admission. Findings include the fact that changes in women’s formal and informal supports began occurring years before their husbands’ admissions. The all-encompassing role as caregiver for their families continued to be central in their lives even after the admission. While women met their material and emotional needs through a range of formal and informal services, the participants were more likely to see needs met through informal means. Themes emerging from the research included those of guilt, entitlement, obligation, and reciprocity.

Resident-centered care has been the standard philosophy in accredited personal care homes (PCHs) across Canada since 1990. Health care aides (HCAs) are the primary health care providers in PCHs and key to residents' quality of care and quality of life. However, studies have not examined HCA work satisfaction in relation to the four elements of resident-centered care: providing flexible scheduling, following residents' preferences, promoting a home-like environment and offering permanent assignment to promote consistency of care. This cross-sectional, ethnographic study was conducted using face-to-face interviews with nine HCAs working in four PCHs in Winnipeg, Manitoba, Canada. The results indicate that HCAs' work satisfaction was highly related to their caring relationships with residents and their working relationships with other HCAs and staff. The implementation of resident-centered care depended on institutional and managerial support. Lack of this support created stressful situations for HCAs and caused them concern about the quality of care and quality of life of residents. / May 2009

Resident-centered care has been the standard philosophy in accredited personal care homes (PCHs) across Canada since 1990. Health care aides (HCAs) are the primary health care providers in PCHs and key to residents' quality of care and quality of life. However, studies have not examined HCA work satisfaction in relation to the four elements of resident-centered care: providing flexible scheduling, following residents' preferences, promoting a home-like environment and offering permanent assignment to promote consistency of care. This cross-sectional, ethnographic study was conducted using face-to-face interviews with nine HCAs working in four PCHs in Winnipeg, Manitoba, Canada. The results indicate that HCAs' work satisfaction was highly related to their caring relationships with residents and their working relationships with other HCAs and staff. The implementation of resident-centered care depended on institutional and managerial support. Lack of this support created stressful situations for HCAs and caused them concern about the quality of care and quality of life of residents.