“If I Do not Go to Work, They Will Die!” Dual Roles of Older-Adult Personal Support Workers’ Contributions During the COVID-19 Pandemic

Abstract

When COVID-19 devastated older-adult organizations (long-term care homes and retirement homes), most public attention was directed toward the older-adult residents rather than their service providers. This was especially true in the case of personal support workers, some of whom are over the age of 55, putting them in two separate categories in the COVID-19 settings: (1) a vulnerable and marginalized group who are disproportionately impacted by COVID-19; and (2) essential healthcare workers. Since the current disaster-driven research, practice, and policy have primarily focused on generalized assumptions that older-adults are a vulnerable, passive, and dependent group rather than recognizing their diversity, expertise, assets, and experiences, this study aimed to identify their contributions from the perspective of older-adult personal support worker (OAPSW). This qualitative study conducted in-depth interviews, inviting 15 OAPSWs from the Greater Toronto Area, Canada. This study uncovered the OAPSWs’ contribution at three levels: individual (enhancing physical health, mental health, and overall well-being), work (improving working environment and service and supporting co-workers), and family (protecting their nuclear and extended families). The outcomes inform the older-adult research, practice, policy, public discourse, and education by enhancing the appreciation of older-adults’ diverse strengths and promoting their engagement and contributions in disaster settings.

Keywords

Canada / COVID-19 / Individual-work-family triangulation / Older-adult personal support workers

References

[] Adams, R., and H. Wu. 2020. Enhancing our healthcare heroes’ overall well-being: Balancing patient health, personal risk, and family responsibilities during the COVID-19 pandemic. Natural Hazards Center Grant Report Series, 316. Boulder, CO: Natural Hazards Center, University of Colorado Boulder. https://hazards.colorado.edu/quick-response-report/balancing-patient-health-personal-risk-and-family-responsibilities-during-the-covid-19-pandemic. Accessed 1 Apr 2024.

[] Aldrich N, Benson WF. Disaster preparedness and the chronic disease needs of vulnerable older adults. Preventing Chronic Disease, 2008, 5(1): Article A27

[] Allison TA, Oh A, Harrison KL. Extreme vulnerability of home care workers during the COVID-19 pandemic—A call to action. JAMA Internal Medicine, 2020, 180(11): 1459-1460,

[] Barusch AS. Disaster, vulnerability, and older adults: Toward a social work response. Journal of Gerontological Social Work, 2011, 54(4): 347-350,

[] Basa, J. 2022. Health care workers in need of mental health support amid pandemic burnout. CTV News, 24 January 2022.

[] Bender AE, Berg KA, Miller EK, Evans KE, Holmes MR. “Making sure we are all okay”: Healthcare workers’ strategies for emotional connectedness during the COVID-19 pandemic. Clinical Social Work Journal, 2021, 49: 445-455,

[] Brooke J, Jackson D. Older people and COVID-19: Isolation, risk and ageism. Journal of Clinical Nursing, 2020, 29(13–14): 2044-2046,

[] Brophy JT, Keith MM, Hurley M, McArthur JE. Sacrificed: Ontario healthcare workers in the time of COVID-19. New Solutions: A Journal of Environmental and Occupational Health Policy, 2021, 30(4): 267-281,

[] Canadian Institute for Health Information. 2021. The impact of COVID-19 on long-term care in Canada: Focus on the first 6 months. Ottawa, ON: CIHI. https://www.cihi.ca/sites/default/files/document/impact-covid-19-long-term-care-canada-first-6-months-report-en.pdf. Accessed 1 Apr 2024.

[] d’Entremont, Y. 2021. Researchers launching online survey to learn how pandemic is affecting grocery store workers. Halifax Examiner, 23 December 2021. https://www.halifaxexaminer.ca/featured/researchers-launching-online-survey-to-learn-how-pandemic-is-affecting-grocery-store-workers/. Accessed 1 Apr 2024.

[] Doolittle, R., E. Anderssen, and L. Perreaux. 2020. In Canada’s coronavirus fight, front-line workers miss their families, fear the worst and hope they’re ready. The Globe and Mail, 4 April 2020.

[] Drolet J, Alston M, Dominelli L, Ersing R, Mathbor G, Wu H. Women rebuilding lives post-disaster: Innovative community practices for building resilience and promoting sustainable development. Gender & Development, 2015, 23(3): 433-448,

[] Hapsari AP, Ho JW, Meaney C, Avery L, Hassen N, Jetha A, Lay AM, Rotondi M, et al.. The working conditions for personal support workers in the Greater Toronto Area during the COVID-19 pandemic: A mixed-methods study. Canadian Journal of Public Health, 2022, 113(6): 817-833,

[] Helou M, Osta NEI, Husni R. Impact of the COVID-19 pandemic on healthcare workers’ families. World Journal of Clinical Cases, 2022, 10(27): 9964-9966,

[] Hemmler VL, Kenne AW, Langley SD, Callahan CM, Gubbins EJ, Holder S. Beyond a coefficient: An interactive process for achieving inter-rater consistency in qualitative coding. Qualitative Research, 2020, 22(2): 194-219,

[] Hoernke K, Djellouli N, Andrews L, Lewis-Jackson S, Manby L, Martin S, Vanderslott S, Vindrola-Padros C. Frontline healthcare workers’ experiences with personal protective equipment during the COVID-19 pandemic in the UK: A rapid qualitative appraisal. BMJ Open, 2021, 11(1): Article e046199,

[] Hou C, Wu H. Rescuer, decision-maker, and breadwinner: Women’s predominant leadership across the post-Wenchuan Earthquake efforts in rural areas, Sichuan, China. Safety Science, 2020, 125: 1-6,

[] Jia F, Krettenauer T. Moral identity and acculturation process among Chinese Canadians: Three cultural comparisons. International Journal of Intercultural Relations, 2022, 88: 125-132,

[] Kelly C, Bourgeault IL. The personal support worker program standard in Ontario: An alternative to self-regulation?. HealthCare Policy, 2015, 11(2): 20-26

[] King EC, Zagrodne KAP, McKay SM, Holness DL, Nichol KA. Determinants of nurse’s and personal support worker’s adherence to facial protective equipment in a community setting during the COVID-19 pandemic in Ontario, Canada: A pilot study. American Journal of Infection Control, 2023, 51(5): 490-497,

[] Langmann E. Vulnerability, ageism, and health: Is it helpful to label older adults as a vulnerable group in health care?. Medicine, Health Care, and Philosophy, 2023, 26(1): 133-142,

[] Lieberman, C. 2021. COVID-19: Retired health-care workers answer call to help on front lines. Global News, 19 March 2021.

[] McConnell D. Balancing the duty to treat with the duty to family in the context of the COVID-19 pandemic. Journal of Medical Ethics, 2020, 46(6): 360-363,

[] Moye J. Mental health in older adults during COVID: Creative approaches and adaptive coping. Clinical Gerontologist, 2022, 45(1): 1-3,

[] Ng R, Indran N. Reframing aging during COVID-19: Familial role-based framing of older adults linked to decreased ageism. Journal of the American Geriatrics Society, 2022, 70(1): 60-66,

[] Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, Mehta RS, Warner E, et al.. Risk of COVID-19 among front-line health-care workers and the general community: A prospective cohort study. The Lancet: Public Health, 2020, 5(9): e475-e483

[] Nizzer, S., N. Moreira, S. McKay, and E. King. 2022.Who meets home care workers’ emotional support needs? Toronto, ON: VHA. https://www.vha.ca/wp-content/uploads/2022/10/Moreira_WhoMeetsHomeCareWorkersEmotionalSupportNeeds_Abstract_Sept2022.pdf. Accessed 1 Apr 2024.

[] Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health and Mental Health Services, 2015, 42: 533-544,

[] Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 2020, 88: 901-907,

[] Pinto A, Hapsari AP, Ho J, Meaney C, Avery L, Hassen N, Jetha A, Morgan Lay A, et al.. Precarious work among personal support workers in the Greater Toronto Area: A respondent-driven sampling study. CMAJ Open, 2022, 10(2): E527-E538,

[] Saldaña J. . The coding manual for qualitative researchers, 2009 Thousand Oaks, CA SAGE

[] Sinha SK, Spurlock WR, Allison GA, Earley B, Taylor C, Prendergast E, Snelling J, Carmody J, et al.. . Closing the gaps: Advancing disaster preparedness, response and recovery for older adults, 2020 Ottawa, ON Canadian Red Cross

[] Slick J, Wu H. Rhodes ML, Comfort L. The need to protect the most vulnerable: The COVID-19 crisis in long-term and residential care in Canada. Countries in crisis: Collective cognition action and COVID-19, 2022 New York Routledge 182-207

[] Solly KN, Wells Y. How well have senior Australians been coping with the COVID-19 pandemic?. Australasian Journal on Ageing, 2020, 39: 386-388,

[] United Nation. 2020. Policy brief: COVID-19 and the need for action on mental health. https://unsdg.un.org/resources/policy-brief-covid-19-and-need-action-mental-health. Accessed 1 Apr 2024.

[] Vervaecke D, Meisner BA. Caremongering and assumptions of need: The spread of compassionate ageism during COVID-19. Gerontologist, 2021, 61(2): 159-165,

[] White EM, Wetle TF, Reddy A, Baier RR. Front-line nursing home staff experiences during the COVID-19 pandemic. Journal of the American Medical Directors Association, 2021, 22(1): 199-203,

[] World Health Organization. 2023. COVID-19: Vulnerable and high-risk groups. https://www.who.int/westernpacific/emergencies/covid-19/information/high-risk-groups#:~:text=If%20you're%20at%20risk,to%20contact%20your%20health%20provider. Accessed 8 Oct 2023.

[] Wu H. Airdropped urban condominiums and stay-behind elders’ overall well-being: 10-year lessons learned from the post-Wenchuan Earthquake rural recovery. Journal of Rural Studies, 2020, 79: 24-33,

[] Wu H, Karabanow J, Hoddinott T. Building emergency response capacity: Social workers’ engagement in supporting homeless communities during COVID-19 in Halifax, Nova Scotia, Canada. International Journal of Environmental Research and Public Health, 2022, 19: Article 12713,

[] Wu H, Perez-Lugo M, García CO, Gonzalez F, Castillo A. Empowered stakeholders: University female students’ leadership during the COVID-19-triggered on-campus evictions in Canada and the United States. International Journal of Disaster Risk Science, 2021, 12(4): 581-592,

[] Xia Y, Ma H, Moloney G, Velásquez García HA, Sirski M, Janjua NZ, Vickers D, Williamson T, et al.. Geographic concentration of SARS-CoV-2 cases by social determinants of health in metropolitan areas in Canada: A cross-sectional study. CMAJ, 2022, 194(6): E195-E204,

[] Young JC, Rose DC, Mumby HS, Benitez-Capistros F, Derrick CJ, Finch T, Garcia C, Home C, et al.. A methodological guide to using and reporting on interviews in conservation science research. Methods in Ecology and Evolution, 2018, 9: 10-19,