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

Abstract

In Canadian residential long-term care, paid companion services are increasingly viewed as helping to meet older adults’ psychosocial needs. Complimenting 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 organizational 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” (Stacey 2011). In this way, these precarious workers inadvertently reproduce dominant narratives, including those that stigmatize dementia and residential care and facilitate the privatization of person-centred, relational care. Organizational 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 psychosocial care in nursing homes, highlighting organizational vested interests in avoiding risk and downloading responsibilities to families and to private, independent and temporary workers.