The EU-funded research project, ‘Proxima’, provides a valuable insight into the well-being and quality of work of home care workers in Belgium. According to the study, a high proportion of home care workers report low job recognition (33%), lack of social support (64%), back problems (47%) and low remuneration (46%). Strategies to improve the quality of work in the sector relate to areas such as active ageing, risk prevention, balancing the division of work, forms of direct participation in the job and communication channels.
In operation since 2003, the Proxima project (in Dutch and French) aims to carry out research into home care and improve the quality of working conditions in the subsector. The research is accompanied by the dissemination of information, training initiatives and public awareness campaigns targeting management personnel and employees. At present, more than 20,000 individuals work in home care, which is an expanding branch of the health and social care sector due to the individual nature of Belgian society and ageing of the population. Home care workers provide a range of basic home services, such as cleaning and other household work. Their clients comprise mainly sick, disabled or elderly people.
Various research methods used
The Proxima project used a variety of research methodologies to compare individual job situations, psychosocial risk factors in home care and organisational practices of the participating home care service companies. More than 1,000 workers completed a written questionnaire about their psychosocial work situation. Managers of almost 90 home care service organisations were interviewed about how they organise the work and support their home care personnel. In addition, the situation experienced by 15 home carers was mapped by participatory observation.
Funding for the project comes from the European Social Fund (ESF) and the Federal Public Service Employment, Labour and Social Dialogue (Federale Overheidsdienst Werkgelegenheid, Arbeid en Sociaal Overleg/Service public fédéral Emploi, Travail et Concertation sociale, FPS). The project is a joint initiative between the Directorate-General ‘Humanisation of working life’ of the FPS, the Higher Institute of Labour Studies (Hoger instituut voor de arbeid, HIVA) of the Catholic University of Leuven (Katholieke Universiteit Leuven, K.U. Leuven) and the Psychology of Work Department of the University of Mons-Hainaut (Université de Mons-Hainaut, UMH). The main results of the project were published in 2006 and are used to develop strategies to improve the quality of work for home carers, such as the following:
- ‘proxibane’ (in French, 98Kb PDF): a participatory risk analysis method to improve individual working conditions;
- ‘lombalgies’: a training tool to prevent back problems.
Main findings
Almost all home care workers (99%) are women. They tend to be low-skilled and are around 40 years old with 12 years’ experience in the job. Although low-skilled, most of the workers followed a specific certified vocational training programme to perform their job. The most important reasons given by women for choosing this career path are their desire to help people, the human relations element of the job, the degree of job autonomy and increased options for better work–life balance.
However, home care workers indicated a number of health and safety problems that they encounter in their work, including the following:
- some 38% of women have been sexually harassed at some point in their job;
- the working environment is not always optimal. About 21% of home care workers report working very often in houses that are not suitably adjusted for the clients’ physical problems, 14% state that they have worked in unhygienic houses and 10% recount working in an unsafe environment.
- exposure to physical risks is high. Around 62% of home carers report physical health problems on a regular basis. Backache is the most commonly reported occupational health problem.
The survey results reveal that home care workers have a high level of autonomy and a wide variation of tasks in their job. Although most of them are satisfied with the social support received from their direct supervisor and colleagues, some workers would like to have more contact with their supervisor (38%) and with their colleagues (64%). Over half (53%) of home care workers do not have weekly contact with their direct supervisor. This group of workers, in particular, questioned the lack of social support from and contact with other health and social workers, such as the doctor of a client or patient.
Although relatively satisfied with their job, home carers most often criticise the low societal recognition of their occupation and the low level of remuneration. Working time flexibility and the possibility to determine working hours are regarded as positive assets.
Points of action
Based on the research findings, action points have been defined to improve the quality of working life in the home care sector. By introducing a range of targeted organisational and personnel policy measures, the quality of work and the well-being of home care workers can be improved:
- active ageing policies – many home care workers leave the job before the end of their career. A majority of the people surveyed report that their job is more difficult for older workers;
- better division of work – the type of care required by a client/patient should be taken into account in a more detailed way, thus avoiding the distribution of work on a geographical basis only;
- risk prevention – improving the living conditions of clients with the use of technical facilities will also improve health and safety conditions for home carers. One example of such a facility includes a mechanical device to help get a client/patient in or out of bed more easily;
- increased social support – working in isolation should be balanced by more coaching, training and forms of direct participation in the job;
- job recognition – it is important for home care workers to better inform the client, and others in their environment, about what they expect from the job. Moreover, the medical support services also need to recognise the value of the work performed by home carers.
References
For research reports and more information on the project, see the Proxima web page (available in Dutch and French).
Guy Van Gyes, Higher Institute for Labour Studies (HIVA), Catholic University of Leuven