'Going the extra mile' for older people with dementia: Exploring the voluntary labour of homecare workers

Dementia (London). 2020 Oct;19(7):2220-2233. doi: 10.1177/1471301218817616. Epub 2018 Dec 12.

Abstract

Homecare workers provide essential physical, social and emotional support to growing numbers of older people with dementia in the UK. Although it is acknowledged that the work can sometimes be demanding, some homecare workers regularly 'go the extra mile' for service users, working above and beyond the usual remit of the job. This form of voluntarism has been interpreted as an expression of an essentially caring nature, but also as the product of a work environment structured to tacitly endorse the provision of unpaid labour. This paper draws on a qualitative study of what constitutes 'good' homecare for older people with dementia. Using homecare workers' reflexive diaries (n = 11) and interviews with homecare workers (n = 14) and managers (n = 6), we explore manifestations of, and motivations for, homecare workers going the extra mile in their everyday work. We describe three modes of voluntary labour based on these accounts which we characterise as affective, performative and pragmatic. Our study highlights the complex relationships between job satisfaction, social benefit and commercial gain in the homecare work sector. Further research is needed to define the full range of affective and technical skills necessary to deliver good homecare, and to ensure that homecare work is appropriately credited.

Keywords: care work; home care; job satisfaction; older people; unpaid labour.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dementia*
  • Home Care Services*
  • Home Health Aides*
  • Humans
  • Qualitative Research