Pat Armstrong

York University · Department of Sociology

When looking to promising international approaches to improve quality care in long-term care, it is necessary to avoid cherry-picking specific dimensions ignoring the integrated nature of what makes these approaches promising in the first place. In looking at promising Scandinavian or Green House models, attention is often paid to the size of facil...

Seeking to support qualitative researchers in the artful development of feminist care scholarship, our goal here is to ‘look back’ on how we have conceptualized the problems of care and developed research that illuminates the social organization of care in distinct ways. As part of a ‘feminist care scholar retrospective’, we present five condensed...

Leadership in long-term care is a burgeoning field of research, particularly that which is focused on enabling point of care staff to provide high-quality and responsive healthcare. In this article, we focus on the relatively important role that leadership plays in enabling the conditions for high-quality long-term care. Our methodological approach...

The high rates of nursing home deaths in the wake of COVID-19 have led to calls for their elimination and their replacement by home care. Based on years of research in Canada and abroad, this article argues that nursing homes are not just necessary. They provide significant benefits for those living in, working in, and visiting in them. In developi...

The pandemic has shone a light on problems within the long-term care (LTC) sector. As was true prior to COVID-19, many of the present issues in LTC can be traced to challenging working conditions, such as persistent understaffing of care workers. Working short-staffed means rushing through care, while only satisfying the most basic bodily needs of...

Austerity was presented as the antidote to sluggish economies, but it has had far-reaching effects on jobs and employment conditions. With an international team of editors and authors from Europe, North America and Australia, this illuminating collection goes beyond a sole focus on public sector work and uniquely covers the impact of austerity on w...

This chapter identifies seven forms of overlapping and interwoven privatization. In the current era of austerity, privatization has been able to extend its reach through these integrated processes and, in some cases, operate almost by stealth as an overarching ideological force that legitimizes private-market relations in places where it once would...

The Royal Society of Canada Task Force on COVID-19 was formed in April 2020 to provide evidence-informed perspectives on major societal challenges in response to and recovery from COVID-19. The Task Force established a series of working groups to rapidly develop policy briefings, with the objective of supporting policy makers with evidence to infor...

Clothes and laundry are simultaneously profoundly personal and political. In this article, we illustrate how our book, Wash, Wear and Care: Clothing and Laundry in Long-Term Residential Care, applies feminist political economy to reveal the importance to workers, residents, families, and volunteers of the invisible and undervalued work involved in...

From a neoliberal perspective, governments should steer and not row; competitive markets provide effective, quality services; and individuals should take responsibility for much of their own health. These assumptions provide the basis for privatisation, a process with multiple forms that are often quite complicated and difficult to see. More of the...

Within mainstream cancer literature, policy documents, and clinical practice, "work" is typically characterized as being synonymous with paid employment, and the problem of work is situated within the "return to work" discourse. The work that patients perform in managing their health, care, and everyday life at times of illness, however, is largely...

This article explores the operation of gender and industrial relations in long‐term care work or nursing home work, ‘from within’ the experience of the predominantly female workforce in seven unionized facilities in Canada. Drawing on qualitative case study data in non‐profit facilities, the article argues that the main industrial relations challen...

This pilot study analyzes interview research with long-term residential care nursing staff in four Canadian provinces, revealing relationships between workers’ psychological health and well-being and working conditions that include work overload, low worker control, disrespect and discrimination. Further, individual workers are often required to co...

Although high income countries increasingly emphasize care at home, long-term residential care is and will remain the place where some of our most vulnerable live and work. Based on over 500 interviews with the entire range of actors in long-term residential care, intensive observations by interdisciplinary teams of at least 12 in 27 different site...

Cleaning and cleaners make three main contributions to long-term residential care. While cleaning in hospitals has received considerable research attention, much less attention has been paid to connecting cleaning and cleaners with the specific nature of long-term care and resident needs. In this article we explore three critical contributions clea...

Changing resident and staff populations, along with political economic reforms, call for new insights into the kinds of skills needed to work in long-term residential care (LTRC). This paper explores the skills of three occupational groups in LTRC: direct care workers, nurses, and doctors. We highlight complexities and ambiguities that exist regard...

Mealtimes are among the busiest times in nursing homes. Austerity measures resulting in insufficient staff with heavy workloads limit the amount of time available to assist residents with eating. Within a feminist political economy framework, rapid team-based ethnography was used for an international study involving six countries exploring promisin...

Creative Team Work: Developing Rapid, Site-Switching Ethnography is much more than a description of a new way of doing rapid ethnography to capture the rich complexity and contradictions of social relations, although it is certainly that. It is about the imagination, stimulation, and reflection that can come with international, interdisciplinary te...

As E. P. Thompson so clearly put it, all research is a dialogue between theory and evidence. This implies at least two essential requirements for effective research. The first is to make assumptions explicit so that the accumulation of evidence can be assessed in light of these assumptions. The second is to understand that all research is a process...

The final chapter identifies some critical lessons learned during an eight-year project. Many in the team had worked on large grants and/or on ethnographic studies. Developing a new version of ethnography, however, required creative teamwork. So did moving beyond narrower forms of interdisciplinary and international research and more traditional ap...

Purpose: To explore long-term residential care provided by people other than the facilities’ employees. Privately hired paid “companions” are effectively invisible in health services research and policy. This research was designed to address this significant gap. There is growing recognition that nursing staff in long-term care (LTC) residential fa...

This book is about that invisible laundry work and its relationship to the dignity and personal identity of both those who do the work and those who wear the clothes. Drawing on interviews and observations from our international study involving the UK, the US, Sweden, Norway, Germany and Canada, we analyze both laundry labour and the importance of...

Autrefois, les soins aux ainé.e.saîné.e.s étaient surtout assurés par des femmes non rémunérées anonymes, chez elles. Celles-ci étant entrées sur le marché du travail, beaucoup de ces soins sont maintenant assurés par des préposés aux bénéficiaires (PAB), surtout féminins. Avec l’introduction massive de la gestion par indicateurs dans les organisme...

Family members often continue to support older relatives who have transitioned to long-term residential care (LTRC). To contribute to research on the intersections of family and formal care, this paper explores the work undertaken and skills used by family members— the majority of whom are women—who support relatives in LTRC. Findings are then cont...

Background: According to the Canadian Health Care Association (1), there are 2,577 long-term care ("LTC") facilities across Canada, with the largest proportion (33.4%) located in Ontario. Most studies focus on residents' health, with less attention paid to the health and safety experiences of staff. Given that the work performed in Ontario LTC fac...

The unpaid care work undertaken by family members and friends often continues when relatives move to long-term residential care (LTRC). Using a feminist political economy approach, this paper explores the labour and skills of family/friend carers-most of whom are women- in LTRC. Data were gathered using the rapid site-switching ethnography method,...

Using feminist political economy, this article argues that companions hired privately by families to care for residents in publicly funded long-term care facilities (nursing homes) are a liminal and invisible labour force. A care gap, created by public sector austerity, has resulted in insufficient staff to meet residents’ health and social care ne...

This paper argues that privatization, especially in the form of for-profit, chain ownership, undermines security in old age. Using data from research in Canada and focusing on the specific case of long-term residential care, this paper examines four aspects of security; security of physical access, security of financial access, security of quality...

The Canadian women’s health movement learned with and from movements in other countries, and like them had roots stretching back long before second wave feminism (Vickers, 1992). Nevertheless, Canadian feminists have carved their own path and even taken the lead in some areas. Like other western activists (Kuhlmann, 2009), they were concerned about...

Nursing, personal care, food and cleaning are publicly funded in Ontario’s long-term care facilities, but under-staffing usually renders all but the most basic of personal preferences superfluous. This individualization of responsibility for more personalized care has resulted in more families providing more care and opting to hire private, private...

Residential care is a highly regulated sector. Regulations are often a product of scandal, and they reflect an understandable desire to safeguard nursing homes vulnerable populations. However, research on Ontario nursing homes reveals significant tensions between regulations and care. Regulations, and the reporting they require, take valuable time...

Introduction: From a feminist political economy perspective concerned with equity for and among women, I explore the issue of the mental health of health care workers. This means understanding states, markets, ideas, discourses, civil society and the determinants of health as interrelated parts of the same whole. Main Body: Mental health, broadly d...

Objective: To explore the social organization of food provision in publicly funded and regulated long-term care facilities. Methods: Observations were conducted, along with 90 interviews with residents, families, and health providers in two Southern Ontario sites using rapid site-switching ethnography within a feminist political economy framewor...

While a large body of research documents the nature of informal home care, almost none focus on informal, unpaid and largely invisible long-term care (LTC) work by family, volunteers or students, or the paid work of private companions. Heavy work results from people’s unpredictable and irregular needs as well as austerity measures that result in to...

Background: According to the Canadian Health Care Association (2007), there are approximately 2,577 Long Term Care Facilities across Canada, with the largest proportion (33.4%) located in Ontario. Most studies focus on residents’ health with less attention paid to the health and safety experiences of staff. Given that the work performed in Ontario...

Thinking about women's occupational health reveals tensions that are involved in doing all occupational health research. By 'tensions' we mean conflicting pressures that are not easily or perhaps ever resolved. Recognising such tensions can lead to better science, even when the underlying issues persist. Based on research about women's occupational...

With increasing demands for evidence-based decision-making, the academic community must be ready to train researchers who can reduce the gap between health care research and practice. One program dedicated to promoting such training is the Canadian Health Services Research Foundation (CHSRF, now the Canadian Foundation for Healthcare Improvement) a...

While a large body of research documents the nature of informal home care there is almost no research documenting informal (invisible) unpaid nursing home care (by family, volunteers or students), or the “other paid work" of privately paid companions. Previous research has established how the heaviest workloads in nursing homes occur during morning...

Je m'appuie sur l'économie politique féministe pour argumenter qu'il nous faut changer notre approche. Au lieu de nous concentrer sur les structures du travail axées sur la déqualification et le contrôle de la maind'œuvre ou sur les individus et leur apprentissage formel, nous devons nous interroger sur les conditions qui empêchent les individus d'...