Pat Armstrong

Pat Armstrong
York University · Department of Sociology

PhD

About

207
Publications
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2,551
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Introduction
Pat Armstrong currently works at the Department of Sociology, York University. Pat does research in Political Economy and Health Politics and Policy. Their current project is Reimaging Long-term Residential Care: An International Study of Promising Practices" and :Changing Places: Unpaid Work in Pubic Places"

Publications

Publications (207)
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Chapter
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...
Article
Full-text available
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...
Article
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...
Chapter
Full-text available
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
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...
Book
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...
Chapter
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...
Article
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...
Book
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...
Article
Full-text available
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...
Conference Paper
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...
Article
Full-text available
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...
Article
Full-text available
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,...
Article
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...
Article
Full-text available
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...
Chapter
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...
Article
Full-text available
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...
Article
Full-text available
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...
Chapter
Full-text available
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...
Article
Full-text available
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...
Conference Paper
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...
Conference Paper
Full-text available
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...
Article
Full-text available
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...
Book
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...
Conference Paper
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...
Article
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'...
Article
Full-text available
In this paper we argue that long-term residential care, especially for the elderly, can be used as an indicator of equity and thus, of the extent to which there is a state devoted to the welfare of its citizens. By equity, we mean treating both those who provide and those who require care in ways that are appropriate for their needs and that mainta...
Article
Canadian frontline careworkers are six times more likely to experience daily physical violence than their Scandinavian counterparts. This paper draws on a comparative survey of residential careworkers serving older people across three Canadian provinces (Manitoba, Nova Scotia, Ontario) and four countries that follow a Scandinavian model of social c...
Chapter
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...
Article
Full-text available
“A society that treats its most vulnerable members with compassion is a more just and caring society for all” (WHO 2002:5). Long-term residential care is where many of our most vulnerable members live and, in spite of moves towards aging in place, where many will continue to live in the future. It is also a workplace for thousands of paid and unpai...
Article
Full-text available
RÉSUMÉ Le présent document se concentre sur les méthodes mixtes nous avons utilisé pour comprendre conditions de travail de leur travailleurs dans les établissements de soins de longue durée. Nous avons mené une enquête auprès des syndiqués travailleurs de santé en Ontario ( n = 917), et une autre enquête dans trois provinces ( n = 948) et quatre p...

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