|dc.description.abstract||Ageing is an inevitable part of the human life cycle. Life for older adults can be active and independent, and often until late older age, but for some people older age means living in an aged residential care (ARC) facility. The New Zealand workforce in aged care health services predominantly comprises caregivers who are relatively poorly paid with limited training and are required to provide personal care to an increasingly frail population – yet they continue care for this vulnerable population. Population ageing means that while the proportion of older adults living in ARC facilities may remain the same, in future the absolute number of older adults in residential care is likely to increase Cornwall and Davey, 2004) and reliance will grow on this workforce to provide care for a vulnerable group.
The objective of this research was to understand the factors that encourage motivation and engagement of the caregivers who care for these frail people. An improved understanding of these factors will add value both economically and socially to enhance the care of older adults and improve job satisfaction and employee retention of caregivers.The methodology used for this research was Participatory Action Research (PAR), which underpinned the design of two qualitative studies. The initial exploratory study, with participants from four rural ARC facilities, identified three key themes that influenced caregiver motivation. These initial themes were developed in a subsequent study in a 42 bed facility to explore in more depth how caregiver motivation could be encouraged. The research design was based on Lewin’s cycle of plan, act, observe, and reflect, which determined the four-step process. Key to the research design was the establishment of an advisory group of caregivers who developed a nine-point action plan, which was accepted by management and implemented in the facility. Their action plan included caregiver-only meetings, detailed task sheets, rotating rosters, leadership development for nurses, and a review of their performance appraisal system. The implementation of their action plan was observed and analysed, with the final results reflected back to the participants.
Data was collected via verbatim transcripts of advisory group meetings, evaluation interviews with staff, and field notes, which included observations of the process. The data was analysed using NVivo software and results informed a model describing how caregivers can be encouraged to engage more fully in their work. This model comprises three influencers (Communication, Contributing to workplace, and Caring for self), which were associated with three key overlapping experiences (Being listened to, Having a voice, and Feeling valued) with caregiver engagement at the centre of the model. The model demonstrates that if these three influencers and the three overlapping experiences are evident in the workplace the caregivers are more likely to be engaged in their work. The model developed through this research provides potential strategies to address issues of workforce development, retention of staff, and quality of care in New Zealand ARC facilities. These will be emerging issues for our society as the population ages and requires an increased health services and the health workforce becomes constrained.||