Health care aides' struggle to build and maintain relationships with families in complex continuing care settings.

Research on the relationships between health care aides (HCAs) and families of clients has been situated mainly in long-term care settings and includes scant findings about the perceptions of HCAs. Based on the findings of a larger qualitative study using a grounded theory approach, this paper addresses the topic of HCA-family relationships in complex continuing care (CCC). In-depth individual interviews with eight HCAs and a follow-up focus group with HCAs from three CCC facilities were analysed. Building relationships with families entailed "being there for them and their relatives", while maintaining relationships involved "dealing with disappointments". Factors influencing building and maintaining HCA-family relationships included "having supportive team members", "having resources available", and "functioning within care-team hierarchies". The findings highlight the importance of minimizing the unit and organizational factors that disrupt HCA-family relationships.