The work of visiting homemakers in the context of cost cutting in long-term care.

Policy making and service organization in long term care for frail elderly people are dominated by concern with reducing institutional costs and increasing the use of relatively inexpensive home care services. Little attention has been focussed on the implications of cost cutting for those at the point of home care service delivery. A qualitative study of visiting homemakers sought to explore these implications. A sample of visiting homemakers working in southern Ontario took part in semi-structured interviews about their work experiences. Analysis of interview transcripts revealed the exploitative potential and tensions introduced by funding restraint, and suggested that home care workers' ability to deliver high quality, personalized care is compromised by organizational practices that speed up and intensify their work. Further research on home care providers and their elderly clients is needed to document the outcomes of economically driven public policies for those who deliver and receive them.