By: Gillian Joseph
Twenty-first century challenges present serious obstacles to the continued viability of rural communities in Canada, where women have been seriously affected by restructuring as workers and carers. Women are the front-line providers of formal and informal long-term care, and they draw disproportionately on the services of long-term care. In rural communities, nursing homes offer job opportunities, but have also been pointed to as sites of abuse, of unstable, low-paid jobs, and as suffering some of the worst impacts of health care underfunding and restructuring. Long-term care policy thus affects women employed in the sector and the lives of the largely female, increasingly aging population in need of care. These factors make long-term care an important rural women’s policy issue, linking issues associated with restructuring, gender, work and rural community in specific, but often unnoticed ways. Recent reform in Canadian long-term care has led to the use of accountability structures, such as the patient classification systems. We argue that classification systems comprise the actions of people whose day-to-day work involves feeding vast amounts of information into the system. This information feeds into reports that determine a level of care for each resident, and these then determine the allocation of funding provided to that home, and thus staffing levels.
The study revealed the specifically rural consequences and requirements of patient classification systems. We argue that classification systems organize women’s work with detrimental consequences for rural long-term care work and the communities they serve. The relationship between long-term care and rural sustainability is bi-directional. If nursing homes disappear, rural communities suffer. Conversely, if communities decline, long-term care homes and services in these areas are in jeopardy. The report recommends policy changes to improve the lives and working environments of women employed in rural long-term care homes, as well as the quality of life of the elderly women and men who reside there.
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This project was funded by Status of Women Canada.