title: "We only own the hours": discontinuity of care in the British Columbia home support system.
abstract: This article uses the concept of continuity of care to examine the implications of health-system restructuring for workers and staff in the BC home support system. Home support primarily serves frail seniors living in poverty and has the potential to provide assistance with tasks like bathing, dressing, and toileting, as well as offer social support and relational care to isolated clients. Through presentation of qualitative data from focus groups and interviews with home support workers and clients in the Greater Vancouver area, we demonstrate how the casualization and intensification of work in a context of increasing client acuity levels has diminished both continuity and quality of care. This article discusses how restructuring in the home support sector in BC has reduced the overall number of persons under care in the system, disrupted continuity of care, and compromised quality.
authors.affiliation: Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, Canada. zsharman@interchange.ubc.ca
authors.forename: Zena
authors.initials: Z
authors.lastname: Sharman
authors.forename: Arlene Tigar
authors.initials: AT
authors.lastname: McLaren
authors.forename: Marcy
authors.initials: M
authors.lastname: Cohen
authors.forename: Aleck
authors.initials: A
authors.lastname: Ostry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia; D002170:Canada; D003266:Continuity of Patient Care; D005260:Female; D016330:Frail Elderly; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012944:Social Support