Structural violence in long-term, residential care for older people: comparing Canada and Scandinavia.
Canadian frontline careworkers are six times more likely to experience daily physical violence than their Scandinavian counterparts. This paper draws on a comparative survey of residential careworkers serving older people across three Canadian provinces (Manitoba, Nova Scotia, Ontario) and four countries that follow a Scandinavian model of social care (Denmark, Finland, Norway, Sweden) conducted between 2005 and 2006. Ninety percent of Canadian frontline careworkers experienced physical violence from residents or their relatives and 43 percent reported physical violence on a daily basis. Canadian focus groups conducted in 2007 reveal violence was often normalized as an inevitable part of elder-care. We use the concept of "structural violence" (Galtung, 1969) to raise questions about the role that systemic and organizational factors play in setting the context for violence. Structural violence refers to indirect forms of violence that are built into social structures and that prevent people from meeting their basic needs or fulfilling their potential. We applied the concept to long-term residential care and found that the poor quality of the working conditions and inadequate levels of support experienced by Canadian careworkers constitute a form of structural violence. Working conditions are detrimental to careworker's physical and mental health, and prevent careworkers from providing the quality of care they are capable of providing and understand to be part of their job. These conditions may also contribute to the physical violence workers experience, and further investigation is warranted.
Re-imagining Long-term Residential Care, York University, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada. Electronic address: balbertb@yorku.ca.
Albert
A
Banerjee
School of Health Policy & Management, York University, Toronto, Ontario, Canada. Electronic address: dalyt@yorku.ca.
Tamara
T
Daly
Department of Sociology and Women's Studies, York University, Toronto, Ontario, Canada. Electronic address: patarmst@yorku.ca.
Pat
P
Armstrong
Department of Social Work, Stockholm University, Stockholm, Sweden. Electronic address: marta.szebehely@socarb.su.se.
Marta
M
Szebehely
School of Social Work, Carleton University, Ottawa, Ontario, Canada. Electronic address: hugh_armstrong@carleton.ca.
Hugh
H
Armstrong
Social and Political Thought, York University, Toronto, Ontario, Canada.
Stirling
S
Lafrance
D000368:Aged; D002170:Canada; D017028:Caregivers / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006707:Homes for the Aged / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D011369:Professional-Patient Relations; D018570:Risk Assessment; D012537:Scandinavian and Nordic Countries; D014754:Violence / Q000706:statistics & numerical data*; D017132:Workplace / Q000592:standards*