That's not our role: A qualitative study of family-responsive workplace policies for staff in nursing homes

Work-family tensions exist for virtually all workers. These tensions are potentially more acute for nursing home workers because they have to provide care at work and home, are usually low-income and have work schedules which conflict with child- and elder-care. Family-responsive policies help ease such tension; however, there is a dearth of research on family-responsive policies in nursing homes. Our study investigated the attitudes, concerns and priorities regarding family-responsive policies among executives and managers in nursing homes.

Using a time-limited, focused, and topic-oriented approach, we conducted semi-structured in-depth interviews of 53 executives and managers at four nursing homes in Massachusetts. Analysis took an inductive approach, which included line by line coding for themes and then grouping of themes into key findings.

Three overarching themes emerged to describe shared attitudes, concerns and priorities among study participants: (1) doubt over what role, if any, managers should play in family-responsive policies; (2) distrust of workers and family-responsive policies; and (3) fear of overuse of these policies. Also, we found two contextual factors overlaying the themes: (a) general undervaluing of family-responsive policies and (b) a multi-layered social structure in which employees get different treatments under the same policy.

The resistance to family-responsive policies among the study participants is potentially harmful to care of nursing home residents. Further studies are needed on family-responsive policy interventions that are specifically designed for nursing home workers.