Paid companions for the elderly: ambiguities, relationships and 'being in the world'




Outcalt, Linda Allison

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The restructuring of Canadian health care for more than twenty years has ushered in opportunities for growth in private home care services. Within this socio-economic reality, some seniors and families feeling the impacts of the cutbacks to health and social services have turned to other alternatives of care to fill care gaps. A new type of caregiver, the paid companion, has surfaced in this respect. Operating either independently or through private health care agencies, paid companions resemble surrogate family members or friends who perform a variety of services for the elderly who can afford to pay for private home care and support. My research objective has been to explore and develop an understanding of the experiences and relationships of paid companions and their clients within the context of the political-economic climate of neoliberalism that has supported the development of paid companions. This thesis presents research conducted between 2009 and 2010 in the Greater Victoria area with 30 participants: 15 companions, 8 clients, and 7 key informants. The two qualitative methods of qualitative (semi-structured open-ended) in-person interviews and autodriven photo elicitation were utilized in order to examine the subjective experiences of paid companions and their clients. The research revealed the ambiguity and divergence of opinion around the terms ‘companion’ and ‘paid companion,’ which are inherent in the nature of the work itself. The majority of participants emphasized that friendship and fictive kinship often form the core of a relationship that has been built on caregiving and trust. While paid companions derive fulfillment by providing care for clients, the relationships they develop with them are intrinsically linked to the companionship and care they give. Although clients’ care needs most often stem from general health and mobility issues, the relationships that are gradually formed with their companions often become as important as the task-based assistance their companions provide to them.



paid companions, elder care, private home care services, neoliberalism, visual methods, photo elicitation