WASH, WEAR, and CARE – Clothing and Laundry in Long-Term Residential Care Pat Armstrong and Suzanne Day; McGill-Queen’s University Press, 2017.

Posted: August 27, 2018

WASH, WEAR, and CARE – Clothing and Laundry in Long-Term Residential Care
Pat Armstrong and Suzanne Day; McGill-Queen’s University Press, 2017.
Book review by Lynn Spink

WASH, WEAR, and CARE summarizes research that uses laundry & clothing in Long-term Residential Care homes (nursing homes) as a way to explore larger questions about care and how work is organized. Some findings, such as the real costs of contracting out laundry work, are also relevant to hospitals.

The book is part of a seven-year project – Re-imagining Long-term Residential Care: An International Study of Promising Practices. The project includes professors, unions and community organizations in Canada, the United States, the United Kingdom, Germany, Norway and Sweden.

Anyone with experience in a long-term care home as a resident, a family member, or worker knows that clothes are critical to care – one of the premises of the book. How residents are dressed signals who they are. For some it is the last connection they have with their life outside the nursing home. Clothing is an indicator of dignity and respect for residents and for the workers who care for them.

Laundry includes linens, towels, and clothing. Laundry is often an invisible aspect of care because it is considered women’s work – unskilled. If it’s done by volunteers and family members they’re usually women. It may be done by workers whose work is limited to doing laundry, or by workers for whom laundry is only one of many tasks. In some places racialized men and immigrants are laundry workers.

Forty-eight researchers from 19 universities in Canada, the United States, the United Kingdom, Germany, Norway, and Sweden visited 25 nursing homes in these countries. They selected sites based on information from community organizations, unions, governments and reports, including inspections. Teams of 12, with locally-based researchers and outsiders, visited each home at different times throughout one week, with a minimum of two researchers per visit. They made field notes and conducted 500 interviews with residents, relatives, workers, managers, volunteers, and visitors. Many of the detailed observations are supported by references, listed at the back of the book.

Examples range from a nursing home in Texas where laundry is contracted-out to a private for-profit company to a nursing home in Sweden where there’s a washing machine in each resident’s room. There workers doing laundry are a visible part of residents’ daily lives and residents can do their own laundry if they wish. There’s a UK nursing home where a resident with dementia folds the clean towels, for her a comforting memory of a time when she did the housework.

How clothes and laundry are handled can show whether the place is more like a home or an institution for residents. The conditions of care for residents reflect the working conditions of staff. Many of the ten critical factors the larger project identifies are reflected in this study. Number one is that public or non-profit ownership, combined with adequate funding & staffing, is essential. Privatizing laundry work is not only likely to increase costs in the long run, but it denies the contributions laundry work and workers can add to the social care of residents.
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If you’re a resident or family member concerned about the smell of dirty linen piled in carts that rattle when pushed down the hallways, there are descriptions of other ways several homes deal with dirty linen, ways that keep the smell confined.

If you’re a worker you’ll find examples of the severe health hazards people handling dirty laundry face, including infections and physical risks such as repetitive strain injuries. There are a variety of ways – good and bad – that employers deal with them.

If you’re a manager facing a Board that’s proposing to cut costs by contracting out the laundry work to a private company, you can present evidence showing that once nursing homes have done that – laid-off workers and cleared out the facility’s laundry machines – private companies often raise their prices. By that time it’s too expensive to return to in-house laundry.

If you’re helping someone choose a nursing home, then WASH, WEAR, AND CARE is an excellent window on some important things to consider. You can order the book from McGill-Queen’s press online: http://www.mqup.ca