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Background: Home care services, with the aim to support older adults in their homes, faced intense external pressure to create sustainable working conditions for staff during the COVID-19 pandemic. Studies have indicated elevated burnout and stress among residential care staff, and it is likely that similar challenges exist in home care services. Overall, the consequences for staff's work environment and health under the extremely strained conditions of the COVID-19 pandemic merit closer examination. Therefore, the aim is to illuminate home care workers’ experiences of their work environment and health risks while supporting older adults during the COVID-19 pandemic.

Methods: To gain an in-depth understanding of personal experiences during the pandemic, five focus group interviews (FG) were held in northern Sweden during spring 2022. Open-ended questions were delivered via a semi-structured interview guide. Thematic analysis was used to guide data analysis.

Results: Expanded and unclear responsibilities characterized the work environment during the pandemic. This was summarized into four sub-themes: my own health was jeopardized; a wind of change towards more responsibility; struggling between being a lifeline and being contagious; and organization and management as facilitators or hindrances.

Conclusions: The findings underscore the importance of management strategies and organizational preparedness to support staff’s mental health and mitigate challenges during crises. The health risks associated with increased workload, stress, and mental burdens were evident in the narratives. The study emphasizes the need to strive for a good work environment, set priorities to reduce workloads and mental stress, and incorporate time for recovery among staff during crises. It is also of great importance that different authorities in healthcare and social care create effective cooperation so that information, knowledge, and policies are effectively disseminated to frontline staff who have the concrete responsibility for our elderly.

Background: The work for Swedish home care workers is challenging with a variety of support and healthcare tasks for home care recipients. The aim of our study is to investigate how these tasks relate to workload and health-related quality of life among home care workers in Sweden. We also explore staff preferences concerning work distribution.

Methods: A cross-sectional study was conducted in 16 municipalities in Northern Sweden. Questionnaires with validated instruments to measure workload (QPSNordic) and health-related quality of life (EQ-5D), were responded by 1154 (~ 58%) of approximately 2000 invited home care workers. EQ-5D responses were translated to a Quality-adjusted life-year (QALY) score. For 15 different work task areas, personnel provided their present and preferred allocation. Absolute risk differences were calculated with propensity score weighting.

Results: Statistically significantly more or fewer problems differences were observed for: higher workloads were higher among those whose daily work included responding to personal alarms (8.4%), running errands outside the home (14%), rehabilitation (13%) and help with bathing (11%). Apart from rehabilitation, there were statistically significantly more (8–10%) problems with anxiety/depression for these tasks. QALY scores were lower among those whose daily work included food distribution (0.034) and higher for daily meal preparation (0.031), both explained by pain/discomfort dimension. Personnel preferred to, amongst other, spend less time responding to personal alarms, and more time providing social support.

Conclusion: The redistribution of work tasks is likely to reduce workload and improve the health of personnel. Our study provides an understanding of how such redistribution could be undertaken.