The Ontario Health Coalition is sounding the alarm about a critical shortage of personal support workers (PSWs) in the province's long-term care homes.
In a report released on Wednesday, the coalition states Ontario's long-term care homes have been dealing with a shortage of one to two PSWs on almost all shifts. This means the homes can be short five to 10 PSWs over every 24-hour period. In some cases, the coalition has heard from homes that have been short 20 to 50 PSWs.
“Residents are not receiving baths, oral care, and proper medication dispensing,” said Peter Bergmanis, co-chair of the London branch of the Ontario Health Coalition. “Care is rushed and risk for errors increases. It creates a high accident and high injury rate.”
The coalition points to a large imbalance in the amount of pay for the required duties as one reason for the decline in the number of people entering the industry. In each of the eight communities where the coalition held roundtable discussions with PSWs and long-term care home administrators, it was determined wages were "not significantly higher than minimum wage" and yet workloads were much heavier than in jobs with comparable compensation.
"We have seen this coming for many years," said Bergmanis. "The system has been getting strangulated even though there have been small cost of living level increases. They are still not maintaining the kind of required care levels the long-term care homes need."
The level of violence being exhibited by residents within long-term care homes has been on the rise in recent years, with roughly half of all residents exhibiting some form of aggression, the report notes. Approximately 86 per cent of individuals within long-term care homes have also been diagnosed with some form of dementia.
Despite the steady rise in the levels of acuity, care levels have dropped to their lowest point of the decade, according to data from the Ministry of Health. As a result, residents in many cases are no longer receiving the basic level of care. During roundtable discussions in Chatham, the coalition was told that led to increased odour, falls, depression, infections, and anxiety among residents. In London, long-term care staff admitted to cutting corners due to "assembly line care," while in Windsor roundtable participants reported care, such as baths, being missed entirely.
"The struggle is real," said Shoshannah Bourgeois.
The London area PSW has worked in the field for roughly a decade and stressed it is hard to entice people to join an industry where the wages and benefits are inadequate for the work being done.
"There is an amount of money that we need to be able to make to be able to live and when you can't afford to run your car, to afford child care, how can you afford to do that job?" asked Bourgeois. "So you are working two or three jobs without a day off, without vacation because you can't afford it."
The coalition report states that enrollment in PSW courses across the province is so low that in many cases community colleges are opting to cancel the course altogether. High tuition and lack of promotion are cited as reasons behind the lack of interest.
Ten priority recommendations are being made by the coalition to help address the critical shortage of PSWs in Ontario. They include enhanced and competitive wages, a regulated four-hour daily minimum care standard within homes, and a publicity campaign to highlight PSW successes.
"That is just the beginning point," said Bergmanis. "We have to deal with the curriculum at the college levels perhaps tuition has to be subsidizes. We can't attract people to go into a profession that is so onerous, so violent in nature and expect to just pay them minimum wage. There are so many systemic and societal factors here that we have to address."
However, Chatham-Kent Leamington MPP Rick Nicholls points out that the province has invested in several staffing initiatives, including $4 million for the "PSW educational fund" for more training opportunities. Another $19.4 million has also been put into maintaining direct staffing levels at long-term care homes.
Nicholls does admit that attracting people to a field where the workforce feels underpaid and overworked is a challenge, but is sure with time it will get better.
"It's a complex system. There are several million parts that are moving all at once and we have to try and coordinate them and get them aligned. It's a huge jigsaw puzzle and you put those jigsaw puzzles together one piece at a time," said Nicholls.
-With files from Paul Pedro