Martima, a personal support worker with West Neighbourhood House's Parkdale Assisted Living Program, cleans a client's apartment at May Robinson apartments, in Toronto on April 17, 2020.Chris Young/The Canadian Press
The care of Canada’s frail elderly rests on the shoulders of personal support workers. To the extent they are under stress, the entire long-term care system is under stress. And they are under a lot of stress.
Personal support workers, or PSWs, may be the most undervalued workers in our society. They need and deserve better access to training. They need and deserve full-time, stable employment. And they need better pay.
If they don’t get these things, the chronic labour shortage in the field will worsen. And the frail elderly will suffer.
PSWs make up 70 per cent of the long-term care work force providing direct care. They help bathe and toilet and feed those who need that help, in an institution or in their home. They help them take their meds, provide range-of-motion exercises, and offer comfort.
For many of the frail elderly, their PSW can make the difference between a good day and a bad day.
But PSWs are becoming less available. Data compiled by the Canadian Institute for Health Information on PSWs in Alberta revealed that their numbers declined by 7 per cent between 2021 and 2022. Ontario’s Financial Accountability Office projects a continuing decline in the availability of PSWs through to 2026.
Many of them work part-time because employers are reluctant to pay for the benefits of full-time employment. (Though some PSWs prefer the flexibility of part-time work.)
Those entering the field – 90 per cent of them female – often make very little more than minimum wage. Pay in Ontario can range from $17 an hour to $35 an hour. The minimum wage in Ontario is $16.55 an hour. The Ford government, to its credit, has sustained pay increases to PSWs brought in during the COVID-19 pandemic.
Workers must deal with chronic staff shortages, which can lead to stressful shifts that increase physical and emotional exhaustion, leading to burnout. They are often looked down upon or taken for granted by other health care workers. They sometimes lack access to training that would improve their skills and pay.
The Ontario Personal Support Worker Association represents 62,000 workers in the province. But an estimated 100,000 workers do not belong to the OPSWA.
“The role of the personal support worker is vital,” chief executive officer Miranda Ferrier said. Yet they all-too-often are not treated that way. “They are not looked upon as essential.”
While shortages of doctors and nurses get most of the attention, it is PSWs who make the wheels go round. We discovered that in the early weeks of the pandemic when fears of COVID-19 caused many of them to abandon their jobs. People suffered and died as a result.
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As the pandemic waned, PSWs once again faded into the background. But we depend on them just as much as before, and in the years ahead we will need them even more.
There are now more than 860,000 Canadians over 85, twice as many as in 2001. Two decades from now, that figure could be around two million.
This is around the age when many older people start to become frail, and more than a quarter of the people over 85 live in some kind of assisted home. More than 9,500 of us are centenarians, one of the fastest-growing age groups in Canada.
So even as the numbers and needs of Canada’s older population increase every year, the availability of PSWs decreases. The Ontario Long Term Care Association estimates the number of nurses and PSWs will need to double over the next five years in order to meet current standards of care.
“The core issue in long-term care is how employers view the front line,” Ms. Ferrier said. “They need to show them the respect that they deserve.” That means stable, full-time employment with adequate pay and full benefits.
Anyone who has a frail elderly person in their life knows how vital PSWs are. Let’s give them the respect they are owed. And nothing shows respect like better pay.