Caring in Crisis: Ontario’s Long-Term Care PSW Shortage

The Ontario Health Coalition released a new report developed in partnership with Unifor on the Personal Support Worker (PSW) crisis in Ontario’s long-term care homes. In a press conference at the Ontario Legislature, Natalie Mehra, Executive Director of the Health Coalition, noted that we chose the word “crisis” carefully. The situation is so extreme that funded long-term care beds cannot be opened because there are not enough PSWs to provide the care.

The report is based on eight round-table meetings held across Ontario over the last year, including more than 350 participants including home operators and administrators, PSWs, union representatives, family councils, seniors, college staff who develop/coordinate PSW courses, local health coalitions and other long-term care advocates.

“The conditions of work are the conditions of care for residents,” said Natalie Mehra. She emphasized, “The PSW staffing crisis is real. Every long-term care home, every shift, in the north and in the south, rural and urban, we are hearing the same thing from hundreds of front-line staff, families of residents and home operators. PSWs have taken heavier-care and more complex patients year after year, risking injury and harm, without pay and working conditions that are commensurate to the work. Most of the tools to fix this situation are in the hands of the provincial government which instead of acting urgently to fix the crisis, is actually cutting funding.”

Shortages mean that homes are working with one to two vacancies in every area. That might mean that they are trying to operate 5-10 staff short, or in some larger homes, they reported that they are 20-50 PSWs short. Work is rushed and stressful. Injuries are common. Compensation is too low for the heavy work burden. The impact of the critical staffing shortages on workload, quality of life and quality of care is profound. The report also finds that as a result of these conditions there is declining enrollment in PSW courses in colleges.

The Health Coalition made a set of initial recommendations to alleviate the PSW crisis in long-term care homes including:

  • Increased funding directed to improve PSW staffing levels, wages and working conditions;
  • A minimum care standard;
  • A provincial human resource recruitment and retention plan with concrete timelines and public reporting;
  • In-house Behavioural Supports Ontario (BSO) in all homes;
  • Tuition reductions and grants for PSW college programs;
  • Mandatory reporting of staffing shortages;
  • Publicity campaign with positive image of personal support work, and;
  • Restored capacity in our public hospitals to avoid offloading patients whose care needs are too complex for long-term care.

“Every step of the way, we heard that PSWs face impossible workloads and heavy physical labour that leads to preventable injuries. These unsafe conditions, paired with low pay, precarious working conditions and few or no benefits must end,” said Jerry Dias, Unifor National President. “I challenge Premier Doug Ford to spend a shift at a long-term care home in Ontario with me to witness the dangerous and disrespectful conditions that seniors in care must live with.”

The Ford government has set long-term care funding levels for per diem funding (that is the daily hands-on care funding) at 1 per cent this year. Inflation is double that or more. This means the government is imposing real dollar cuts on long-term care homes’ care funding. In addition, the Ford government is cutting more than $30-million for other long-term care funding. For municipal (public) long-term care homes, this means either cuts to services or increases in municipal taxes to cover Ford’s provincial cuts. This is on top of the loss of municipal funding from the Ford government’s elimination of cap and trade and additional cuts to Public Health Units that will also offload costs to municipalities. •

Click here for full report.

The Ontario Health Coalition is comprised of a Board of Directors, committees of the Board as approved in the Coalition's annual Action Plan, Local Coalitions, member organizations and individual members. The Ontario Health Coalition represents more than 400 member organizations and a network of Local Health Coalitions and individual members. Follow their tweets at @OntarioHealthC.