February 2020

Ontario faces a shortage of community-based personal support workers (PSWs). Many senior citizens and people with disabilities can remain in their homes and communities only with support, but family members are often not available. PSWs help with personal and household tasks and sometimes give medications or injections. They offer emotional support and can alert others on the health care team when a client’s condition changes. Without such support, senior citizens and people with disabilities often end up in institutions.

One Story – Two Sides

Paul, 88, came home from the hospital after he broke his hip. His daughter is helping him, but she needs to return to her family in Alberta. Paul needs daily support, but he gets only two hours each week, and not always from the same PSW. He’s worried and scared. Will his meagre savings disappear? Will he have to move to a nursing home?

Jasmin, 55, is Paul’s PSW – at least sometimes. She has worked in the community since she came to Canada from the Philippines. Jasmin enjoys helping clients in their homes, but the stress is getting to her. There are more and more clients, and visits are rushed. Unpaid travel between visits adds time to her day, and she can barely afford her small apartment. If she worked in a nursing home, she’d miss her clients, but she’d earn more and have more predictable hours.

PSWs are the backbone of home care, but older ones are retiring, fewer workers are entering the field, and many current ones don’t remain. As the boomer cohort and those that follow move into their eighties and nineties, the current scarcity of PSWs will become a crisis.

Care Watch advocates for a labour strategy to build a pool of community-based personal support workers.

A PSW labour strategy would span ministries responsible for health, long-term care, seniors, immigration, and education. It should address:

• Respect: Most PSWs are middle-aged or older – often women of colour, racialized, and/or new immigrants. Their labour is undervalued, as is the unpaid caregiving women traditionally give ageing family members.
• Equitable wages and benefits: Community-based PSWs earn from $16.50-$19/hour, often with no pay for travel time between visits. Most aren’t unionized, and hours can be unpredictable. PSWs in hospitals or nursing homes typically earn $20-$25/hour, tend to be unionized, and normally have more stable shifts.
• Job conditions: Underfunding and staff shortages force many PSWs to care for more clients, and for clients with higher needs, but in less time, jeopardizing client and worker safety. Stress and burnout drive some out of home care.
• Immigration and education: Many PSWs are women from low- and middle-income countries. Some are highly trained and experienced, but Canada is slow to recognize their qualifications or help them upgrade.

What can you do?

Listen to PSWs, or those who want to be PSWs. What could be working better for them?

Ask politicians what they and their parties are prepared to do to fix the current shortage:

• Are they consulting with organizations that represent PSWs (for example, Ontario PSW Association, Personal Support Network of Ontario or their unions)?
• What are their positions on PSW wages, benefits, and working conditions?
• How will their immigration and educational policies attract and certify PSWs from other countries?
• Are they prepared to advocate for and support a PSW labour strategy?