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Toronto – The Ontario Health Coalition released a new report today developed in partnership with UNIFOR on the Personal Support Worker (PSW) crisis in Ontario's long-term care homes. The report “Caring in Crisis: Ontario’s Long-Term Care PSW Shortage” is available on the OHC website here. 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.”

“Intolerable” levels of violence and homicide spark renewed call for improved care standards in Ontario’s long-term care: new report

Toronto—In a Queen’s Park press conference today the Ontario Health Coalition launched a 30-community tour of a new report, “Situation Critical: Planning, Access, Levels of Care and Violence in Ontario’s Long-Term Care”. The report was inspired by increasingly frequent complaints by families and care workers of violence in long-term care homes (nursing homes). In its research, the Health Coalition found what it describes as “shocking” and “intolerable” levels of homicide, the extreme end of a “spectrum of violence that is escalating”. Almost 80,000 Ontarians reside in long-term care homes.

Among the key findings in the report:

There were 27 homicides in Ontario’s long-term care homes, according to the Ontario Coroner in the five years leading up to the report: a homicide rate that is 4-times that of Toronto and 8-times that of communities that are similarly-sized to Ontario’s long-term care home sector (80,000 people).
Resident-on-resident violence has increased since 2011 and staff injury rates in long-term care are among the highest of any industry in our economy.
Access to long-term care is poor, and even more difficult for equity-seeking groups.
By every measure the acuity, that is the complexity and heaviness of the care needs of the residents in long-term care has increased dramatically. This is a result of massive hospital cuts: Ontario has cut more hospital beds than any other province and is almost at the bottom of OECD rankings. As a result, today’s long-term care homes are yesteryear’s chronic care and psychogeriatric hospitals, but without the same resources.
In fact, long-term care beds are funded at 1/3 the rate of chronic care beds but house residents that used to be considered chronic care or psychogeriatric care. This shift is saving money at the expense of the health and safety of the vulnerable residents in long-term care and their care staff.
While acuity has skyrocketed hands on care levels have actually declined. The result is the escalating violence that we are witnessing.

Quotes:

“By any reasonable measure the twin issues of insufficient care and violence in Ontario’s long-term care have reached a level that can no longer be ignored,” she added. “Voluntary approaches to improving staffing are a proven failure. If you put your child into day care there is a staffing ratio: a limit on the number of children for each staff person. We are asking for the same thing: a minimum care standard that would guarantee a minimum average of 4-hours of hands on nursing and personal support for each resident, and we are insisting that this be a requirement that is enforced.”

“No one should have to go through what my mother and my family went through,” added Lance Livingstone, a senior himself, who struggled for months to find his mother a space in long-term care and was ultimately unsuccessful and she passed away. “The government has cut care and continues to ration it in order to give tax breaks to the wealthy. We can afford to provide decent long-term care for seniors and others who need it. The truth is families can’t afford to go without it.”

For more information: Devorah Goldberg, Research & Campaigns Director; Natalie Mehra, Executive Director.

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