Labour Reform in Long-Term Care

by Amena Imran, FCO Health Policy Research Analyst

COVID-19 has brought issues in the long-term care sector to the forefront, notably, how the sector does not have a coordinated plan for a workforce that is prepared to provide care to residents in homes. Ontario's staffing crisis and structural issues existed long before the pandemic, and as the novel coronavirus spread, issues only worsened.

Staffing shortages, low attraction to personal support worker jobs, declining wages, worker dissatisfaction and burnout not only impacted workers, but the care residents receive and family relationships.

Personal support workers are front line workers who play an integral role in the community, group living, and long-term care homes. Personal support workers provide care such as personal care, hygiene, mobility, and support for everyday functions. They are not regulated but must receive a certification of completion from an educational program.

In April 2020, the province passed emergency legislation barring employees from working in more than one long-term care home to reduce community spread. While this directive did save lives, it drove demand for personal support workers, but job conditions remained the same. Advocates have been calling on the ministry to consider improving working conditions and pay.

Many personal support staff work in precarious conditions, are not paid for travel time and have a lack of paid sick days. Workers cannot afford to take a day off, which places pressure on staff to go to work even if they are not feeling ill. Often times, the role falls on women and racialized workers, who work with low returns. Despite enduring harsh conditions, many personal support workers enjoy their jobs and relationships with residents. The sector needs to focus on improving working conditions which can ultimately impact the wider long-term care system.

“Personal support workers are the backbone of health care but the bottom of the power structure”

Job stability also has an impact on the care people receive. Long-term care homes are where residents live full-time and require the attention and support of workers to take care of them day in, and day out. Workers need to have a supportive environment in order to successfully fulfil their roles. Fixing the staffing and working conditions is essential to addressing the deeper issues in long-term care homes, in particular, for-profit homes.

Recommendations to the sector include:

  • Wage increases
  • Benefits and paid sick days
  • Stable hours and guarantee of full employment
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