Despite the use of acronyms for the title of this column, I bet you made sense of it just fine! Isn’t it surprising how often the letters PSW are in our daily vocabulary today? Everyone knows that PSW stands for: Personal Support Worker, one who manages the daily tasks for people who are suffering from illness, injury or dealing with the effects of aging. The most prevalent application for which is elder care. As families have shrunken in size and siblings become more physically distanced from one another to pursue work abroad, away from their family of origin, PSWs have become invaluable resources to assist in the care of their aging parents.
That care provided isn’t always performed in long term care facilities, many PSWs aid people living in their homes and of all ages. I’m just going to focus on care provided to elders. The more familiar setting for a PSW is in a long term care facility but when an elder is recovering from surgery and convalescing at home or has limited ability to perform the normal activities of daily life (ADLs) but still at home, PSW support is allocated based on degree of need. Sometimes an hour a week is recommended, sometimes 5, 15 or even full time. And that’s a problem. Because even though an elder may be entitled to 5 hours of PSW care every week, PSW help is hard to find, especially in rural Ontario.
It’s long been said that home care keeps people out of hospitals and long-term care facilities. It almost always costs less, is often better for patients and represents a welcome reprieve for worn-out primary caregivers. Personal care, frequent and laborious in nature as it is, is often exhausting! PSWs are a welcome resource for the elder’s caregiver to avoid personal burnout. The difficulty lies in obtaining the needed hours that one is entitled to when PSWs are in such short supply. Why is that?
Across Ontario, home care agencies are struggling to recruit and retain personal support workers. PSWs almost always land a job right from school, but many soon leave working as a PSW for a variety of reasons.
In a recent, related article, published in the Ottawa Citizen various authorities on the subject were interviewed. Here are some of their responses.
“We are in crisis across the province,” said Miranda Ferrier, president of the 33,000-member Ontario Personal Support Workers Association. “We have families calling us, desperate for a PSW.”
The article went on to state that a survey of the associations’ members found that 79 per cent were unhappy with their jobs. The reasons they cited, from highest to lowest, included: staffing issues, pay scale, work environment and long or unpredictable hours.
About a third of the respondents reported that they had already left the field. Almost two-thirds said they were burned out, 21 per cent said the job didn’t pay enough and 5 per cent said they had been injured.
Lambton County is primarily rural and Ferrier mentions in her interview that PSWs are even harder to recruit and retain in rural areas, where they have to travel long distances between assignments. “The wear-and-tear on vehicles is immense. And who wants to travel for 45 minutes for a one-hour shift?” said Ferrier.
To paraphrase much of the remaining article a CEO of an Eastern Ontario Local Health Integration Network (LHIN) added that the situation is serious.
Their LHIN is seeing a job market where supply doesn’t meet demand. Expressed in client service wait times the CEO said that for much of 2015 and 2016, it took less than 10 days for a client to receive a first home visit. That increased to an average of 77 days by June 2017, before dropping but wait times are on the way up again.
While wait times ebb and flow, there is clearly a tremendous need for PSWs. I get a short column to express the details of this complex issue. Many factors contribute to the instability of PSW availability, it is a mobile workforce that goes where working conditions or pay are better. Who can blame them! One simple example would be that clients want workers in the morning and in the evening to coincide with their getting up and going to bed, but workers don’t want split shifts and in a rural setting, that challenge is compounded.
Some food for thought. While the province may set the minimum wage, work of varying degrees of difficulty, complexity or in a challenge environment or schedule often finds for itself a premium. Home care workers are the bottom of the PSW hierarchy today. While hospital PSWs can earn up to $26 an hour, those who work in home care earn only a little over $16. Everything from the price of fuel to the scheduling and geographical client location challenges along with having to face potential violence from clients makes recruiting enough PSWs a difficult challenge. I believe this wage/benefit equation will soon work itself out.
I should add, many PSWs get tremendous personal fulfillment meeting the needs of their clients. While some do not, work as a PSW can be a stepping stone for further roles in the medical field and as PSWs are desperately needed today, the time seems right for anyone willing to consider the personal care of others in our rapidly aging society.