‘What would they do without us:’ a PSW perspective

Family members visit a resident at Lambton Meadowview Villa in mid-March.

Editor’s Note: The name of the PSW and her place of employment is being withheld at her request to protect her job.

It had been a long day, but Macey was still angry.

The Lambton County personal support worker had been at work as fears about the COVID-19 pandemic in long term care homes ramped up. The 20- year veteran was still steaming after being disciplined for changing her mask. So, she sat down at her computer and typed out an email.

“I had to clean up a resident whom was covered head to toe with vomit, which is part of my duties. Not pleasant, but has to be done…

“We are allowed one mask per shift. So, after exiting the room, after cleaning this person up, I took off my personal protective equipment at the door including my mask; my one mask. I had to get a new mask. The regular masks were not readily available to me at the time without having to walk through the entire home either with the infected mask on or with no mask at all. So, I had to take a mask that was available… It was the same kind of mask but it had a clear eye protector on it.

“I got disciplined for putting a new mask on. I got centered out in front of residents and co-workers for changing my mask.

“I got disciplined for trying to protect myself, other residents, my family,” she wrote.
Her anger was still at the surface when she talked to The Independent a few days later.

Macey started working in long term care when she was only 16. After a decade of taking care of the elderly, she was told she needed to be a certified PSW, so she went back to school

She got her degree, but not much changed. Macey is classified as part time but could work every day of the week if she wanted to because of staff shortages.

PSWs are typically not paid that well but do a lot of the personal care for residents many of whom lash out because they suffer from dementia or Alzheimers. She’s been bitten and punched and regularly has to deal with bodily fluids like vomit.

When COVID-19 became a reality, Macey and her PSW coworkers watched as nurses in the for-profit home where she works received N95 masks to protect themselves from the virus “but we had to take care of them without one.

“It makes you worried and it makes you feel not valued. It’s okay if we got sick but protect the nurses,” she says.

Macey’s experience in the early days of COVID-19 could have happened anywhere in the province according to union leaders, health care advocates and politicians.

Trish Douma is the regional director of the Christian Labour Association of Canada. It represents PSWs in a number of homes in Ontario, including in Petrolia and Sarnia.
She says being a PSW has “never been easy before and it is downright near impossible right now.”

Long before COVID-19, the CLAC and other unions had been pushing the provincial government to improve the standard of care for residents. Right now, they get less than three hours of hands-on-care a day. The unions believe it should be at least four.

But Douma says money always seems to drive the process, something that has been clearly demonstrated as health care workers fight to get personal protective equipment in long term care.

“I understand that previous to this, homes only needed three days of PPE in the case of a pandemic,” she says adding “I would have assumed there was a big warehouse where there was more.”

But it soon became clear there was not. “The pandemic was called March 11, the questions in long term care came quite quickly after that. Within days, the concerns were raised,” says Douma.

Premier Doug Ford during his daily news conferences in the earliest days of the crisis stressed how they were scrambling to find the right amount of protective equipment for hospitals. It was only later, when people heard about Pinecrest Nursing Home in Bobcaygeon, that the need became evident in long term care.

The home had its first cases March 20. Two days later 20 residents and eight staff had the virus. Twenty nine residents died of the virus and 32 staff members were infected.
Pinecrest would be the first of 189 long term care homes with a COVID-19 outbreak. As of Sunday, 1,388 elderly residents have died and 1,631 staff have tested positive. Media reports now list five PSW among the province’s 1,881 deaths from the novel coronavirus.
The grim death toll of both the elderly and staff has led for calls of a public inquiry to the entire system.

The Ontario Health Coalition is one group which believes the problems with long term care started in the 1990s when the then-Conservative government allowed for-profit companies to build and run long term care homes, receiving public money to do so and making a profit from their work.

Shirley Roebuck, the head of the Sarnia-Lambton Coalition, says its one of the main reasons there are major cracks in the long-term care system.

The coalition, working with data collected by journalists, compared how many COVID-19 deaths there were in for-profit, not-for-profit and government run homes.

The study looked at a two week period and found that for-profit homes had more outbreaks resulting in deaths (50) and saw the a death rate increase 28.52 compared to municipally run homes, which over the two week period saw their death rates drop over 18 per cent.

Officials say the rate of death is “significantly higher in for-profit homes.”
Roebuck is one of the people who wants a full public inquiry to examine long term care and whether there is a place for making a profit off of the care of the elderly.

“They (the Conservative government) should not be allowed to sweep under the carpet the dirty laundry of the long-term care industry any longer.”

NDP Leader Andrea Horwath also wants to see a public inquiry saying the crisis in long term care is not new but has been brought clearly into the public eye as story after story emerges about “horrifying” conditions in some of the homes.

“We need not only to look to the future, how do we fix it for the future,” she tells The Independent.

“We’re in a crisis at this very minute.”

Horwath says the “iron ring” the premier says was put around nursing home has chinks in it. And she says when a home is in crisis, like has been seen time and time again during COVID-19, the province should step in immediately. “There shouldn’t be a choice, if it is in crisis, it should be taken over.”

In fact Horwath advocates the complete takeover of long term care by government. The NDP wants to see long term care regulated under the Canada Health Act, like hospitals so there are higher standards to protect workers and residents.

“I don’t think people should be profiting off the care of our vulnerable loved ones…in their last year to have the only goal as their comfort and their care, not profit.

And Horwath says the provincial government needs to improve conditions especially for personal support workers like Macey. “It’s a hard job and it’s not respected.”

Horwath says PSW should have full-time hours and a job that feeds a family. That would attract more people to an industry which is in high demand as the population ages.

The NDP leader couldn’t say how much that would cost. “But we know what the cost is when we don’t do it; people are dying…There is no number you can put to that.”

The for-profit long term care industry believes they are providing a valuable service. And it doesn’t think further regulation is needed. Recently the Ontario Long Term Care Association called on the province to “remove regulatory and policy impediments to optimize the current long term care system capacity” and provide more money to build more beds.

While politicians and pundits talk about what is wrong with the system, Macey considers her options. She used to enjoy helping seniors but that feeling has faded. “Honestly, it feels like an assembly line at some times. You go from one room to the next. There are residents who appreciate you, who can voice their needs and can voice their appreciation and if you have five seconds to spare you can talk to them.”

That, she says, is rare.

And in a time when walking into work is dangerous, those fleeting moments with appreciative residents don’t go very far. Neither does the applause from the public who have dubbed people working in long term care as health care heroes.

“We didn’t mean anything before this and now suddenly we’re heroes?”

But for now she continues her work taking as many shifts as she wants with no benefits or hope of holidays.

“I’ve been doing this for 20 years and that’s all I’ve ever known. What else can I do? And then I feel bad. We are actually helping these people. What would they do without us?”