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Long Term Care Staff Study - Part 1 - PSW
Introduction

Long-term care is in a state of crisis, but you may have known that already. Nothing new. Before COVID-19 made its mark on the world and the industry, the tragedies within long-term care finally fell under scrutiny. At least here in Ontario. Due to the actions of a few bad actors, now tried and convicted, and the resulting investigation, the relatively new Ministry of Long Term Care (MLTC) issued the request for an investigation into the staffing situation within the industry. In the span of 6 months, despite the 1st wave of COVID-19, a 50-page document was produced. We have taken the numbers and compared them to the source where ambiguous and condensed them into a visual guide. In this 1st part, we will be looking at the state of Personal Support Workers (PSWs). Part 2 will explore the state of Nurses as outlined in this study into long-term care in Ontario.

Staff Distribution

At first glance, the above data may seem promising, but it’s far from the truth. One staff member per resident may seem like a dream come true, everyone has one, and there are a few to spare. Where’s the problem? Why is everybody screaming that we need more PSWs? They make up 58% of the hired staff of a home?

Mental health and chronic conditions can’t wait 12-16 hours until a caregiver is back on shift. It can’t wait over the weekend or when a caregiver has to take time off. With less than half (PSWs, Practical Nurses, and Registered Nurses) working full time, you can be sure that 1 staff to 1 resident becomes 1 staff to 2 residents if we talk about 1 shift a day.

Despite being more than 1 hired staff per resident, despite there being more than 1 trained PSW in Ontario per resident in long-term care, residents still receive on average 2.3 hours of attention from a PSW in a 24h time period. This is on par because, when talking about long-term care PSW, it employs only half of all the PSWs in the province. Clearly, not the 1 to 1 days we are hoping for.

Long Term Care Staff Study - PSW Demographics
Demographics Unpacked

Although anecdotal, regarding demographics, many of the homes we work with also tell us that the first language of close to half of their caregivers is not English. This is not to say they lack fluency, but an indicator of them being 1st generation immigrants; this in part can be correlated with age and sex distribution. Healthcare and Education being female-dominated industries, both preferred choices of new immigrants who may lack the transferable work or educational experience, or Canadian accreditation may come at a higher cost than that of transition.

Long Term Care Staff Study - PSW Enrolment Programs
Enrollment

Although an attractive job for newcomers, and a position in high demand, there is not enough incentive to become a PSW. At the time of writing, we did not receive a number for the available enrollment positions across the province, but the long-term care study describes it as “consistent.” Across the years, a visible drop of students is visible from 8000 in 2016 to 6500 in 2019. Of note, the same document also mentions the industry losing on average 9000 PSWs/year as of 2011.

Long Term Care Staff Study - PSW Depletion
Drop out, burn out.

Caregiver job satisfaction is the leading cause of burnout and them fleeing the industry. The lack of attractive wages does not help the situation either.

Understandably, staffing can be the largest cost of a home. Hiring more people may mean that everyone gets fewer hours or a smaller hourly pay. It’s not fair.

Without a top-down reform, attractive salaries, and industry recognition, there are few options to go with. Among them is to invest in technologies that can better the lives of caregivers. Enhancing communication for everyone will result in a better environment to work in and better care outcomes. We’ve actually written about strategies a home can adopt to avoid staff burnout. Free online resources and working with as opposed to ‘around’ or ‘against’ the families is a great first step. You can read it here.

Download the infographic from here.

Lastly, if you wish to read the full study the infographic is based on, you can do so here.

Part 2 – Nurses coming in 2 weeks.


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First off, if you did not know that the https://www.lgbtagingcenter.org/ exists… now you do, and you’re welcome. Furthermore the acronym has happened Intersex and Allies. Thus the current version is LGBTQIA+, double welcome.

Quick LGBT History.

So why is this important, you may ask. And it’s a fair question to ask. It’s 2021, most of us probably have that gay friend or relative and we know that they are ok people. We say this as we live in cities with active communities and neighborhoods. But it was not always like this. When it comes to long-term care, those who are now at the age where a nursing home or assisted living facility is something to consider still have fresh in their mind the events that lead to Pride from the 60s. Here I’m talking about the Stonewall riots, arguably the most significant event in the liberation movement across North America. The LGBT youngsters of the time, those struggling with their identity, or those born shortly after having memories of anti-gay legislation, violent discrimination, and the bloody clashes that happened in the summer of 1969.

Exactly one year after the riots, the first Pride event was hosted. With the aim to commemorate the events and show the community’s solidarity against oppression.

Aging

Yes, as fabulous as some of us may be, we still age. Often times with a dire need for additional care. And as mentioned above, the 2020 urbanite who has LGBTQI+ in their network may disregard one’s sexual preference and treat them like any other person. You know, like the intent behind the whole liberation movement. But now, think those aforementioned activists and rebels who were on the front line in 1969. The participants of the various initiatives shortly after. All these people harbor a strong distrust of government institutions, such as law and healthcare. Furthermore, legal recognition of same-sex couples is a recent development. They have been discriminated against by these systems for decades. Adoption laws did not recognize same-sex couples.

There is only one sad conclusion to be drawn. The aging LGBT community often ends being comprised of isolated, lonely, childless, and potentially impoverished individuals. The loneliness epidemic, which we wrote about in the past, is stronger felt by the aging LGBTQs.

Care

With the above in place, there is little to no support network for these individuals. This in turn makes care more challenging in some circumstances. Be it the embedded mistrust of the system, or the caregiver’s personal biases or expectations from LGBTQI+ individuals. Whatever the case, it remains important for the service provider/caregiver to educate themselves on the best practices to interact with individuals coming in with different backgrounds, histories, and trauma. When it comes to the LGBTQI+ there are plenty of resources on the internet to facilitate the institutional or individual’s educational process. On this topic, another great resource is The National LGBTQIA+ Health Education Center, specifically this practical guide.

The extra mile

If you’re reading this and know of people who are living relatively isolated lives be it at home or retirement homes, there are 2 ways you can improve their long-term well-being. The Advance Care Plan, and caregiver education.

The Advance Care Plan

This is the millennia of TikTok, YOLO, and Carpe Diem. But to Live Laugh Love long time, we need to take care of our future selves with some of the decisions we make today. The idea of an advance care plan is nothing new, it is something that gets missed. It simply implies writing down how we want to be cared for when and if we are no longer able to take care of ourselves. How do you want to be called? What are some of your favorite routines, music, shows? …when should they pull the plug?

We all die. Most of us will need some form of care before we get there. We should have a say on how that care is provided. And for members of a historically discriminated against group, such a plan will hold accountable those slower to change and ensure one’s wishes will be respected.

Caregiver Education

We’re getting there. Organizations such as the Registered Nurses’ Association of Ontario have dedicated interest groups to help bring awareness. But when it comes to personalized care, it’s also important to have some of the details of that Advance Care Plan or the input from the guardian/primary_caregiver at hand. Technology, such as CareStory, but not only, can help facilitate this. Consider what solutions would best help you, your home, your residents, your co-workers or your friends have a higher satisfaction when engaged in the care process.

Conclusion

  • Pride is a show of solidarity that was born out of a violent clash between the LGBT Comunity and the Police in New York in the 60s.
  • LGBTQ adults have experienced historic, systemic, discrimination.  They are wary of trusting institutionalized care.
  • LGBTQ older adults are more likely to be alone and impoverished.
  • Awareness groups and professional organizations are making efforts to make the system more accessible and inclusive.
  • LGBTQIA+ individuals should consider the importance and creation of an Advance Care Plan.
  • Communicating care preferences directly or through proxy via technology such as CareStory will improve the quality of care one receives.


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    Contact us


    Call us

    1-647-243-2981


    Visit us anytime

    294 College Street, Toronto, ON, Canada


    Send us an email

    info@emersewell.com



    Subscribe


    Sign up for Medicare newsletter to receive all the news offers and discounts.




      Social networks


      Facebook

      www.facebook.com/carestory_ca


      Twitter

      #CareStory_ca


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      Copyright by Emersewell Inc. 2020. All rights reserved.



      Copyright by Emersewell Inc. 2020. All rights reserved.