PROBLEMS MUST BE ADDRESSED
Keeping personal care workers is key
The COVID-19 pandemic has focused public attention as never before on this province’s failure to recruit and retain adequate numbers of personal care workers in homes for the elderly.
Personal care workers, called orderlies when they work in hospitals, are responsible for ensuring basic needs are met, which can mean helping residents or patients to eat, bathe and dress, accompanying them to appointments etc. They also communicate with medical staff about residents’ physical and mental health and liaison with families.
As of last March, the province employed 41,563 such workers, called “préposées aux bénéficiaires” in French, in its hospitals, long-term care centres, private seniors’ homes and rehabilitation centres.
But the coronavirus has hit homes for the elderly in Quebec particularly hard. At least 300 of the province’s 2,600 homes for the elderly have seen COVID-19 outbreaks, and 850 residents of these facilities have died so far. Many employees have also fallen ill, exacerbating an existing labour shortage, while others are not working for fear of passing the virus on to vulnerable family members.
Since early last week, Premier François Legault has been begging family doctors and medical specialists to fill in temporarily at seniors’ homes, since the equivalent of 2,000 employees, mainly personal care workers, were “missing.” Legault said Tuesday that 1,000 doctors, nurses, nursing students and other health-care workers have heeded his call so far, and he expects to fill the other 1,000 “missing” posts shortly.
He also said his government is in talks with the unions representing these workers, and hinted personal care workers are in for a permanent pay raise.
But the pandemic is not the only reason for the shortage of personal care workers, and a pay increase in itself will not solve the problem, experts caution.
“We already knew before the COVID-19 pandemic that there was a big problem with staffing, so we should not be surprised that it is much worse now,” said Dr. François Aubry, professor of social work at the Université du Québec en Outaouais.
He said the government must address not only pay, but also the precariousness of these jobs, the high injury and illness rates among these workers, and the ratio of residents to workers.
“The job of personal care worker is one of the most precarious professions that exist in Quebec. Only about 30.5 per cent of these workers have full-time, regular jobs,” Aubry said.
Another 40 per cent have permanent part-time jobs, and the rest are occasional, part-time workers often working on call at more than one facility.
Dr. Louis Demers, a professor at the École nationale d’administration publique, points out that the province was having serious difficulty holding onto these workers, who make between $20.55 and $22.35 per hour, long before the COVID-19 crisis hit.
For example, of the 5,869 personal care workers who started work in 2014-2015, only 2,253 were still working by March 2019. That means more than six out of 10 of these workers are quitting after barely five years on the job; a good indication that working conditions are poor, Demers said.
These workers may be attracted to the profession because they want to improve quality of life for people in long-term care, but that is difficult if they have dozens of heavily disabled people to care for.
“Even if you give them $10 more an hour, if they don’t have time to care for people properly, they might be happy to have the money, but they won’t necessarily be able to do a better job,” Demers said.
Another problem is that many of these workers — 82 per cent of whom are women — are nearing retirement age. More than 6,000 of them are expected to retire over the next five years.
The rate of absenteeism because of illness and workplace injury among personal care workers was the highest of all health-care workers, even before the pandemic hit.
“It’s a tough job, both physically and mentally,” Aubry said.
Before COVID-19 hit, about 15 per cent of the workforce were already off because of workplace injuries, mainly from lifting patients, or due to stress-related or other illness.
And the job has been getting more dangerous over the years, as staff-to-resident ratios have increased. The on-the-job injury rate is up 60 per cent since 2013, and absences due to illness or stress are up 24 per cent.
Demers suggests that improving job satisfaction by providing stable jobs and reducing the number of patients each worker must care for may be as important to attracting and retaining these workers as a pay increase.
“The last thing you want is to attract people who are just there for the money,” he said. “Personal care workers are people who need to love elderly people to be good at their jobs. It’s not like stocking shelves in a grocery store ... You have to be sociable, conscientious, concerned about how the people are doing. Personal care workers are precious, I agree with the premier. They are important people, the importance of whom we have neglected. Now, it’s their time.”