Homecare workers plagued by violence
Researcher says understaffing can cause higher chance of abuse
All Nicole Lochrie knew about her next client was their address, appointment time and how long she had to be there.
“That’s very common. I would say for 95 per cent of my new clients when I was working in homecare, that was the situation,” said Lochrie, a former London personal support worker (PSW) of five years.
Because the client was unable to speak due to her disability, Lochrie relied on the woman’s husband for instructions on what she needed to do.
Once she had put her client in bed, Lochrie said she felt the husband grab her from behind. “He attempted to assault me. He was grabbing my chest. He forcibly put his tongue in my mouth . . . It got as far as to where he had my pants down” before she managed to flee the house, Lochrie said.
Though research is limited, experts say PSWs face high rates of workplace violence, some of which is related to critical levels of understaffing in settings such as long-term care or community living residences.
There are no data available on a provincial or national level to analyze the relationship between a PSW’s working conditions and their health, according to a study published in June 2017 in the BMC Health Services Research journal.
A recent poll conducted for the Ontario Council of Hospital Unions (OCHU) found 68 per cent of nurses and PSWs across the province have experienced physical violence at least once on the job over the past year.
Tamara Daly, a health services researcher and associate professor at York University, said PSWs face an increased likelihood of abuse in the workplace if a facility is understaffed.
“If they are run off their feet and they don’t have enough time to provide care . . . then you get higher incidences of hitting, punching and scratching directed towards workers,” she said, a conclusion based on her research that correlated staffing levels to violence against workers.
Daly and her team began a study this fall to look at working conditions in long- term care, including the levels of violence and injury for PSWs. The last time this study was done, about a decade ago, the researchers found that Canadian PSWs were six times more likely to face daily violence compared to Nordic countries.
This translates to at least 40 per cent of PSWs in Canada experiencing violence in the workplace on a daily basis. Daly predicts the violence levels would be even higher today.
Denmark, Finland and other Nordic countries included in the study had a staffing ratio of three to four residents per worker during the daylight hours, but the ratios in Canada are at least double and sometimes triple that, she said.
The province does not have a minimum staffing standard for long-term care and PSWs are facing a greater burden of care as patients with more complex health needs are transitioned out of hospitals, said Natalie Mehra, executive director of the Ontario Health Coalition.
“The government has approached the restructuring of health care from the perspective of trying to cut costs predominantly, so that means a kind of cascading downloading from hospitals, to long-term care, to the community. From RNs (registered nurses) and RPNs (registered practical nurses), to personal support workers and unregulated staff,” she said.
Though the burden of responsibilities in the workplace is increasing for PSWs, some believe a lack of communication by employers in the workplace can put workers at risk. “Sometimes we knew nothing about these residents that would come in,” said April Hill, a PSW of 12 years and representative at the Ontario Personal Support Workers Association (OPSWA). Hill said this information is important for a PSW’s safety, especially when caring for patients with dementia and aggressive Alzheimer’s disease.
“If we don’t know they’re aggressive, next thing you know, we’re getting punched or slapped or kicked or hair pulled. There has even been sexual assault,” she said.
And a professional code of silence among workers means a lot of this client-to-worker abuse may never get reported, often because workers fear potential retribution from their employers.
“When you’re using fear tactics, a lot of people don’t want to say anything,” she said.
OPSWA offers whistleblower protection to members of its association, advertising that they will report instances of abuse, whether directed toward PSWs or clients, on behalf of the PSW.
“With long-term care and home care, intimidation is probably the number one used tactic with employers,” Lochrie said.
Following the incident, Lochrie was ordered off work by her doctor for four months after suffering from severe anxiety and panic attacks. She was let go upon returning to work.
“As much as these companies ask you to be a whistleblower and speak out, the moment you do, you’re in hot water,” she said.
“The way that PSWs are treated, in my opinion, is criminal.”
In September, the Ministry of Labour launched a seven-month health-care-enforcement initiative to address violence and injury in health-care settings such as hospitals, long-term care and retirement homes, and family and community health centres.
A spokesperson said the ministry does not explicitly track data related to PSWs facing workplace violence, resulting injuries or incidents, work refusals and complaints.