Long past time to treat PSWs right
It’s a story that’s become far too familiar.
Arlene Reid was a personal support worker from Jamaica who lost her life to COVID-19 last month. Her union says the Peel Region long-term-care homes in which she worked didn’t have the right protective gear available.
Christine Mandegarian was a personal support worker who died of COVID-19 in mid-April. Her union says workers didn’t have proper masks in the Scarborough long-term-care home that employed her.
Hundreds of the women of Haitian origin, who walked across the border from the United States on the infamous Roxham Road to seek refuge in Canada, are now hard at work as PSWs in the long-term-care homes of Montreal, which are among the deadliest places in the country right now. Who are these women, who are now commemorated as COVID-19’s martyrs but who were treated with so little respect beforehand? And what have we learned from their often-brutal experiences?
After a solid decade of fretting about the pending tsunami of aging and its fiscal and societal implications, the wave is upon us — and it’s crushing the way we take care of each other. We’ve improved the Canada Pension Plan and hiked seniors’ benefits over the years, but the pandemic is now showing how completely unprepared we were to deal with the labour and caregiving implications of an aging population.
It’s a broken equation. Families are stretched to pay for elder care, but what feels so expensive to them actually depends on underpaid labour hired from the ranks of marginalized workers — mainly women, often racialized minorities, who need the work so badly that they have little power to demand better conditions.
Now we’re scrambling for solutions as we re-examine how we value our seniors and the workers who care for them. The options, experts say, point to a public-policy fix that will be expensive but necessary.
Cynthia Cranford, an associate professor of sociology at the University of Toronto, has interviewed 344 people in long-term-care system to understand how and why, in her words, “the most socially marginalized workers are funnelled into working in the most precarious parts of the system.” Many of the PSWs in urban centres are women of colour or single mothers who have caregiving and health backgrounds, she says. Often, if they come from Africa or Asia, their credentials aren’t recognized here, and they take short courses in personal support work to move quickly into the Canadian workforce.
They’re snapped up for parttime work with few benefits or protections. They embrace their work because it’s meaningful, Cranford found, but it’s a “constrained choice.”
The pay is low, partly because the eldercare system is strained, but partly because there’s a wage penalty for what’s considered “women’s work” — especially if you’re a woman of colour, says Naomi Lightman, an assistant professor of sociology at the University of Calgary. Her research suggests that wages for PSWs are about 15 per cent lower than they should be.
The result is high turnover and chronic staff shortages. The quality of care is at stake, too.
“It’s dirty work, it’s difficult work, and it’s now life-endangering work,” Lightman said.
Frank Epape runs a PSW company in Ottawa that supports long-term-care homes and private residences. He says he can’t recruit anyone to work right now — the long-standing problems of poor equipment, low pay and hard work, compounded by the virus, have driven everyone away. “There is a huge shortage,” he says.
What the pandemic has shown us is that their work is fundamentally essential: when PSWs don’t show up, because they’re sick or afraid, we need to call in the army.
Luckily, there is also a small army thinking hard about how to repair the systematic failures of long-term care for seniors.
“COVID has revealed where the problems are and where the changes need to be,” says Michael Nicin, executive director of the National Institute on Aging.
Increased unionization will likely help improving wages and conditions, he said, and the unions are indeed already pushing hard. But there’s also a need to look at why people with similar jobs in hospitals are paid so much more, and work with better protective gear.
There’s demand for change on the client side of the equation as well.
“You’re thinking, ‘What do I have to do to stay out of those places?’ ” Nicin said.
Nicin and others are contemplating what a publicly run insurance system for longterm care would look like, or at least a far higher degree of government standard-setting, funding and regulation.
Costly, no doubt, but a price perhaps worth paying for an ethical and just system that treats caregivers and seniors alike with the respect they deserve.