Residents living in long-term-care (LTC) facilities are suffering because of understaffing, unions representing the workers allege in a scathing report.
The 65-page document written by the Ontario Council of Hospital Unions (OCHU) says numerous deficiencies leave many Ontario seniors depressed and at greater risk of illnesses.
According to the OCHU, in November 2013, five focus groups were conducted with 35 personal support workers (PSWs) and registered practical nurses (RPNs) working in LTC facilities in Guelph, Blind River, Ottawa, Minden and Toronto.
The OCHU recently presented the study, Long Term Care in Ontario: Fostering Systemic Neglect, to the media at the Royal Canadian Legion Milton branch It was one of several stops OCHU has made since releasing the report earlier this fall.
OCHU regional vice-president Kevin Tyrrell and PSW Dorothy Winterburn were in town to outline the report’s findings.
Tyrrell, who works at a 255-bed facility in Toronto, and Winterburn, who works at a Minden facility with 62 residents, say they believe current staffing levels in Ontario need to double in order for residents to receive proper care.
Allegations in the report include what Tyrrell calls “dangerously-high resident-to-staff ratios.” The report suggests figures of up to 15 residents per PSW on dayshifts and up to 42 residents per PSW on nightshifts and 30 to 42 residents per RPN on both day and nightshifts.
Locally, on average, staffing levels during daytime hours in Halton Region’s LTC homes are one PSW providing care and services for six to eight residents, said Andrea Montgomery, acting communications advisor, Halton Region.
There may be times when staffing levels are higher, she added, dependent upon resident care requirements. In addition to PSWs, there are also various regulated health care professionals in each home at all times, she said.
Montgomery noted the staffing ratio at night (beginning at 11 p.m.) is approximately one PSW to 20 residents.
According to the Ministry of Health and Long Term Care, the government remains committed to ensuring quality care in LTC homes.
David Jensen, MOHLTC media relations co-ordinator, said that since 2008 the government has funded 2,500 new PSW positions and more than 900 nursing positions.
“LTC funding has increased to $3.9 billion in 2014/15, from $2.1 billion in 2003/04,” Jensen said.
Further, he said, current legislation (the Long-Term Care Homes Act (LTCHA) safeguards resident rights and improves the accountability of LTC homes for the care, treatment and well being of residents.
However, Tyrrell and Winterburn believe understaffing results in more incidences of injuries, infection, bedsores, abuse and unsafe work practices.
Tyrrell is seeking the hiring of more PSWs, so that they can devote four hours per resident to their care each day.
“This would ensure showers and proper baths are provided and it would reduce anxiety and depression amongst seniors,” he said.
Winterburn agreed, adding, “You should never have to rush their care. This is their home.”
Jensen stated legislation safeguards resident rights and improves the accountability of LTC homes.
“Each LTC home must have a written staffing plan for nursing services and personal support services,” he said. “Under the act, every resident must have a written plan of care that sets out the care to be provided to meet the resident's assessed needs and preferences.
“This includes nursing, medical, personal support, dietary, nutritional, restorative, recreational, social care, etc.”
Further, Jensen said that in 2013, the average hours of direct care per resident per day in Ontario LTC homes was 3.4.
A PSW for 13 years, Winterburn said she avoids eye contact with residents because she makes promises she can’t keep such as, “I’ll be back to toilet you in five minutes, knowing full well that is unlikely to happen."
In addition, Winterburn said by not regularly toileting residents, it can hasten incontinence.
Jensen stated that the LTCHA requires LTC homes to have a program that promotes continence and “ensures that residents are clean, dry and comfortable.”
“Section 51 of the Regulation provides that every resident who requires continence care products must have sufficient changes to remain clean, dry and comfortable,” he said. “There must be a range of continence care products available and accessible to residents and staff at all times, and in sufficient quantities for all required changes.
“Every resident who is unable to toilet independently some or all of the time must receive assistance from staff to manage and maintain continence,” he added.
Winterburn said she believes short-staffing leaves her with no time to provide residents with social or emotional care that they need to stay healthy.
“I’d like to leave my shift feeling proud of the work I’ve done, but I don’t.”
Tyrrell and Winterburn are on a tour of 50 Ontario communities that began in Northern Ontario in September.
It will hold its final stop at Queen's Park in January, when the union will suggest legislation be introduced that speaks to the four-hour minimum standard, as well as file an age discrimination complaint with the Human Rights Commission, Tyrrell said.
According to the OCHU’s website, the organization includes 30,000 CUPE hospital, long-term care, ambulance and central laundry workers in 120 bargaining units across Ontario.
The report can be viewed in its entirety at Long Term Care report.