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October 27, 2020

Problems in Long-Term Care

Reuel S. Amdur

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In Ontario, the key problem in availability of staff in long-term care pertains to personal support workers (PSW's). That is what Bernard Bouchard told a virtual audience in Ottawa's Social Workers in Aging and Gerontology (SWAG) on October 22. Bouchard is a recently retired social worker and administrator of long-term care facilities.

He explained that the problem arises because PSW’s are frequently part-time and on-call, and while in the past they often worked in several locations in order to have the hours they needed, with the corona virus outbreak they are now only allowed to work in one. They are especially unavailable on weekends and holidays. 

Part of the answer is to move to full-time positions and to use of people who are less qualified, while providing training and opportunities for training to make them full PSW’s.  As well, he argued, there needs to be the possibility of calling upon other people in case of staff shortage, such as family members.  Workers in long-term care are suffering from burn-out from working short staff and excessive overtime.  The reluctance of PSW’s to show up for work is exacerbated by COVID-19 and other emergency situations.

Bouchard told his audience that long-term care has been in crisis for a long time.  There is a massive waiting list, such that it can take years before someone can get a bed.  Of course, that situation results in inappropriate hospital bed occupancy.  He said that Ontario needs an additional 30,000 long-term care beds as soon as possible, and they should all be in private rooms, one bed to a room.

He spoke of the case of serial killer nurse Elizabeth Wetlaufer.  When she was fired from one post, she simply went down the street to another home, on a number of occasions.  This situation continues.  People who are discharged because of poor work simply move to another facility.

The availability of nurses has become more problematic, he said, since the academic requirements were increased to completion of a bachelor’s degree. 

One issue that has become exacerbated by the COVID-19 situation is that of conflict between the rights of residents and their families as against safety concerns of staff.  He cited a personal experience.  He recently allowed family members to visit a sick resident, arousing the ire of staff concerned about their safety.  They picketed the home and complained to the local community newspaper.

He saw one role for social work in long-term care to be that of mediating among residents, family members, staff, and administration.

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