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Long-term care staffing crisis worse than before pandemic, survey says

Posted: July 24, 2020

(July 23, 2020)

By: Elizabeth Payne, Ottawa Citizen

Residents of Ontario long-term care homes are going without baths, missing crucial care and waiting hours for their meals because of worsening staff shortages, a staff survey released by the Ontario Health Coalition suggests.

The survey of more than 150 staff members at 75 long-term care homes revealed a staffing crisis in long-term care resulting in substandard care of residents and unsustainable working conditions for already stressed staff.

With a possible second wave of COVID-19 on the horizon, the situation in long-term care homes is now worse than it was prior to the pandemic, said Natalie Mehra, executive director of the advocacy group and author of the study.

“It is hair-raising,” said Mehra.

“We are expecting a second wave and long-term care homes are not ready.”

Although the study heard from a small proportion of long-term care workers across Ontario where there are more than 600 homes, Mehra said she is confident the responses reflect issues that are provincewide. She said her organization has also been receiving calls from workers concerned about worsening staff shortages in long-term care.

During the first four months of the pandemic, long-term care homes were the epicentres of the COVID-19 pandemic in Ontario, with more than 65 per cent of deaths among residents.

In Ottawa, and across the province, some homes had hundreds of infections and dozens of resident deaths. Three personal support workers at long-term care homes in Ottawa died from COVID-19 and others became ill.

Since the pandemic began, workers have been instructed to work at only one home at a time to reduce the spread of infection. That has exacerbated pre-existing staff shortages. Traditionally, many care-home workers work at multiple long-term care homes because few institutions offer them full-time hours.

Other workers have left jobs because of working conditions or fears they will become ill, worsening shortages.

The Ontario Health Coalition is calling on the provincial government to follow the lead of Quebec and British Columbia and begin actively recruiting personal support workers and other care home workers with paid training and living wages.

In Ontario, front-line workers, including those in long-term care homes, received a four-dollar-an-hour pandemic pay bump. But that is set to disappear once emergency orders end.

Prior to the beginning of the pandemic, Ontario’s Conservative government appointed a panel to come up with a staffing strategy to deal with the personal support worker shortage. That panel has yet to table its report.

In its survey released Wednesday, the Ontario Health Coalition said 95 per cent of those who responded reported their long-term care home was short staffed. Sixty-three per cent said staffing levels were worse than before COVID-19 hit and 28 per cent said staffing levels were the same.

When asked about the effect of being short-staffed, respondents offered a list of care they could not provide; Mehra called it “deeply disturbing.”

About 100 staff who were surveyed reported that residents regularly miss baths and showers because of staff shortages.

It requires two people to use lifts to safely transfer residents out of bed and increasingly a second pair of hands is not available, staff members said.

They also described emotional support of residents as “non-existent” and said there is often no time to brush the teeth, shave or care for the nails of residents.

More worrisome, 50 of the staff members who completed the survey said they did not have enough time on the job to feed and hydrate residents properly, to reposition them so they don’t get bed sores or to take them to the bathroom. That is resulting in more falls among residents, said Mehra.

“Overall, it is a completely unacceptable level and quality of care,” she said.

Many homes have shortages of personal support workers, who make up the bulk of long-term care staff. But there are also shortages of nurses, housekeepers, dietitians and people who do laundry, activities and rehabilitation.

Mehra said many family members have contacted her with concerns about their loved ones losing weight and becoming dehydrated during the pandemic.

This newspaper has also spoken to family members who say their elderly loved ones lost weight while in a home during the pandemic as well as a nurse who reported residents of one home being fed hours late and appearing glassy eyed.

Shelley Smith, who worked as a personal support worker in Ontario long-term care homes for 30 years called the findings of the Ontario Health Coalition survey “repulsive.”

“I don’t understand how this is allowed to happen,” she said.

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