The Personal Support Worker Shortage

Quantity over quality is not the solution

By Alex SH Lee, Samuel Lasinski

Canada is experiencing an unprecedented rise with its aging population. More older Canadians require more personal and bedside support, a need often fulfilled by personal support workers (PSWs). The pandemic generated a great sense of urgency to support long-term care facilities and address the multifaceted challenges that front-line workers like PSWs have been facing. In 2021, the Ontario government funded the creation of accelerated, hybrid caregiver programs at 24 colleges to combat staff shortages.

“The government offered to find PSWs to go to school and pay for their education. We started accelerating the time needed to become a PSW”, explained Taylor Boroof, spokesperson for the Ontario PSW Association. “Essentially, we are creating PSWs as quickly as possible.”

However, there is significant doubt over the quality of a “hybrid program” and whether these graduates are adequately trained. In fact, sacrificing quality education in an effort to accelerate it may diminish the strength of the PSW workforce, as it misses many deeper, systematic issues of lack of workplace support and failure to keep up with the changing landscapes of healthcare.

Firstly, relying on online modules and restricting practice of such bedside skills to accelerate graduation cannot accurately capture the rigorous nature of caregiving. Some practical aspects of bedside care cannot be taught online, especially due to the rising complexity of resident needs and staff shortages during the pandemic.

Secondly, inadequate culturally-safe care training will disproportionately impact those from marginalized communities. For instance, the Indigenous community has a great emphasis on emotional and spiritual well-being that necessitates a kincentric approach to care, which means treating people as though they are extended family members. Cultural competence is especially important to delivering high-quality care to our Indigenous populations, one of the fastest aging communities in Canada.

Lastly, we can agree that much of professional learning occurs on the job. Unfortunately, PSWs and other caregivers do not have this luxury because educational and longitudinal resources in their communities are lacking. For this reason, the accelerated hybrid model misses the mark on retaining PSW staff. One can argue that it exacerbates the turnover rate because the new graduates will feel more undertrained without community resources to support their continued growth as professionals. While increasing workforce capacity may be effective in the short-term, there must be more long-term institutional support that PSWs can lean onto to create a better, wellstaffed work environment.

“One of the main things I’ve heard from students is that they feel alone in the workplace. They were thrown into school really quickly. This is what you’re going to learn, now go out into the field, do it all on your own,” said Booroff. “There might not be people out there to help you because we’re all drowning in our own work.”

Canadian healthcare is facing workforce shortages all around, especially physicians. Yet, physician training is not being shortened in order to address the problem. In fact, the residency training for family physicians has become longer by an additional 1 year, in order to expand on increasingly important topics such as senior care, new technologies, and mental health. Evidently, more healthcare training must be provided with the changing times. But why are PSWs getting less training?

“We need to start our money into resources that are actually going to carry us until the end and play the long game here,” said Booroff.

PSWs go through a deeply personal journey - an opportunity to recognize one’s own strength and give back to the elderly who once cared for them. Their work is personally rewarding as much as it is societally impactful. The government must recognize the importance of the PSW role, put resources into proper education, and listen to those on the ground that are screaming for help.

As Booroff aptly states: “No more conversations about how we need to change things. Make the change happen.”

To learn more about the issues faced by caregivers, as well as what is being done by government and community advocacy groups to combat them, we invite you to listen to episode #109 of Raw Talk Podcast, titled “Caregivers: The Forgotten Pillars of Health Care.”

Additional resources on healthy aging and supporting Canadian caregivers can be accessed from the following organizations: AGE-WELL, the Ontario PSW Association, and the Center for Aging + Brain Health Innovation

We would like to acknowledge Raw Talk Podcast’s episode #109 team. This episode was hosted by Helen and Prisca with content development by Prisca and Junayd. Noor, Helen, and Frank conducted interviews on which both the podcast and this article are based. Episode audio engineering was completed by Alex. Co-executive producers Noor and Junayd oversee the production of all Raw Talk Podcast episodes.