“Wake up” – Front line workers of Long Term Care

Its Monday morning and we start our day at 6am, that’s if you’re talking about the day shift because we provide 24 hour care. Some of us without breaks, some of us without food, most and if not all front line workers experience this type of work environment. Fast-paced, belittling and abusive. We are the front line workers of Long Term Care.

Mary’s POA wants her out of bed at 6:00am, no excuses, even calls at that time just to make sure. Mary. Is. Not. Getting. Up. One staff on either side of the bed bracing blows to the stomach and nails digging into each of their arms. Reassuring words leave their mouth “it’s okay Mary, were here to help you” “we need to get you cleaned up, can we please change your clothes”. Mary. Is. Not. Getting. Up. A call placed to the POA to give their recommendation to have her lay in bed a little longer. Belittling language shouted from the other end of the phone “I don’t know what’s wrong with you people, but I have no problem getting her out of bed when I’m there”. Do you please the POA so she doesn’t make a call to your director or do you get physically assaulted?

We deal with unrealistic expectations from family and friends of residents. Of course we want your loved one to be awake and out of bed on time, but when there is 4 staff to 40 residents we can only spend so much time with each person. Therefore, if your mom is having a bad day and needs more time to settle in bed before she wakes up, she is going to lay in bed a little longer. What’s the point in rushing someone of out bed, creating agitation and encouraging physical abuse towards the staff ? Right, so we aren’t reported for “neglecting” your mother.

Bob, Bob has schizophrenia and bi-polar, he’s 65 and resides on the same unit as your sweet 92 year old grandma. He wanders the hallways, screaming every so often, sometimes frightening the other residents. He’s experiencing delusional thoughts and believes his walker is the one your grandma is holding. Bob is screaming, yelling, holding the walker above his head, he hits your grandma and she falls over, fractures a hip.

Most people who need 24 hour care are placed in long term care homes, and many have dual-diagnoses (dementia/bi-polar) (dementia/schizophrenia). Creating a very unpredictable and dangerous environment for co-residents and staff.

Hank has dementia and recently lost his wife whom he kissed every time he saw her. Hank wanders the hallways kissing each female he comes across. He longs for that continued feeling of affection and companionship. Hank now has a stigma as a “predator” since actions as such, the ministry deems as sexual abuse. Management requires the staff (4 PSWs 1 Nurse) to complete 15 minute checks on him, all while they care for 40 other residents.

6 minute care is not a lie, we literally have 6 minutes to spend with each resident in the morning before rushing them to the dining room for breakfast. We serve and clean up after an entire restaurant full of people, 4 of us. We rush to get our documentation done because god forbid we actually spend time with the residents rather then writing about them. You’ve forced us to look upon these awesome people as numbers. We don’t have time to understand who they are as people, you’d rather us document the time their bed was made and if their bowel movement was witnessed or unwitnessed. We are doing the best we can with what we have. Many people with their loved one in long term care can feel themselves getting angry about their loved ones care. Ask yourself is this a staffing and system culture issue or is this an issue with the direct employee. I can assure you, 95% of the time there is something wrong with the system running the show; whether it be government or internal (direct management).

You see why we’re at the end of our rope, we don’t receive enough money to be harassed, overworked, abused and belittled. We care, and that’s why we come to work everyday, we will run ourselves off our feet to make sure your loved one has their basic needs met. I say basic needs because we only have time to complete their basic needs: ensure they are comfortable, fed and pain free. To be honest, sometimes we cant live up to those basic expectations. Yes, some residents sit in saturated or soiled clothing, some have food on their shirt from breakfast and some are wearing other residents clothing. Is it okay? Of course not. But it takes myself and 3 other staff to shower one man because we fear for our safety, it takes myself and one other staff to use a lift to toilet a resident in a wheelchair, so if your loved one has berry stains on her shirt, we’re sorry we haven’t gotten around to changing it. We still have 20 other residents who need toilets, 15 of whom need a 2 person lift, 5 residents need showers and probably 3 residents haven’t made it out of bed yet. Give us a break, we’re doing the best we can.

Stand behind front line staff of Long Term Care. Clearly, the abuse headlines, W5 reports and negative media isn’t enough for the government. People dying isn’t enough for the government. I don’t know what has to happen before it gets worse; I don’t know if it can get any worse, but we need to be loud about this, we need to get angry about this, these are lives in danger, these are Moms and Sisters, Grandpas and Uncles. They’re people.

Well everything written above (May 2019) got a whole lot worse. Covid-19 swept long term care homes across the world, and we finally understood the consequences of piling four residents into a room, with the use of one bathroom, and one hallway. We seen residents suffer depression in isolation without family or friends able to visit, regardless of the precautions taken. In the depth of the pandemic, in some homes, staff were unable to provide care for their basic needs like getting fed, thirst, changing or showering. In Canada, the military was called into some Long-Term Care homes, and some residents had died of malnutrition. So, it’s safe to say that it got worse, and it was the pandemic to show us just how bad it could get. We are STILL underprepared for another pandemic, there are still staff shortages across the country, and 4 residents piled into a room. The one good thing is, is that there have been standard guidelines given to the federal government to highlight the weaknesses in Long Term Care; they vowed to try and work with the provincial governments to set new standards for assisted living. Whether or not that happens though, will be decided.

Are you are caregiver? A staff member in Long-Term Care? Give our Instagram and Facebook page a follow to learn more about the importance of compassionate and emotion-focused dementia care.


Caring for Dementia

37 responses to ““Wake up” – Front line workers of Long Term Care”

  1. Dayna Avatar
    Dayna

    I have work for LTC for 18 years.The ministry and their committee are a joke.I would like them/ their loved ones to come and live by the “standards” they except us to comply with. The most unrealistic standards .Their answers are always “everywhere has daily problems!” These ppl that I care for have fought our war, lived through depressions,had their loved ones died. Yet I’m suppose to tell them when it’s time for them to get up, go to bed,that they need to drink/eat more.Ministry standards.The ministry has a person for each department, yet we have maximum three PSW to take care of 28 residents. No one speak up for them! Instead they watch videos and tell us we should try this or that approach.Come do my job first then tell me when/where I’m suppose to fit that into my eight hours job.Stop sitting at your cussy desk job and try mine!

    Like

  2. Bernice Avatar
    Bernice

    I worked as a PSW 20 years ago and thought it was bad then. It’s even worse now for the PSWs who are run off their feet, take abuse, and can’t do their job the way they would like because they just don’t have the time. My hat goes off to all of them. They are the front line caregivers and deserve your thanks.

    Like

  3. Lucy Avatar
    Lucy

    I have worked 20 plus years in LTC. Few years ago I was so badly beaten up by a resident with dementia. My career ended that day. Management were more concerned with money they get from heavier care residents then they are about staff safety. We were told to sing to keep resident calm so we could do her care. 2 of us for 30 plus people. Like we have time to sing. My partner that day had no education or training. I now sit at home. Too injured to work any job. I no longer pay into a pension, lost my benefits. Union? What union. SEIU has turned their back on me just as fast as my workplace did. Healthcare systems are.so badly broken. For workers and patients. This article is so accurate. I remember one day we walked out of room our clothes torn, both of us bleeding. To.be.comfronted by a residents wife. Very upset, calling us names, yelling at us. She had his call light on for 10 minutes. I apologized said we were busy with another resident. I asked what was so important. Her husband wheelchair bound, mechanical lift dependent. Needed his shoelace tied. I almost walked out of the building that day. I almost snapped. So with blood running down my arm, I crouched down and tied his shoelace. I really had to bite my tongue.

    Like

  4. MD Avatar
    MD

    Such truth, I did 1st year nursing placement in a long term care facility and I commend PSW’s. You have my respect and I would defend and stand behind you. The amount of work you guys do is exhausting and sad because I wanted so badly to get to know residents but was to busy feeding, toileting, dressing, changing 50+ residents. 👏

    Like

  5. Linda Dupuis Avatar
    Linda Dupuis

    Worked 45 years long term care,,,,this writing is very true,,,,,,need new law in place,,,,,,,,6 residents per each PSW,,,,,,,residents who are aggressive should have mandatory meds,,,,,,,no matter what family say,,,,,,to protect other residents and staff from their abuse,,,,,,,

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  6. Donna Buchanan Avatar
    Donna Buchanan

    My Mom is in a LTC nursing home in my home province while I am the only family she has left and live on the other side of the country. I rely heavily on the pcw, nursing and admin staff to care for her. Luckily I have quite a fue inside staff that I know personally that take their personal time to give Mom extra attention and keep me informed. Without this I would be beside myself every day. During work hours they don’t have nearly enough time to spend with each resident as they want to or need to. This is defiantly a government issue that needs to be corrected. Dignity in our senior years should be a right not a privilege! Many if not all have spent most of their lives contributing to the community in which they lived In some capacity. Illness of some sort has put them in the LTC facility and they suffer from the fact nobody has enough time to properly help them with basic personal care. It is a crime against humanity of the worst kind. Staff is fustrated and over worked and unable to change this situation. These folks and the caring loving staff that are front line are trying their best to do all they can with the time allotted and should not be stressed to the point of burn out. Somebody of authority has to step up and make changes in this system. We as a human race cannot just forget what these people have done to build our country and the contributions they have made! We have to protect and care for them as they did for their young! To the staff in these facilities I say bless you, please hang in there, we know you are doing you’re best, we are not nor ever will blame you. Government take heed, you as well will be that person in that LTC facility one day! Beware!!

    Like

  7. Lisa Keegan Avatar
    Lisa Keegan

    I have been a PSW for 16 yrs now I’m full time now 15 yrs ..i have worked in a locked unit now for 14 of those yrs with demitia residents …ranging from the age of 69 to 102 …
    It’s not easy at all ..some days I feel so emotionally drain .but yet I keep doing it every single day …
    Some many residents have came and are now gone …they all mean the world to me …Ya there are days I feel I have to move to a different floor , yet I keep doing…somerhing keeps me there …Gid knows what …The PSW/ RPNs that I work with say ” I’m one of few that has alot of patience for these ladies …they say I’m so caring and compassionate.
    I feel so lucky to be in their lives .
    To make a difference in there final days .makes me feel so appreciated….ya I do feel we should make alot more than we do …we go through he’ll and back ..In the end i just feel good that I know i take goid care of them .😁👼

    Like

  8. Ann Corkery Avatar
    Ann Corkery

    Thank you for all you do. A pay raise and some more help would be good. God bless.

    Like

  9. Carol Avatar
    Carol

    Exactly !! I think the focus needs to be the families and healthcare workers working together as one voice ! If your loved one isn’t getting the care you think they deserve ( and rightly so), stop the verbal assaults on the staff that are literally run off their feet .. and start asking questions . You screaming at me that your husband/father needs to go to bed right now doesn’t help when I’m trying to deal with another resident who has fallen or a resident that is aggressive .. If this doesn’t change you won’t have to worry if your father gets to bed.. there will be no staff left, as front line workers ,we get it from all directions and something is going to give …

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  10. Janice Avatar
    Janice

    My Mother is looked after by an amazing bunch of Angels at Bradford Valley. They are often understaffed and ran off their feet. The management plucks them from their long term coworkers to other floors without consulting them. This really affects the morale and is not at all good for dementia patients that become accustomed to familiar faces. I can’t praise the staff enough. They try their hardest but are often asked to to double shifts. Are you kidding me? It would be hard enough for some people to get through one 8 hour shift. I don’t know what it will take for our government to step in and really start caring about this situation. Get these front line staff the help and money these deserve. It’s actually disgusting how they are treated.

    Like

  11. Nicole Bridgen Avatar
    Nicole Bridgen

    Thank you for publishing this article and sharing it with the world.
    The long term care world is becoming more and more devastating every day that I step through the doors of my workplace. We are not equipped or mentally prepared to meet the challenges of the dynamic case loads in each unit. The age range, ethnic diversity, diagnoses are all far ranging and we are simply human; we can not just switch our nursing focus from one person to the next with seamless perfection. Schizophrenic Bob can not be cared for in the same way as expressive Mary. We all know this but with the time constraints and the complete physical and emotional demands of the job we often fail to meet all of their needs in the moment.
    32 people with completely varying diagnoses, history and triggers can not successfully live together in one unit without proper supports.
    We the caregivers fight the good fight every.single.day. We work endlessly to know the story of each of your loved ones and to fight for the last chapters of their story to be memorable and honourable. You as family members can help us fight the good fight by standing beside us. We agree that your loved one deserves better care. We agree that they are the most important person in the world.
    I am 31 and I feel like my career in health care will be short lived if we dont see a drastic change. We the health care providers can not let our bodies, our souls and our families (who bear the brunt of our grumblings) suffer any longer. Something has got to give.

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  12. Donna Purvis Avatar
    Donna Purvis

    This is an excellent article..I spend a lot of time with my loved one and I see the staff running…short staffed, some days difficult situations arise that are out of the usual …I feel they don’t have enough help even when everyone is there. I could not do their job and am so grateful for them every nite as I leave. I think the people that make the decisions about how much staff each Lodge has should work there for a couple of weeks…bet they couldn’t do it! I know I couldn’t!

    Like

  13. Concerned Avatar
    Concerned

    I work in a long term care facility and see what goes on. Personally I would say money is a big issue for us yes but in order to keep the part time employees they need to be getting benefits as well. I know several psw who work in retail and at tim hortons, why because they are offered benefits. We do care for your loved ones yes, but remember we also have loved ones at home that we need to protect.

    Like

  14. Linda Avatar
    Linda

    very accurate , and this i do see day in day out every day at my work . am a Dietary Aide and i see this all the time , PSW exhausted , frustrated , stresses and teary eyes and more. my hats up to them hard working dedicating and caring .. at the end of the day there humans as well , they have families , kids, wife , husband and so on….. Government needs to be aware and society as well on what goes on in long term care..

    Like

  15. Jane Arends Avatar
    Jane Arends

    This article is completely true. I work in LTC. What the article missed though was all the times PSW’s work short staffed like I did today, and management still expect us to get everything done as if we are fully staffed. Documentation = funding.

    Like

  16. Chris King Avatar
    Chris King

    And in the next 5 to 10 years, they predict that the number of people with dementia will double. We can’t cope now with the needs of the elderly…how on earth will people get care when the numbers double? I give all the credit due to the caring, dedicated PSWs who are trying their best in the most impossible circumstances! Bless them one and all!

    Like

  17. Jeannette Avatar
    Jeannette

    As the niece and POA for a 98 year old, immobile, resident in Longterm Care, I am appreciative of everything I see the staff doing for each and every resident. Their patience shines brightly.
    I am not concerned with the statistics to which charting contributes. I realize attention to changes in a resident’s appetite, in declining capacity, decreasing abilities in general, can be important indicators, but as a relative and POA I would rather see more time spent with the residents and more staff to assist with the stringent morning, mid-day and evening schedules which are made more difficult for the “too few’ staff and the residents, awaiting their care, perhaps just wishing to be lifted into bed sooner than later. I must say from what I have witnessed, the staff do an amazing job of juggling and making the not-always-so routine appear seamless! I praise them!

    Like

  18. Elizabeth Avatar
    Elizabeth

    I worked in Long Term Care facilities for 22 plus years and this is the most accurate description I have ever read. Finally, someone who is not afraid to tell it like it is! So often PSW’s and front line workers are shown in a bad light but seldom does anyone focus on the abuse that they receive from the residents and family members. I finally quit my job in Long Term Care to care for an elderly couple in their own home. The pay is still very low, definitely not enough to live on, but I no longer come home bruised and stressed out from the abuse I endured from residents, family members and management. I feel so much better having gotten out of that toxic environment. It’s like leaving an abusive relationship.

    Like

    1. Deb Avatar
      Deb

      I absolutely agree with every word written here. PSW,s are the backbone of the healthcare system and without you I am nothing. I appreciate each and everyone I have the great privilege of working with and yes, we are a team, and I do not function without your love,compassion, dedication to our residents, and the abuse you face each day if tragic. You need more support from management, and perhaps if they lived a day in your shoes they would realize how valuable you all are. I just want to say THANK YOU SO MUCH FOR EVERYTHING YOU DO!

      Like

  19. Ev Avatar

    The essay says it all.
    I work in homecare. Far easier then long /nursing term care institution
    I don’t c/o about the occasional slap, pinch, kick, spit or insult …not because I’m a better person. Nope because I know others have it worse. I have seen their wounds both physical and the sadness in their eyes.
    We can’t do otherwise but care

    Like

  20. Sandy Avatar
    Sandy

    This is extremely accurate. As a PSW in long term care for the last 19 years I have been in every one of those scenarios At one time or another. And constantly being told that charting must be done this takes us away from residents who need us . Every day we leave work feeling guilty for something I didn’t have time to get done for a resident. They deserve much better and so do we !!

    Like

  21. Sharon MaGee Avatar
    Sharon MaGee

    What can we do to make people aware. We will have less and less psw to care for our seniors

    Like

  22. Sharonmagee Avatar

    What can we do it is in crisis Healthcare is so bad that if we don’t do something now we will not have any psws

    Like

  23. Ila Boshaw Avatar
    Ila Boshaw

    These are the people who have paid their dues. Worked hard their whole life, raised their family, paid their taxes. People in prison ( criminals) are treated with more respect than our seniors. They helped build our country and look how our country is treating them..I have no complaint with our health care workers it’s what we have let our government get away with. It’s time to take our country back starting with health care next education….Where will it stop…

    Like

    1. Pat Brooks Avatar
      Pat Brooks

      Yes I agree with you.But also I think they should bring back yrs ago called candystripe girls to help in hospital. They could earn their credits or whatever just by helping psw with help at the breakfast lunch and supper meals .Like given the patient their drinks well psw are bringing the residents down to their tables also maybe could help with the residents snacks in morning afternoon and before bed then that would free the psw more time for caring for residents.I know the psw don’t get the praise they should. But that’s just my idea of getting more help for the psw workers also be nice for residents to see another friendly face .😀

      Like

  24. Cheryl adams Avatar
    Cheryl adams

    I think they should be paying PSW more money and that way more would apply.
    It’s not the easiest job in the world, but a necessary job! Hire more to lesson the load of the front line care giver!! We are all going to be there, one day!! Bless you all for what u do!!!

    Like

    1. Susan Minshull Avatar
      Susan Minshull

      Cheryl, while I agree with you on the pay aspect, I also know a lot have taken this profession strictly for the pay and have no feelings for the person they are feeding or tending to except get it done fast and disappear…and not to attend to another person…..lived thru it with my husband…..doesn’t take long to know who have compassion and who have not

      Like

    2. DARLA MAE FISET Avatar
      DARLA MAE FISET

      Thank you for your kind words.. As a PSW I care about my clients and love my job… I agree with you it’s time we workers and our clients are put first… We are the backbone of healthcare Without us where would healthcare be…

      Liked by 1 person

    3. Mike Avatar
      Mike

      That money has to come from somewhere. It would directly increase the monthly cost each resident is paying to stay in that LTC bed. Which families would not accept. Dont get me wrong, I work in Dementia care and have since I graduated from nursing. Psw and nurses dont earn enough for what they do.

      Like

      1. Becky McIvor Avatar
        Becky McIvor

        Well Mike I worked in long term care for 35 years. Residents unfortunately might have to pay more. Funnily enough they pay it to non government run homes with no rules or regulations but when they become to I’ll to stay in those places then they come to long term care.. The needs of the clients has changed immensely over the last decade. People are at home longer with home care. If the ceo’s Managing these homes were not taking home huge salaries then the actual people that are in the need of help would get it. There are always too many hands in the pot, if you know what I mean. After 35 years of service I was making $20 an hour. Becky McIvor

        Like

      2. Alison Kenney Avatar
        Alison Kenney

        I worked in long term care for 34 years and have seen it all. I agree that the staff does not make enough money to be abused be residents. I have been hit, hot coffee thrown at me bit and one time had a bed pan thrown at me and it was not empty. Long term care take special people to work in them, not just anyone. Grads to all staff that work in LTC.

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      3. Leanna Avatar
        Leanna

        The money should already be there when some residents are paying around $3000 a month to stay in the homes

        Like

    4. Shawn Avatar
      Shawn

      There are plenty of people applying for jobs in this field. Personal salaries of PSWs or front line workers is not the issue, although I wouldn’t say no to a raise as I have never seen one since I started working and as the cost of living rises it gets harder everyday even on us. The reason we don’t see more people to lessen the load is because Government and Business don’t want to hire that many at once. They have set a bar as to how many hours of care each individual resident has a day and they refuse to raise it, even though the need has doubled, so that they don’t have to spend more money on hiring additional staff. Both need to be pressured/forced into increasing the amount of hours needed so that more staff are put out on the floor at once. But sadly I think we’ll never see it as they throw money into other things to avert our attention from the real need, and most people seem to fall for it.

      Like

    5. Doreen Avatar
      Doreen

      Please we really need these caring loving passionate people to look after our parents and ourselves they really are the heart and soul of these long care facilities and they are not getting the wage or training that they deserve

      Like

    6. Cherie Avatar
      Cherie

      Thank you your comment is appreciated but lessening the burden has nothing to do with hiring more staff. More money needs to be allotted from the government to create extra positions to help front line workers. The workload as it stands now is impossible for nursing staff to keep
      Up with.

      Like

    7. Bonnie Gostola Avatar
      Bonnie Gostola

      The problem is not paying more money, the problem is not having measurable care level standards that identify basic minimum staffing ratios that assure that all of our at risk citizens can have proper care. The other problem is that Private for profit care centres receive funding to adequately meet some of those established standards from the government purse (your tax dollars) but would rather short staff their establishments in favour of meeting the needs of shareholders, not their clients.

      Like

    8. Cathy Hanson Avatar
      Cathy Hanson

      It’s not so much the case of paying more, although I totally agree that the front-line workers should be paid a lot more for what they do, but it’s more that the government needs to provide more funding in order to hire more PSWs to lessen the work load.

      Like

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