Personal Support Workers in Long-Term Care

The first step to improving the lives of residents in long-term care? Ask the Personal Support Worker.

Today, May 19th, is Personal Support Worker Day in Ontario. This article is inspired by the compassionate and hard-working front-line staff responsible for the care of our loved ones.

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If you want to know what’s really going on in a long term care facility, ask the personal support workers (PSWs).  We recently completed a project seeking to bring innovative solutions to problems faced in a local long-term care facility. We had the opportunity to interview, shadow and learn about the role and responsibilities of PSWs.  We soon came to know them as a dedicated, skilled and compassionate part of the health-care team.  PSWs are the eyes and ears on the ground and their views are key to operational improvements.

"PSWs are the eyes and ears on the ground and their views are key to operational improvements."

PSWs provide care to our most vulnerable seniors and residents, including those with complex mental and physical challenges. The role of the PSW is both physically and emotionally demanding.  Working in this fast-paced environment often leaves them exhausted and overwhelmed by the end of the day.  Through observation and discussion it was no surprise to learn that the nature of the profession lends deep insights into organizational governance, workplace culture and employee wellness - all factors that greatly impact a residents quality of care.  

"...the nature of the profession lends deep insights into organizational governance, workplace culture and employee wellness - all factors that greatly impact a residents quality of care."

Applying Human-Centered Design principles we worked to cultivate empathy for PSWs at all levels of management by listening to compelling personal stories and immersing ourselves into their workday.  Through questions and observations we developed a narrative to share with the management team that highlighted the complex problems experienced in the delivery of care by front-line staff.

Our research found that to perform their role well, PSWs must gain the trust of multiple residents and their family members, colleagues and management. This trust is critical considering the work PSWs are responsible for.  PSWs complete delicate tasks such as toileting and general hygiene (bathing, brushing of teeth, combing of hair, etc…) while also being the heavy lifters, moving grown men and women from beds to wheelchairs and back again.

"PSWs are constantly on the move, monitoring their environment, antennae raised to catch potential falls before they happen, redirecting wanderers and documenting every detail of a residents day."

PSWs are constantly on the move, monitoring their environment, antennae raised to catch potential falls before they happen, redirecting wanderers and documenting every detail of a residents day.  Even mealtimes are a time for care and nurturing: skillfully feeding residents spoonfuls of softened food and medicine, and most importantly, listening to and reassuring residents who must rely on others for a task they can no longer manage.

Our conclusion: PSWs are the linchpin of excellence in resident care.  PSWs intersect with all areas of the long term care system, from provincial regulations, internal policies and procedures, medical and para-medical personnel, spiritual, physical and recreational activities staff, environmental services, food services, equipment and facilities.

"Empowered, healthy PSWs play a key role in providing quality, dignified care in long-term care facilities."

Empowered, healthy PSWs play a key role in providing quality, dignified care in long-term care facilities. When prospective families decide which long term care facility will best meet their loved ones needs, they need look no further than to the wellness of the PSWs in the facility to understand how well they will be cared for.  PSWs are the eyes and ears in long-term care facilities and we would do well to listen to them.

Authors: Marika Escaravage, Strategist, Facilitator & Communication Advisor and Michelle Reimer, Founder & Creative Director, Citizens First