Quis Curat Dantium Curam? Who Cares for the Carers?

Fixing Healthcare Starts with Legitimizing the Caregiver Profession

We stand at a massive inflection point for our healthcare system. For decades decision makers have fretted at the baby boomer demographic bulge that would impact in the 2020’s, and how our overburdened healthcare system would cope – but very little was done to address this problem of tomorrow.   

And then we were hit with the 2020 pandemic that showed just a few hundred extra ICU patients put our entire healthcare system at risk of collapse. 

Tomorrow is today, and we are facing the coming silver tsunami with a fractured system designed in the 1950’s that has been patched with duct tape for the past 70 years.  There is only one solution to this problem – We must build and integrate Comprehensive Healthcare at Home into our healthcare supply-chain. 

Ageing, managing chronic conditions and medical recovery at home takes pressure off hospitals and primary care.  It frees up beds.  It lowers cost across the healthcare ecosystem. And there is empirical data that shows homecare significantly improves health management, medical recovery and health outcomes. 

But there is a “problem within the problem”. 

At the heart of homecare and through the entire healthcare supply chain are the frontline Personal Support Workers (PSW’s).  They are underpaid, under recognized, and under supported.  Consider that today, a hairdresser or barber as a profession has more structure and licensing than PSW professionals providing critical support for people at their most vulnerable time of need. 

The challenges in this job lead to high turnover, with more than one third of Ontario’s more than 100,000 PSWs having less than 1 year of experience.  This leads to undertrained individuals providing inconsistent care – which leads to a poor experience and satisfaction for patients. 

We need to change this role from a transient gig with inconsistent hours, low wages, and high physical and mental stress into a respected profession. It needs to encourage consistency, quality, education, and continuity of homecare professionals.  And in turn compensation, work environment and recognition must continually advance. This is a big step in truly delivering “comprehensive” healthcare at home and improving other healthcare touchpoints. 

Over the past few decades multiple failed attempts have been made to provide some sort of registry or oversight to this profession.  Registries in 2011 were scrapped in 2016, and a new proposal in 2017 never got off the ground.  Currently the Health and Supportive Care Providers Oversight Authority Act of 2021 is in place but lacks teeth and support from the industry to fulfil its mission.  Amendments proposed in December 2023 may help this but have not been passed as yet. 

A properly implemented PSW registry would help in all respects – the frontline workers would have a chance to show their work history and professionalism, making it easier to get jobs and find career advancements.  And those workers that are not as motivated to professionalism will be forced to improve or be weeded out of this critical role.  Unfortunately, today PSW’s fired for misconduct from one employer are getting a job at another agency, hospital or long-term care home the very next day. 

In our own respect at Stay At Home Nursing we are trying to be an agent of change.  We have instituted a training and “certification” curriculum for all our PSW’s. This voluntary (yet highly encouraged) skills-growth offers training both through our agency and other third parties to develop crucial skills.  PSW’s who participate in it have tiered and permanent pay increases as they learn more skills. 

But we also recognize that we can only influence so much from our side and want to reach out across our network and ecosystem. This is our rally cry to drive training and skills programs to create a movement for PSW’s and their recognition.  Please join us!   

There has never been a more critical time for this given the recent pandemic and demographic bulge already impacting our healthcare system.  The only realistic, expedient solution is to dramatically increase our ability to deliver comprehensive healthcare at home.  Doing this requires not only consistency and quality of the caregivers, but also leveraging mature technologies such as remote monitoring, AI vision and alerts, and virtual care.  

Homecare services overall must also step up and deliver greater support and guidance to patients and their families around navigating the complex healthcare system and set of players.   This is also a natural evolution and growth for certain PSW’s who want to grow their careers into a “Healthcare Navigator”. 

This frees up hospital beds, lowers the strain on the healthcare system, and drives greater efficiency.   But it is bigger than that.  It also delivers a better experience and healthcare outcomes for clients. 

And let’s never forget that at the heart of this is our frontline caregivers.  We must take care of these heroes, and for many who may not stand up for themselves.  We must care for our caregivers! 

My Thoughts Sincerely: 

Robert Stanley,   

CEO, Stay at Home Nursing 

Come join us.  Make a difference.  Be part of the home team! 

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