The PSW Perspectives on the Staffing Challenge in Long-Term Care report was created to help share the voices of those who often go unacknowledged and unheard – the personal support workers (PSWs) – and to help understand their day-to-day professional experiences.

The Ontario CLRI at the Schlegel-US Research Institute for Aging (RIA) has partnered with Overlap Associates to invite PSWs of Ontario to voice their experiences with the ongoing staffing shortage in LTC homes. PSWs were given a chance to voice what kind of changes they would make in their LTC homes and how they could make their home culture better and improve human resources practices.

The ideas and solutions given by PSWs in this report are easy for homes to use right away; small changes that PSWs identified can make a huge difference to their roles and their overall experience, such as:

• Setting up buddy system so PSWs can work in pairs.
• Allowing management and team leaders to ‘walk in PSWs’ shoes’ for a day.
• Providing PSWs with mental health support.
• Distributing and balancing workload so that no one individual is burdened by working with residents with high needs all the time.
• Including PSWs in resident move-in meetings so that they can learn about the family and build the relationship from the beginning.

Tools to support action

PSWs spoke to us of the gap between what they learned in school and the realities of a job in LTC, particularly when they are short-staffed. They identified a need for on-the-job training, longer placements and other opportunities for experiential learning.

PSWs also felt that mandatory training should be expanded to include topics such as crisis intervention and de-escalation, dementia and responsive behaviours, mental health, palliative care, addictions and anti-racism. Home leadership was encouraged to seek out training in team cultures, communication and mental health for team members.

The Ontario CLRI has a collection of resources available on our website to help address the gaps and needs PSW identified.

The following is a list of tools and programs to provide training and guidance to PSWs and team members as well help leaders and managers begin to address issues raised by the PSWs.

• Excellence in Resident-Centred Care – (ERCC) is a Conestoga College certificate program designed for Personal Support Workers (PSWs) and other team members to build practical skills and features 15 online modules covering key topics in LTC. The Ontario CLRI periodically provides backfill funding for PSWs to take this training through the PSW Education Fund.
• Team Essentials – Four modules that provide innovative educational solutions for LTC team members around priority issues in LTC.
• Working Together to put LIVING First – This resource shares the story of how an LTC and retirement living organization (Schlegel Villages) partnered with a research team at the Schlegel-UW Research Institute for Aging to go on a unique culture change journey.
• Homewood Health support for PSWs – Homewood Health has partnered with the Ontario CLRI at RIA to provide free access to their online resources to Ontario long-term care home leaders and team members during the COVID-19 pandemic.
• Clinical Nursing Leadership – This eLearning course will enhance the clinical leadership skills of nurses working in long-term care.
• Caring for Persons with Dementia – This eLearning course is designed to enhance or develop team members’ knowledge on caring for residents living with dementia. The course introduces approaches and strategies to use while delivering personalized, quality care.
• Embracing Diversity Toolkit – The toolkit was created by the Ontario CLRI and was informed by the Supporting Diversity and Inclusion in Long-Term Care Advisory Committee and other experts, including persons with lived experience.
• Person-Centred Language – This page has eLearning courses, useful suggestions, activities, reflection questions and other resources to increase the use and spread of person-centred language in your long-term care home.
• IPAC web page – This page includes tools and resources to equip those working and volunteering in LTC with the skills and knowledge they need to protect themselves, their colleagues, residents, family members, and community members.

What else can LTC homes do right now to support PSWs?

The LTC sector has the chance to come together to support and engage those who care for and protect us and our families – PSWs and frontline workers. Consider implementing one or two of the ideas we heard from PSWs in your home today!

• Enable all team members to support PSWs by training them in key activities such as using lifts and other tasks so that someone is always available to help and support PSWs when needed
• Improve dynamics between experienced and new PSWs (mentorship/preceptorship programs)
• Develop a mobile app for new PSWs to connect with a mentor and have support while adapting to the work environment.
• Plan team-building activities to improve trust and communication.
• Recognize PSWs for excellent care through a submission process where team members, families, residents can nominate a PSW for recognition.
• Provide time to enable PSWs to build relationships with residents and families and provide more person-centred care.
• Educate families about the roles in an LTC home and about expected interactions/behaviours.
• Management can jump in when PSWs are short-staffed or to address staffing challenges.
• Develop a staffing squad of PSWs, management, and other team members to meet regularly and discuss challenges and build resolutions together.
• Ensure continuous training for PSWs on key topics such as dementia, mental health, addictions, crisis interventions, etc.
• Continue full-time positions for PSWs that were mandated during the pandemic.
• Hire more PSWs and other team members.