Opinion: Tears, shame, fear and heroism — what’s it like to work in long-term care during the pandemic

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As a physician working with long-term care residents, I rely on reports from care aides and nursing staff to identify health issues with residents, such as skin integrity, new physical examination findings and changes in behaviour. The demands on care aides are high and long-term care only allots each resident about two hours of care aide time per day. The ratio of residents to care aides can be staggering depending on how a facility structures its staff. 

We ask a lot of these people. I can tell you that working understaffed is more worrisome for many care aides than working in a facility with COVID-19. 

Dedicated care staff, including care aides, are essential for effective, non-chemically restrained compassionate care in a long-term care facility, yet we, as a society, fail to recognize and value their work. 

Care aides across the country typically make slightly more than minimum wage and are often required to hold several jobs at multiple sites in order to support their families. Thanks to the necessary “one site” rule that many regions instituted after the pandemic outbreaks, many of these care aides have now been forced to consider retail jobs to supplement their income — a sure way to exhaust our work pool and a waste of desperately needed talent during a pandemic.   

As the work is undervalued and hard, it tends to fall to those who have few options, such as middle-aged, racialized women. Decades of system-wide failure to recognize and support new and marginalized Canadians has resulted in racialized Canadians in long-term care, and other essential yet low-wage jobs during the pandemic, paying the price. 

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