Thursday, January 29, 2009

PSW training

Another issue arises for seniors cared for in their own homes by outside agencies or hired professionals. They are at risk from workers, such as PSWs who can prey on tT is for Trespasshem physically, emotionally, and financially. The 2007 Sue Grafton novel, T is for Trespass, is a mystery novel about ailing and vulnerable seniors. It demonstrates the vulnerability of seniors to those who may prey on them in their own homes. Our society has moved from a nursing model of care (nursing homes) in which the majority of staff were highly trained nurses with experience in dealing with seniors who have resistance, denial, anger, and chronic diseases and exhibit mobility and lifting issues, as well as complex pharmacologies. Only nursing staff, or those with special certificates, are legally allowed to administer medications.

Eldercare in Canada is currently an unregulated industry. In what we now call long-term care, the majority of staff are unregistered and untracked and may or may not have PSW qualifications. Whether a PSW works in the home or in a profit or non-profit agency, he or she can move from employer to employer if fired or prove to be inadequate or abusive. No controls are in place, as there are for preschool, home caregivers for children (nannies). The British system of training nannies who care for young children has an international reputation. However, those applying from other countries can forge documents and recommendations, which an unsuspecting family or agency might not think to investigate.

We are unaware of foreign practices, yet Canadian agencies continue to recruit and hire absolute strangers to live and work closely in Canadian homes with our loved ones. The agencies that hire do not keep in mind that many of our seniors are very big, and foreign workers can be small and cannot possibly lift them. However, PSWs do not necessarily have training in physical therapy, chronic diseases, and mobility and lifting issues. In Canada, with a minimal fourteen-module PSW course, there is some standardization of practices, yet without having a central registration system we have no way of knowing the type of education a worker has received, his/her previous employers, and his/her official credentials.

It is vital that PSW be highly trained, in a regulated cadre of workers whose expertise, skills and knowledge reflect the importance of the work they do, often one-on-one, with ailing, frail seniors. They need to be registered, provided with retraining and up-to-date PD, as we learn more about caring for those with chronic care issues.

In August, the government gave LTC homes the equivalent funding of 2.94 hours - from 2.16 hours previously. This is supposed to mean that a patient in a long term care facility should receive at least 2.94 hours of care per day. We know that this is only a funding formula and not a standard of care. A friend of mine, PSW Miranda Stolp-Ferrier, is fighting back with a petition. She has seen first-hand how individual LTC Home policies affect residents. She is demanding that workers be well-trained, have a minimum level of education, that workers are enabled to fight inadequate working and living conditions for residents. Miranda has seen horrible conditions. You can log on to and sign your name.

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