Monday, September 12, 2011

What is the difference between a PSW and HCA?

In short: training, education, scope of practice. It does vary province to province, too.

 PSWs are going to have a registry in Ontario.
A Health Care Aide (HCA) is the classification name that came before Personal Support Worker (PSW). Now, the upgraded course for PSW is what is required to work as a caregiver, by some employers.
The Range of Services a Personal Support Worker provides:
  • Home management (Such as shopping, house cleaning and meal preparation)
  • Personal care (such as dressing, personal hygiene, mobility and other routine activities of living in accordance with the Regulated Health Professions Act)
  • Family responsibilities (such as routine caregiving to children)
  • Social and recreational activities.
Some employers are training their own staff. Other for-profits do not require a certificate at all.
 HCA's who are presently working in major facilities usually need to upgrade to PSW if they are looking for work in health care field.
I believe it very important that we also upgrade the training and monitor Scope of Practice.

The first step to that is Registration which will be in full affect in June 2012.
Measure medications and administer to seniors, wound care, monitoring diabetes and blood sugar levels, giving insulin injections, monitoring medical needs is up to many PSWs untrained in this type of care.

The HCA Course was 850 hours. The PSW course is a mandatory 640 hours the PSW course was a mix of the Home Attendent 1 and 2 and HCA. The huge difference between the two is theory. Things have changed, the "scope of practice" for the PSW has expanded and is forever changing. HCAs have been grandfathered, however with the new Retirement Homes Act, 2010 - HCA has up to 5 years to upgrade to PSWs.

The act is silent about controlled acts, only done by licenced health care professionals. Permit PSWs to do some of the routine Activities of Daily Living (ADL). Daily routine to inject insulin where dose is unchanged. PSWs are unable to determine if dosage is correct.
Permission must be obtained for each resident.

The PSW registry in Ontario has no teeth. Last I heard staff do not check credentials. In fact, a 14 module course cannot give enough education to a person who gives the most intimate of care to our loved ones with complex comorbidities. It is education and experience and mentoring that will do this trick.

From White Coat Black Art, an excellent show about PSWs in retirement homes.
Last year, BC became the first province to set up a registry of PSWs, known there as care aides and community health workers.  The registry sets province-wide training standards and ensures a fair process for investigating complaints against front line workers.  Earlier this year, Ontario announced plans to set up its own PSW registry.


  • Personal support worker day is May 19th and recognizes the contributions of personal support workers to our health care system.
  • There are an estimated 90,000 personal support workers in Ontario with about 57,000 providing care in long-term care homes and 26,000 in home care through community health agencies. About 7,000 personal support workers provide care in hospitals.
  • The work of personal support workers ranges from assisted daily living tasks (such as personal hygiene, transferring clients between bed and chair, taking medication and doing light housework) to delegated health procedures (such as changing dressings, tube feedings and oxygen therapy).

No comments: