Home Care: Many Challenges to Overcome

Although they are passionate professionals in the home care industry, health and social services assistants (HSSA) have to cope with more and more obstacles to continue humanely practising their profession. Their working conditions are deteriorating in such a way that many of them are dealing with stress, fatigue and even psychological distress, according to a recent survey be the Fédération de la santé et des services sociaux (FSSS-CSN).

Home care workers are important players in the health care system, since there is a never-ending growth in demand, given the ageing population across Canada. These professionals support people who have a loss of autonomy and help them with their daily tasks. They take care of their hygiene and well-being, in the comfort of their home.

However, half of the 6,165 HSSAs of the Quebec network, the majority of whom are women, testified to their difficult daily reality, in the FSSS survey conducted at the beginning of the year. Although 90% of respondents said they love their profession, they condemned a shortage of staff combined with a crying lack of recognition by the government, the public and employers.

To this is added management problems that result in a heavy work overload. Many also find themselves doing tasks outside work hours, skipping breaks and lunch, for the benefit of beneficiaries.

Barrette Reform
The 2015 Barrette Reform is mainly challenged by HSSAs (82%) as being the source of the increase in the number of homes served and the reduction of time allocated to deliver the same services. Basically, they are asked to do more with less.

In parallel, the privatization of home care services to the detriment of the public sector is a concern for 51% of HSSAs, while the use of private agencies concerned 38.2% in the Montreal region in 2016-2017.

This situation is not exclusive to Quebec, since the Canadian Home Care Association (CCHSA) has also published a report on the increase in the use of private agencies across Canada, the lack of staff and recognition in the public sector.

Impacts on health and services
The physiological consequences of this work overload are such that 74% of HSSAs say they are fatigued during or at the end of their shift, while 68% feel physical pain.  

A high level of “presenteeism” (remaining on the job but with reduced effectiveness) was also noted – coming to work although feeling unwell, when it would have been better to stay home.

Also noted was that 60% of respondents experienced a high level of psychological distress related to their work. For 53% of HSSAs these symptoms appeared within the last year and for more than one year for 47% of them.

Unsurprisingly, this leads to a decrease in the quality of services, while 92% have observed situations that put the safety of users at risk. Only 10% of assistants said they had the time to accomplish the tasks associated with hygiene care.

The Quebec and pan-Canadian associations are trying to remedy this crisis by advocating for better recognition of the profession at all levels. One of the solutions would be a better salary to retain and attract more staff.

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