Heart and Steel

"IF MY DAUGHTER TOLD ME she wanted to be a personal support worker, I’d break her legs,” says Gail Moriarity.

Gail has been a PSW for over 30 years and union steward for over 20 at a long term care home in Ontario. No one knows better how tough of a job it is to be a PSW in Ontario today than Gail.

When I first met her during the course of my work as a CLAC representative, the first thing I noticed about Gail was her warm smile, her welcoming attitude, and how much she cares about her residents. It’s easy to see why she’s a favourite with so many of them. She’s the kind of person you want as your neighbour and friend—and especially as your caregiver.

On days when she is working, I can tell which residents are under her care because of the special little touches she does that make such a huge difference in their daily lives, that make them feel loved and cared for. Their hair is done. Their clothes are just so. If they are upset, Gail will stop what she’s doing and listen to whatever they have to say face to face, even if it means getting down to their level sitting in a wheelchair—and even if it’s the hundredth time they’ve said it.

BUT BEHIND HER WARM SMILE and warm heart lies an undercurrent of steel. You have to be tough to survive 30 years as a PSW. That toughness has been forged daily by the state of crisis that PSWs work under today.

It’s also what makes her such an effective steward. Gail is as equally pas­sionate about caring for her fellow Local 305 members as she is about car­ing for her residents.

When I’m visiting the home, I’m often caught in the middle of many demands for my attention. Gail will quietly and firmly draw my attention to the most pressing issues at hand to ensure action is taken.

She embodies the CLAC spirit of being a champion for her coworkers. She knows that being a stew­ard is not always about just filing a grievance. It’s about being a strong advocate and getting results.

Over the years, I’ve had many long conversations with Gail at the local country café near the home where she works. Our conversations have ranged from the specific immediate concerns of her fellow members to the broad, never-ending crisis that is Ontario’s long term care system. She has seen this crisis unfold in the province. She knows this industry inside and out.

I asked her to share some thoughts about what it’s like being on the front lines doing such a demand­ing job—while simultaneously doing the often thankless job of a steward—and what we need to do to end the crisis in Ontario long term care.

You’ve been working in long term care in Ontario for 30 years. What has changed during that time?

Number one: lack of staff. When I first started, we would take care of six or seven residents per staff member. Now, because of the shortages, we’re taking care of 11 or 12—nearly twice as many but with no extra time to care.

We used to be able to have the time to sit with residents one-on-one, talk about their children and their lives, and have meaningful interactions with them. We just don’t have time for that anymore.

The level of care has also changed. Residents are coming in with more behavioural issues, they need more complex care, and have higher rates of dementia. Many are also much heavier today than the seniors that came in years ago.

What’s the biggest issue with the long term care system right now?

Working short. We’re constantly working short, and there are not enough qualified PSWs to do the job. It’s hard work and it’s backbreaking work.

We often don’t get our breaks because we’re short-staffed. You can never relax because your mind is always worrying about each of your residents and whether you did this or that for them . . . did I bathe that person? Did I dress this one?

I could make just about as much money working at Tim Hortons, but I choose to work in long term care. I love my residents and I feel for them. It kills me when I can’t do enough for them.

What toll has the job taken on you?

This job has left its marks on me—physically and mentally. I’m suffering from fibromyalgia and was just diagnosed with a blood pressure condition re­lated to chronic stress. I push myself and push myself, because the work has to be done! These people need my care, they need my 100 percent, which I can’t always give them.

We’re all struggling physically. The lifting, the hustling . . . it can all become too much. We’re al­ways running, because we do not have the time to care the way we need to.

We run nonstop between toileting, portering back and forth for meals and snacks, stripping and making beds, and putting out linen for the after­noons. And then there are people who need to be moved who require two people to do so. It causes a lot of wear and tear.

I’ve cried and almost walked out of my job on sev­eral occasions. I have friends in other industries who would never be able to do the work we do!

What do the residents do while you’re running around doing everything?

They wander. They’ll ring the bell to get our atten­tion. Some go outside and have a smoke. Many will just be in the lounge watching TV and sleeping.

It’s so sad, because we don’t have time to give them. We don’t have time to ask them how they’re doing today—we’ve got bells ringing non­stop. We’ve got this one asking for help, this one needing to use the washroom. We have one who has to use the wash­room 10 times a day because she has a UTI [urinary tract infection].

Is wandering a big problem with residents?

Oh yes. Some of them have wander bracelets, which set off an alarm if the resident goes past the boundaries.

We have wander guards, and if it gets really bad, they are put in a spe­cialty unit, which is locked. But we still have problems with wandering residents. We go looking for a resident and then find them sleeping in somebody else’s bed. That causes lots of problems!

Long term care facilities are often referred to as homes. What do you make of this?

It’s not the reality of it. It should be their home—they should be able to sleep in, have their meals when they want to, have their bath when they want to and not when the ministry regulates it. The ministry says residents should have two baths a week regardless of how they feel.

But I’ve always been consistent in my care ever since I started in the ’80s. I treat all my residents like they’re my own family, and I do every­thing I can for them. They should all be treated with the greatest dignity, no matter what.

Have there been any positive changes in long term care in Ontario over the years?

None that I can think of. That’s how bad long term care is in this prov­ince right now.

Those of us on the front lines of care are treated so badly. We do not get any respect. It’s really sad, because we’re the ones providing the most intimate care to these seniors in their last years on earth.

And it’s not just the PSWs who are struggling. It’s housekeeping, laun­dry—everyone.

The new staff are not equipped to handle the workload. They may go through the PSW training program but they’re given the false impression that they’ll have all the time in the world to take care of their residents.

But the training is based on homecare work, not long term care, where that is definitely not the reality! And the current trend right now is for people to opt for homecare as opposed to long term care, which is why we’re getting great­er morbidity when seniors come to us because they’re going into long term care as a last resort.

What changes need to be made?

Government officials—the ones in charge of mak­ing policies—should be forced to go into a nursing home and do our job and be treated the way we are. Then we’ll see changes get made!

When the Ministry of Long-Term Care comes in for an inspection, it’s all hands on deck and things run better that day. But it should be all hands on deck all the time.

There also needs to be a greater emphasis on mental health for jobs like ours. I’m glad CLAC is focussing on mental health and training stew­ards on mental health first aid. The abuse and the exhaustion we deal with every day are so bad for our mental health.

Let’s talk about your role as a steward. What’s it like being a steward?

It’s empowering and I do get a lot of respect from my coworkers. It’s so good to be able to go to bat for your fellow members, settle grievances for them, and get them what they deserve.

But it can be frustrating at times. Sometimes, you have to be a bit of a detective to get the whole truth, not just hear one side of the story. There are usually three sides to every story.

And you have to act like a lawyer, too. You have to learn how to argue well to get your point across.

What do you enjoy best about being a steward?

I really enjoy being in negotiations and getting a good outcome for my fellow members. A lot of people seem to think unions are how they’re por­trayed in the movies: slamming the table and say­ing, “This is what we want and if we don’t get it, our people will walk!” In reality, there’s more cooperation involved than steamrolling.

I’m proud of being able to get good settlements for members who deserved it, or I’ve given them a good reference so they can move on. I feel good about getting people their jobs back and handling grievances well.

According to a 2015 study published in Research in Gerontological Nursing, people entering nursing homes in the US are getting heavier and heavi­er. The percentage of those who are moderate­ly and severely obese (body mass index of 35 or greater) has increased from 14.7 percent in 2000 to nearly 25 percent in 2010. Heavier residents require more care, which means more staff, and greater strain on staff providing care.