Op-ed: Long-term care workers face ethical questions in uncaring system

The COVID-19 pandemic has shone an awful light on Ontario’s long-term care system. It has also renewed calls to invest in long-term care and protect residents and their families.

On Thursday, October 1, the Ontario government announced plans to raise the pay of personal support workers by $3 an hour. It’s part of a plan to recruit more workers and retain those already in the system. But it’s not enough.

I know how harmful current conditions of care can be not just for residents and their families, but for care workers whose life trajectories are profoundly shaped by their work.

My five-year stint as a care worker was by far the most demoralizing experience of my life. It was horrible to be tasked with caring for vulnerable people without the organizational supports to pull it off.

At the Ontario care organizations that I worked, providing inadequate care seemed built into the job itself.

I have spent the last several years researching the limits of care in Ontario. I have interviewed many care workers at their wits’ end, including those who reached a breaking point and walked off the job. Many have described life-altering and traumatizing experiences that they are still recovering from years later.

One woman told me “how brutal it was and how much it ruined” her to work within a system “set up” to neglect people she cared about.

Another shared how “really shattering” it felt to be overworked to the point of losing their capacity to care for others.

The Canadian Armed Forces report released in May described the horrific conditions in many of Ontario’s long-term care homes. It cited examples of degrading and inappropriate treatment of residents. It made clear that workers didn’t have adequate staffing levels or the time, resources, training or supplies needed to do their work. They should never have been put in such hazardous and ethically fraught situations.

We’re asking a lot of care workers. Many are asked to give up their lives.

Those who end up leaving because of the stresses involved in the job are cast as heartbreakers abandoning others. Those who stay are viewed as complicit in an uncaring system.

But the moral dilemmas care workers have to negotiate are a matter of design; they are about the limited social and material infrastructure and profound underinvestment in public sector supports for care.

And it’s mostly women – particularly racialized, Indigenous, immigrant and working-class women – shouldering the work; and for-profit care home operators who are profiting off vulnerability.

Calls to recruit and retain care workers outnumber calls to learn from their insights and stories, respond to their vulnerabilities and needs and support them in making choices.

It’s time to rethink idealized histories of care that hinge on “good girls” caring for others indefinitely, against all odds, at the expense of ourselves and regardless of working conditions.

Care needs to be a public, collective responsibility, not a for-profit, private one.

In Canada, care relationships are too often sources of violence and harm for people who need care and for workers. These relationships are fractured. We need to challenge the ways we are so often set up to become pitted against one another.

Major investments and meaningful national standards are needed in long-term care. We also need to have tough conversations about how we stop setting women up for such intimate losses.

Janna Klostermann is a PhD Candidate in Carleton’s Department of Sociology and Anthropology.


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