It is time for federal and provincial governments to come together to address the crisis in long-term care
By Carole Estabrooks
Canada’s federal and provincial governments have shown they can put on the Team Canada hat and (mostly) work together to respond to crises like U.S. tariffs and the COVID-19 pandemic.
They need that same spirit of urgency, determination and collaboration to solve another pressing problem – rising mental health struggles and burnout among long-term care (LTC) workers.
Without concerted government action to create a healthier LTC work environment, the problem will get worse, fueling greater staff turnover and jeopardizing resident quality of care and quality of life.
LTC homes already face significant staffing challenges and struggle to meet the care needs of an increasingly complex resident population – with dementia fueling LTC admissions.
Canada’s aging population will likely further strain LTC homes, making it critical that workplace issues impacting staff physical and mental health be addressed.
Work in LTC has never been easy. It is both physically and emotionally demanding and the wages comparatively low. Workers experience bullying, violence and racism.
Persistent shortcomings in funding and staffing – including shortages, high turnover and absenteeism – result in workers managing heavy workloads that often require them to rush resident care tasks and leave them feeling stressed and overwhelmed.
Despite the increasing complexity of resident needs, LTC homes remain woefully understaffed and heavily reliant on unregulated health care aides (personal support workers) – primarily immigrant women – to provide almost all direct resident care. Care aides often lack formal sufficient training given the increasingly complex resident population.
The COVID-19 pandemic made LTC work even more gruelling. Severe staffing shortages, long periods of mandated isolation, high number of deaths and unrelenting stress – with no time to breathe or grieve – all took a toll on staff. Many workers still carry trauma from their experiences and report experiencing anxiety, depression, insomnia and symptoms of post-traumatic stress disorder.
Research comparing burnout levels in LTC workers from 2014 to 2024 revealed that levels of emotional exhaustion – already high – spiked during the COVID-19 pandemic and have not returned to pre-pandemic levels.
Levels of professional efficacy – a worker’s belief that they can do their job successfully – are also lower now than they were before the pandemic.
Equally worrying are declining levels of job satisfaction and mental health. Both are strongly associated with an intention to leave.
We cannot afford to lose LTC staff or continue having them work in an unhealthy environment. It is not only detrimental to them, it negatively impacts residents, who are among the most vulnerable in society.
Their quality of care and quality of life are directly linked to the LTC work environment and the mental health and well-being of staff.
Finding solutions to reduce burnout and improve mental health in LTC workers requires the federal and provincial governments to work together on a multi-pronged approach to reform.
While LTC is primarily under provincial jurisdiction, federal leadership is vital to ensuring consistency nationwide.
Reforms must include greater investment in the LTC sector, improved quality and safety standards and creating healthy work environments. Change requires development of a workforce strategy that improves working conditions, recruitment and retention, education and training and wages and benefits.
There must also be an emphasis on mental health, including funding policies that support trauma-informed workplaces in LTC. These are work environments that understand that trauma is a universal experience with negative impacts that can affect both LTC staff and residents.
Trauma-informed workplaces create healthy and safe environments through policies and practices designed to prevent or reduce trauma and ensure people feel supported.
They also build positive work environments by guaranteeing staff have manageable workloads, receive equitable pay and benefits, have access to training and development, and are actively included in developing workplace policies and practices.
The federal government must take a leadership role in working with the provinces to make certain that data collected on quality of care and staffing and resident quality of life metrics are consistent in LTC homes across the country. Only such an approach can determine whether reforms are working or further changes are needed.
It must also move forward with a Safe Long Term Care Act and ensure that the legislation includes national standards for a healthy work environment.
It is time for federal and provincial governments to come together to foster healthier LTC work environments that promote good mental health and protect against burnout for LTC workers. Staff and residents deserve nothing less.
Photo courtesy of DepositPhotos
