The working conditions for personal support workers in the Greater Toronto Area during the COVID-19 pandemic: a mixed-methods study

Abstract

Objective During the height of the COVID-19 pandemic, personal support workers (PSWs) were heralded as healthcare ‘heroes’ as many of them cared for high-risk, vulnerable older populations, and worked in long-term care, which experienced a high number of COVID-19 outbreaks and deaths. While essential to the healthcare workforce, there is little understanding of PSW working conditions during the pandemic. The aim of our study was to examine the working conditions (including job security, work policies, and personal experiences) for PSWs in the Greater Toronto Area during the COVID-19 pandemic from the perspectives of PSWs. Methods This study used a mixed-methods design. From June to December 2020, we conducted a survey of 634 PSWs to understand their working conditions during the COVID-19 pandemic. Semi-structured interviews with 31 survey respondents were conducted from February to May 2021 to understand in greater depth how working conditions were impacting the well-being of PSWs. Results We found PSWs faced a range of challenges related to COVID-19, including anxiety about contracting COVID-19, reduced work hours, taking leaves of absences, concerns about job security, and losing childcare. While the COVID-19 pandemic highlighted the PSW workforce and their importance to the healthcare system (especially in the long-term care system), pre-existing poor work conditions of insecure jobs with no paid sick days and benefits exacerbated COVID-19–related challenges. Despite these hardships, PSWs were able to rely on their mental resilience and passion for their profession to cope with challenges. Conclusion Significant changes need to be made to improve PSW working conditions. Better compensation, increased job security, decreased workload burden, and mental health supports are needed. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-022-00643-7.

“You Have to Be Careful About Every Detail” How the COVID-19 Pandemic Shaped the Experiences of Canadian Personal Support Workers Working in Home Care

“…34 For PSWs in our study, the COVID-19 pandemic exacerbated many of these preexisting arrays of cooccurring, job-related factors including low wages, transportation, work-stress, scheduling inconsistencies, and the realities of isolated work. Our findings are aligned with those reported by authors Hapsari et al, 35 who examined the experiences of PSWs working in home and long-term care facilities during the COVID-19 pandemic, and found overlapping experiences around working conditions, job security, and well-being. Our study complements their findings through the understanding of intrinsic rewards as motivating factors, which explain the interconnected relationships between clients and PSWs' occupational conditions in the context of the pandemic.…”

“…Our study complements their findings through the understanding of intrinsic rewards as motivating factors, which explain the interconnected relationships between clients and PSWs' occupational conditions in the context of the pandemic. Similar accounts of stress and "pandemic anxiety" described by participants suggest to us increased emotional labor and risk for burnout; unlike the accounts of support described by Hapsari et al, 35 support systems were not well defined for PSWs in our study. Organizational support can, however, act as mediating factors against the increased occupational stress of working as a PSW during a global pandemic (eg, up-to-date information and access to PPE).…”

Precarious work among personal support workers in the Greater Toronto Area: a respondent-driven sampling study

“…These demographic characteristics are also presented elsewhere. 33 Overall, 86.5% (95% CI 80.7%-92.4%) of the participants were precariously employed (Figure 1). For example, 49.3% (95% CI 40.9%-57.8%) mainly worked part-time hours and 65.3% (95% CI 57.4%-73.1%) were in nonpermanent contract positions (Table 2).…”

How equitable has the COVID-19 response been in Canada?

“…Two other papers focused specifically on the social inequity impacts of government emergency measures and new economic policies at the micro level. Hapsari and colleagues (Hapsari et al, 2022) found personal support workers' (PSW) pre-existing poor work conditions of job insecurity and lack of paid sick leave and other benefits exacerbated COVID-19-related challenges. During the height of the COVID-19 pandemic, PSWs were subjected to increased stress and poorer overall mental health and were largely left to fend for themselves with these additional burdens.…”

“…Deux autres communications portent spécifiquement sur l'effet sur les iniquités sociales des mesures d'urgence imposées par les gouvernements et des nouvelles politiques économiques à l'échelle micro. Hapsari et collègues (Hapsari et al, 2022) ont constaté que les mauvaises conditions de travail préexistantes des préposés aux bénéficiaires (PAB)l'insécurité d'emploi et l'absence de congés de maladie payés et d'autres avantagesont exacerbé les difficultés causées par la COVID-19. Au plus fort de la pandémie, les PAB ont subi un stress accru, leur santé mentale générale a dépéri, et on les a laissés dans une large mesure se débrouiller seuls avec ces fardeaux supplémentaires.…”