John "Jay" Poyner said he spent several nights sleeping in his wheelchair after his PSW resigned and ParaMed did not have anyone available to do the evening shift. /JENN WATT Staff

By Jenn Watt

When one of Jay Poyner’s personal support workers decided to leave her job in February it also left Poyner without someone to help him get to bed each night.

The Haliburton resident has a severe form of muscular dystrophy which in recent years has limited his range of movement making it impossible for him to get into bed by himself. So for several nights in a row in February the 54-year-old slept in his wheelchair – a situation that was not only uncomfortable but also caused him worry that he would develop pressure sores.

“I have a hard time moving” Poyner said seated in his power wheelchair in the shared meeting space in Whispering Pines apartments. “Once I’m in bed I’m kind of stuck there I can’t move.”

Poyner said part of the issue is that ParaMed the home-care provider contracted by the Central East Local Health Integration Network did not have a PSW available to work at the bedtime hour: for him between 10 and 11 p.m.

There is a worker who comes by in the morning to get him out of bed using his Hoyer lift between 7:30 and 8:30 a.m. Even when there’s enough staff that means he is in bed for between nine and 10 hours.

“The part about not wanting to be in bed for say 10 hours isn’t just about [how] I might have to go to the bathroom” he said. “I need to move because I am sore by the time morning hits and I worry about pressure sores.”

The week after his evening PSW left Poyner said he spent the Thursday Friday and Saturday night with no assistance in getting to bed.

Home care is provided through companies contracted by the Local Health Integration Network commonly referred to as the LHIN. The LHIN does intake and assesses eligibility and then a service offer is sent to one of the organization’s service providers.

“ The clinical management of the care is the responsibility of the service provider and the responsibility to manage the contract is the responsibility of the LHIN ” said Karen O’Brien senior manager of communications for the Central East LHIN.

She said that patients are not prioritized over one another but receive service based on their care plan. “ In emergency situations or when there are shortages of human resources patients are triaged to ensure that the most vulnerable are seen first ” she said.

O’Brien confirmed that there is a provincial shortage of PSWs but said she did not have specific figures on the depth of the problem.

“ Some geographic regions are experiencing it more than others in Central East LHIN we are experiencing it the most in our northern regions. We do not have the exact numbers because it changes based on changing needs in communities ” she said.

As to whether there were standards set by the government about what patients receiving publicly funded home care should expect O’Brien said: “ The LHIN always attempts to try and meet the needs of the patients and when care plans are created they are done so with the patients' care needs taken into consideration .”

She said the patient should speak to their care coordinator if they have concerns and if they’re not satisfied they can appeal.

Rodney Lau district director at ParaMed said he couldn't speak specifically about Poyner's case but said the service provider is dealing with a PSW shortage.

“We are sorry to hear about this client’s experience. At ParaMed we take our commitment to client care very seriously and our goal is to ensure the safety and well-being of every person we care for. Due to patient confidentiality we cannot discuss the details of any specific situation. We can say that we continue to work closely with the Central East Local Health Integration Network on this matter. ParaMed like other service providers in our region is faced with an acute shortage of Personal Support Workers and we are working to recruit and retain employees” he said in a statement.

ParaMed did not answer questions regarding contributing factors to the PSW shortage such as whether the rate of pay or compensation for mileage contributed to the problem.

Regarding wages O'Brien said: "There is a minimum wage ($16.50) requirement that all government funded agencies must pay. Agencies also compensate for mileage in different ways (stipend per km etc.)" however the Echo did not receive details from ParaMed about how it compensates its staff.

David Jensen a spokesperson for the Ministry of Health said the government is working on a PSW strategy “ that would optimize and stabilize Ontario’s PSW workforce” with more details soon to come.

He said the ministry has been made aware of factors contributing to shortages including “compensation travel scheduling training access to patient information and the nature of home care service delivery.”

“The ministry is also taking steps to expand the capacity of the home care workforce through client-partnered scheduling an initiative that lets service providers schedule visits directly with home care clients to better match available personal support workers with client preferences” he said.

Jensen said that new legislation would also make things better for patients needing care at home.

“Recently the government announced a plan to enable integrated and innovative models of home and community care through the introduction of the Connecting People to Home and Community Care Act. If passed the legislation will allow Ontario Health Teams to deliver more innovative models of home and community care. Patients will benefit from primary care hospitals home and community care and long-term care providers being able to collaborate directly to provide care that best meets individual care needs. Service maximums will also be eliminated” he said.

More recently Poyner said ParaMed has found someone to come in on a temporary basis but that when there has been bad weather sometimes he doesn’t get help. He inquired with his care coordinator about a program called “family-managed home care” which would enable him to hire someone himself to come in during the bedtime hour. That process is in the works.

Still Poyner said he is frustrated that he’s had to work so hard to advocate for his care and endure so many days without the assistance he needs.

“All in all this has been hell and I’m not afraid to say it” he said.