Health-care aides say overwhelming work conditions at Winnipeg care home putting residents at risk
Aides at Holy Family Home say they're assigned 20 residents on night shift, but ratio climbs as high as 40:1
Some longtime health-care aides are speaking out about what they describe as overwhelming work conditions at Holy Family Home, pointing to repeated instances of understaffing they said put residents and employees at risk of physical and mental harm.
Eight aides from the 317-bed, non-profit personal care home in Winnipeg's North End said they're coming forth as a group in hopes that solidarity will protect them from being sanctioned or losing their jobs.
The aides said they're assigned to 20 residents each while working the evening or night shift, but when a co-worker goes on break, that ratio goes up to 40 residents per aide.
"We're doing our best," said Melda Macalino, sobbing as she recounted her experiences.
She's now on disability leave, after working at Holy Family for 24 years.
Macalino said she developed severe depression after facing non-stop pressure on the night shift.
She said residents — who include seniors and others requiring long-term care — ring a bell when they need help. Macalino said she'd often have five to 10 residents sounding the bells at the same time.
"The bells keep ringing and you cannot leave the residents until you finish [changing them]," Macalino said, adding that the notification system makes it impossible to tell who most urgently needs help.
Macalino said she cares deeply about her clients, but residents often lashed out at her after waiting long periods for assistance.
"Even if it's hard, you have to do it, because no one will look after them."
The aides said the risk of injury to residents goes up the longer they wait, since many will try to get out of bed and take care of their needs themselves.
People sometimes start screaming as they wait, which can lead to arguments among residents, all of which wakes others up, the aides said.
"And if something happens, you're the one who will be blamed, because you're the one what's on the floor," said Macalino.
Her colleagues shared similar frustrations around the late shifts at Holy Family, and say their calls for change have gone unanswered.
"The management doesn't pay attention to us," said Harold Dela Cruz, an aide at the home for 17 years.
"One time I said to myself, 'I just want to give up,'" he said. "I felt … like they're trying to break us."
Grievances filed
Holy Family Home is owned and operated by the Sisters Servants of Mary Immaculate, an order of nuns, and offers "a full complement of health-care services and specializes in meeting the physical, social, cultural, and spiritual needs of its resident population," the care home's website says.
In a statement, the home's CEO, Angela Peeler, said Holy Family appreciates "the dedication of all our health-care aides," and that employees who have concerns should approach management or their union.
But the aides said many are afraid to go to their bosses, after being issued official complaints by Holy Family for incidents they said arose due to understaffing.
Fearing retribution, they went to an advocate for help.
"What got my attention is that intimidation, that they don't want to talk," said Edda Pangilinan, CEO and founder of the Health Care Aide Association of Manitoba.
"They're scared to lose their jobs if they speak up," she said. "Is this Canada?"
Pangilinan said she took members of the group to meet with two regional representatives of the Manitoba chapter of the Canadian Union of Public Employees.
CUPE confirmed it met with the aides and said it filed two grievances on their behalf.
Meeting provincial standards: Holy Family
The provincial health ministry said Manitoba currently requires that personal care homes provide residents with 3.9 hours of direct care per day.
A spokesperson said the province is "on a path" to increase that rate to 4.1 hours, as called for in a 2023 Standards Council of Canada report on long-term care services.
Peeler, the Holy Family CEO, said the home "consistently exceeds this ratio, providing approximately 4.22 paid hours per resident day."
But some seniors' advocates say the formula is flawed, since it doesn't account for individual needs or what time of day that care is provided.
Laura Tamblyn Watts, CEO of the advocacy organization CanAge, said that can lead to an imbalance in staffing, leaving night and weekend crews shorthanded.
"There's a great desire to have a fixed ratio" for staff to clients, she said, rather than the more complicated hourly equation.
"CanAge has talked about ratios similar to early childhood education, where you might have something like a four to one ratio."
But Peeler said the current formula is working.
"Our staffing models are built to ensure the people who live at Holy Family Home receive safe, compassionate care, 24/7," she said in an email.
"Night shifts include two health-care aides per unit, with the recent addition of two float positions on nights to help cover breaks in each of the two buildings."
Staffing levels are similar to other personal care homes, and follow guidelines included in the employees' collective agreement, Peeler said.
Macalino, who worked the night shift, said Holy Family did add two float positions after the start of the COVID-19 pandemic.
But she said the float shifts are only assigned to specific floors on a rotating basis, leaving other units without a spare.
Macalino added there are frequent employee absences, so float workers routinely replace people who called in sick, typically leaving staff without anyone to cover breaks several times a week.
Staffing levels
In a statement, CUPE Manitoba president Gina McKay said the union has long fought for mandatory minimum staffing levels in long-term care homes, adding it raised the matter directly with Uzoma Asagwara, the minister of health, seniors and long-term care, in December.
In 2020, while in Opposition, Asagwara introduced a private member's bill calling for mandatory minimum staffing levels.
"We would like to see similar legislation reintroduced that explicitly includes health-care support workers," said McKay.
In an email, the now NDP government said it's moving forward with an agreement with nurses to increase their staffing levels.
A spokesperson for the health ministry said it expects that will also ease pressure on aides who "have to pick up the slack when there aren't enough nurses."
CanAge CEO Tamblyn Watts said long-term care homes will struggle to hire and retain health-care aides until working conditions are improved.
"If [aides] don't have any help — and they feel like they're being attacked or traumatized by people who are frustrated with the reduced level of care they can provide — they're going to find another career outside of the seniors' care sector.
"This is a crisis that our government needs to pay attention to."
Advocate Edda Pangilinan said she plans to contact the premier and health minister to make sure the aides' voices are heard.
"Treat them as human beings, not slaves," she said. "And listen to them."
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