Unpredictable work hours, vehicle expenses forcing workers out of home care, unions say

Nova Scotians who want to be cared for at home are facing long waits or are not getting the level of care they were promised because of a shortage of nurses and home support workers, according to the unions who represent these workers.

That grim reality was shared with members of the provincial legislature's health committee on Tuesday when it heard from two unions leaders, a provincial government official and the Victorian Order of Nurses, one of the 18 organizations providing home care in Nova Scotia.

Although there's a nursing shortage in home care, the problem is bigger when it comes to the people who provide non-medical support at home, including personal care or light housework.

Nan McFadgen, president of the Canadian Union of Public Employees (CUPE) Nova Scotia, told the committee in the past year alone her union has seen its membership among continuing-care assistants drop by 10 per cent — or by 50 people, from 500 to 450.

McFadgen said she expected the decline to continue until the provincial government provided enough money to service organizations so they can offer full-time work to their continuing-care assistants.

"The conditions of work are the conditions of care for the clients we serve, and right now the conditions of work in home support are in a staffing crisis," McFadgen told the committee. "Without the workers it's impossible to provide the home support and community services."

McFadgen said many of her members didn't know from week to week how many hours they will work and, despite inflation, are not being reimbursed for the full cost of using their own vehicles to travel between clients.

Evelyn Doucette, a continuing-care assistant with 25 years of experience working for the New Waterford Home Care Service Society, spent roughly 10 years living that kind of work-life. She is now getting full-time hours but worries about her younger colleagues.

"They're frustrated. They're scared," Doucette told CBC News in a phone interview from her home in Glace Bay. "They work not knowing if they're going to have enough hours each week."

"I've actually heard from a few this week that have said their schedules are very sparse. They only have a few hours here and there."

Doucette said in the past year about a half dozen CCAs she worked with have left home care to work in a hospital or long term-care facility.

"They don't have to have a vehicle in those places because they can just go there and they're there for the day," she said. "They're guaranteed their shift. When they're called out for an eight-hour shift, they get an eight-hour shift. So it's easier for CCA to work in those environments."

Both Doucette and McFadgen said home-care workers need guaranteed full-time hours and adequate compensation for their out-of-pocket expenses. 

Safety also a concern: union

Janet Hazelton, president of the Nova Scotia Nurses' Union, said the safety of home-care nurses is a concern because the majority work on their own and often have no idea what kind of situations they are about to walk into when they enter a home — particularly during evening and night shifts.

"The home environment is often unpredictable and nurses have very little control over enforcing rules around hazards like smoking, pets, firearms," Hazelton said. 

She said there should be two people per house call to help ensure worker safety — at the very least during the initial assessment visit. 

But Tracey Barbrick, deputy minister for the Department of Seniors and Long-Term Care, said Hazelton's suggestion would be a challenge to implement given staffing shortages of around 10 per cent across the home- and long-term care system.

A department spokesperson later told CBC News the staff vacancy rate in long-term care is about nine per cent, while about 13 per cent of positions in home care are unfilled including full-time, part-time, and casual positions.

Jeff Densmore, regional executive director with the Victorian Order of Nurses, confirmed to reporters following the meeting that his organization has a "significant staffing deficit".

"We're short about 170 [continuing-care assistants] out of about 700 or 800 [positions]," said Densmore. "It's a little bit better on the nursing side but we still have a deficit on the nursing side" of about 100.

Densworth noted the areas with the longest waits for home care from his organization were in the Annapolis Valley, and the counties of Pictou, Colchester and East Hants.

Barbrick told reporters there were about 900 people on the province's waiting list for home care.

"About half of them are getting some level of care but not all the hours they've been approved for," said Barbrick. "A bunch of those people would be getting direct benefits, where we essentially give them the money [to purchase the services they need]."

Although McFadgen raised her concerns at the beginning of the meeting, no committee member questioned her about the issues she raised — unpredictable hours and out of pocket expenses.

That led her to use her closing statement to express her disappointment.

"I would leave you with this," she said. "We have workers that are not getting enough hours to live ... and that none of you asked any questions about that, is not hopeful for our members who will be watching this.

"You've left them with not a lot of hope, and that kind of sucks."