By Graeme Cheadle
The coronavirus pandemic continues to rage, and frontline workers everywhere are bearing the brunt of the risk, often with little help. Support workers in care homes face daily challenges of low pay, exposure to the virus, a chronic lack of personal protective equipment, and not as much publicity as other healthcare workers. Several have already died around the country. Recently Spring Magazine sat down with two support workers in Vancouver. They discuss their workplace and how little support they and those they care for have received in terms of access to PPE and testing. At their request, their names have been withheld to protect them from reprisals from management. This part one of a two part interview.
What kind of work do you do, and what does that entail on a daily basis?
NS: We both work for non-unionized companies that provide support activities for daily living: integration in the community for adults with intellectual disability onset before age 19. That’s funded by Community Living BC, which is a crown agency. Our clients are in the senior age category. A lot of them are survivors of Woodlands [a psychiatric institution notorious for abuse] and other institutions. But this agency also serves people younger than that.
CH: I’ve been working at my organization for 21 years in various capacities. I’ve been an advisor, a supervisor, and I’ve been working residential. I worked in a day program for over 10 years before that, and for the last 10 years I’ve been residential in two different locations. Right now I work with three seniors with intellectual and physical disabilities, and one guy who’s younger, in his 30s. That’s the demographic, in terms of who I support at this moment.
Thinking about your co-workers, do you notice any pattern in terms of them being mostly women, mostly immigrants, or is it pretty mixed?
CH: I can’t speak for the entire company, but in my location it’s mostly women. There are sort of demographics from the 20s to the 70s. There are quite a few immigrant people working there for sure. It’s really mixed, multiculturally.
NS: I would say my location at the same agency is primarily immigrants these days, but that’s a newer trend. And mostly women, for sure.
The national chief public health officer, Dr. Theresa Tam, has said that nearly half of all the coronavirus-related deaths in Canada have happened in long term care homes, and that this number is only expected to increase. Given your experience in this industry, why do you think the number is so high in these homes, and do you feel that anything could have been done to prevent this?
NS: I don’t think she was necessarily referring to our programs. Long term care would be similar to home care, because we’re servicing vulnerable people, and we’re doing that direct care work that’s at close range. But we don’t have as many people coming through the doors as you would in residential care, because our facilities are generally limited to about four clients maximum. I think there’s already been a support worker die of COVID contracted on the job in an agency very similar to the one CH works in, so I think there’s definitely a risk because of the nature of the work that we do, but we’re probably less vulnerable to that because we’re not as big at our facilities.
CH: I think, as far as what they could have done ahead of time, obviously it’s difficult to get PPE. But, just last weekend did they get masks and goggles for bathing and personal care. No one was provided with masks or face shields or goggles or anything [before that]. There were no masks on the individuals that we did the personal care with, and I didn’t really feel like people were taking any precautions or trying to get their own masks. I think there was a lack of education about it as well, which is troubling, because the information was out there. CLBC was putting directives, certainly to our agency. Someone there, I’m hoping, was reading that and disseminating the information, but it was not happening as rapidly as it should have.
Do you think it was more of a problem with communication, funding or longer-term issues, or just in this case it wasn’t really handled as efficiently as it might have been?
NS: Some pretty basic information, some directives, came from Community Living BC for instance, to try to work in a way that’s distancing. And then the burden is on the agency to provide the training to their workers based on those recommendations, and that’s what seems to have been poorly done. The support workers in general have needed pretty explicit instructions to be able to understand how to follow those recommendations in the context of our work.
For another example, we generally do transportation for our clients. We drive them around in vans and things like that. Eventually CLBC came out with a policy. First they said work in a way that’s distant, and the agency should have extrapolated that that means you can’t have multiple people in a vehicle, for instance. But they didn’t seem to get that, or they didn’t communicate that to their staff, so that was going on for a very long time.
Finally, CLBC put something out a week ago saying, “Oh, that means, with transportation, remember, you’re not distancing. If you’re in a van together, make sure that you’re in a vehicle big enough.” So there haven’t been really solid educational materials coming out of the agency. I believe it’s their job to interpret what we’re getting from the crown agency that funds us to help apply what the really basic directives are to our work.
And there’s a million examples of where people are at risk because we’re doing personal care like bathing and dressing and giving medications and things like that where it’s up to the support worker to figure out how they’re going to try and do those things in a way that’s safe, especially with a lack of PPE. And when it comes to PPE too, as far as we’re aware, it’s been on the agency to try and acquire it themselves. The larger company that CH works for right now has said there are two people whose whole job is dedicated to trying to acquire PPE from the regular market.
For myself, I’m a manager at my job, and the crown agency is providing those things to us, and it’s probably just a sort of blood-from-a-stone type thing. They don’t have it either. So the health authorities are not providing it to CLBC as far as we can see. I put my order in with Community Living BC about two and a half weeks ago, requesting the equipment that they’ve said we need to have to do our jobs, and we’re not getting it. So more PPE would definitely lower the risk, and better education. I think those are the two main issues. I mean as managers we got training in doffing and donning PPE that we’ll never get.
CH: Just to add to that, my very large agency, in terms of how to do all these things, has a training module that you do online. A lot of people are ESL…They just say “Well we assume you’ve done it,” and no one shows people how to do it. God forbid, one of the guys gets sick, they say they’ve hired a nursing agency to come in and show us how to do PPE properly if you get a positive COVID-19 case. It’s insane, when any of us can be impacted right now, any of them can be affected individuals. They should already know. I don’t think anyone in my group home knows how to do a self survey and to see whether they have it or not. They say that we should be checking the client’s temperatures twice a day, and we have no thermometer yet.
NS: It’s also basically impossible to take the temperature of many of the people we work with. That’s another sort of unique thing. It’s probably similar to what workers in residential care maybe who work with individuals with dementia might be experiencing, because the individuals that we support – this is a general statement – but it’s extremely common that they don’t have an understanding of distancing, they have behaviors that are quite intrusive in terms of getting close or touching a lot of things. And another challenge there is it’s actually extremely hard to take oral temperatures. But we don’t have access to any other equipment for that.
Is there even testing? How would they even know if anyone in your group homes tests positive?
NS: It would be very difficult to test a lot of individuals, because they’re not going to allow the invasive thing that you’re going to have to do, putting something up someone’s nose, or I don’t know what else…There’s not a lot of education. What CLBC is saying is, yes, call 811 [the BC provincial health information line], do the self-assessment tool.
That’s the thing, we’re kind of doing healthcare, but none of us are trained in healthcare. The same thing about this industry, we’re all doing mental healthcare, we don’t have training in that either. We have a one-day first aid training. That’s what all these staff have. And then whatever they’re providing to us now, they’re trying to inform us of proper practices like doffing and donning and things like that? Those are terms that no support worker has ever heard before now.
I think there is a link on the CLBC website, talking about the priorities for testing. It’s a directive from all the health authorities, the provincial Health Authority. They basically said there’s sort of a second-tier-type priority for testing people who work in environments like we do. I specifically asked CLBC if they would give me a letter to show where we work so that we can present it at a testing site and show that we are a priority, the second-tier priority for testing, and they wouldn’t do it. So, the agencies are creating their own letters to try to support testing among staff. CH was supposed to get a test but never got one.
CH: I went through that, talked to the nurse that you get on the phone and you call 811. And they said “Yes, with your possible symptoms, and the fact that you’re a healthcare worker, you should get a test.” I did this online, but never heard anything back. I was feeling better, I talked to my doctor and he said “Well, it doesn’t sound like you probably had it, you’re probably fine, you know, once you’ve done your quarantine, you’re good to go.” But I never got an e-mail. I was supposed to get an e-mail telling me where to go, when to go. I called back, they gave me a phone number for a place to go. I got ahold of that place, and they said “No, we don’t do that here.” It was really messed up.
It sounds like you are in an industry in which people can easily fall through the cracks. You could have had it, for example, CH, and gone to work and spread it, and it wouldn’t have been discovered, from what you’re saying.
CH: I believe it was fourteen days, at the time I went off. And then they changed it to ten. My HR person was trying to pressure me to come back, after the ten days, and asked me if I had symptoms now and was asking about what my doctor said, and all this crazy stuff. My doctor just said, “Well, do the full fourteen days.” That’s what he wanted me to do.
NS: Another issue too is testing for the clients. A plan would be to have a mobile lab to come around and do testing. I haven’t received any information on that personally, but I think about it all the time, in regard to the individuals who I support are ignoring quarantine and who’ve had coughs and things like that. I’ve had an individual who 811 said needed a quarantine, and they just ignored it. But I keep thinking if he gets it, I’m not going to take him to even a drive-through testing site, because I can’t distance in my little car. There have been no alternatives. They’re very hush-hush with the testing sites, so I haven’t been told that we can call someone to come and do it in his home or anything like that. That would be a lot of risk, if he was really concerned that he might have it, and I’d just sit next to him in my car? So I don’t know what I’ll do, if that happens.
Part 2 of the interviews will discuss the government response to the pandemic.
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