age discrimination Archives - 91��ɫU Centre for Aging Research & Education (YU-CARE)

Temporary agency workers have long been a crutch for a care system in crisis, experts say. Now, they are exempt from new COVID-19 health directives

Tue, 12 May 2020 13:38:44 +0000

By Work and Wealth Reporter. Sun., April 19, 2020

Long before the pandemic hit, “working short” was a chronic problem for personal support worker Febe Jimenez.

Staff were overloaded on a good day at her Hamilton-area retirement home; a single worker’s absence could throw an already tenuous care system built on low pay and long hours into disarray. For temporary relief, she says, help was habitually drafted in from three separate staffing agencies: one for nurses, one for night shift, and one for day shift.

“Before this happened, we were going through agencies like crazy,” Jimenez said.

A new directive issued by the province this week limits the movement of health-care workers between facilities in a bid to contain the devastating spread of in nursing homes. But the directive does not apply to agency workers, who earn their living floating from home to home.

It’s an exemption critics call a health risk — and a sign.

“It shows just how desperate the Ontario government is to adequately staff these long-term care facilities,” said Candace Rennick, secretary-treasurer of the Canadian Union of Public Employees and a long-time nursing home worker.

“We know there is a complete staffing crisis with respect to shortages and retention and recruitment. They are so reliant on this temporary agency contract work that they need to exempt them from a fundamental order to keep people safe.”

In a statement to the Star, a spokesperson for Minister of Long Term Care Merrilee Fullerton said the order did not apply to “agency workers or other critical contract staff” in order to “ensure a steady supply of staff available to work on an emergency basis in long-term care homes.”

“To ensure the safety of long-term care residents, these workers are subject to ‘active screening’ direction set out in a directive by the Chief Medical Officer of Health, which requires a rigorous screening process before being permitted entry into a long-term care home,” the statement said.

Even for directly-hired personal support workers, poor pay has long meant juggling multiple jobs at different homes, says Sharlene Stewart, president of Services Employees International Union Healthcare.

“Workers absolutely want one full-time job. But when you pay them so poorly … you have to work two jobs to barely make a living,” she said.

In light of the pandemic, the government has said these workers can pick one employer and take job-protected leaves of absence from others to comply with new directives.The province has also said it “encourages” long-term-care employers to offer full-time hours to part-time workers.

But the reliance on agencies can pose a risk to residents, caused in part by “the lack of familiarity and the discontinuity in care,” said Laxer. In the midst of a pandemic, “precarious arrangements are leading to what are probably very problematic levels of traffic under these circumstances,” she added.

The model can also pose risks to workers, who often rely heavily on their knowledge of a particular home and its residents to keep themselves safe on the job, said Armstrong.

“Especially in these times, you want that support,” she said.

It’s an issue that was brought to Workforce Planning for Sudbury & Manitoulin head Reggie Caverson’s attention around two years ago — by the head of a private staffing agency.

“They said, ‘do you have any idea how many shifts are being missed at our local long-term care homes?’” Caverson recalls.

“Obviously, they were a private staffing agency so it was a fairly lucrative business for them. But they were very, very concerned about the fact that there were so many shifts that were being missed.”

Caverson and her team investigated, speaking to staffing agencies, nursing homes, and — most importantly — workers themselves.

“Nothing is worse than our field than going into agencies and they’re saying, ‘there’s nothing wrong here.’ But we’re hearing from the workers saying, ‘oh, there’s something really wrong here.’ And that’s exactly what has happened,” said Caverson.

The resulting report, published last year, found that personal support workers in the area were evenly split between full-time and part-time, with 75 per cent earning $20 or less an hour. The report also found that around a third reported working for an employment agency.

Existing research on temporary agency work has long shown that it is often riskier and lower-paid than a permanent job. But while the model poses safety issues in the health care sector too, the concerns around pay sometimes differ, said Caverson.

Canadian cases and deaths by province/territory

Data current as of May 11.This chart is updated daily using data from the Government of Canada Health Infobase website which may not match the data provided by other agencies.

Ontario

British Columbia

Quebec

Alberta

Saskatchewan

Manitoba

New Brunswick

Newfoundland and Labrador

Nova Scotia

Prince Edward Island

Yukon

Northwest Territories

600↑ new cases5004003002001000Jan 31May 11Ontario - pop. 14,711,827308 new cases on May 11.20,000↑ total cases15,00010,0005,0000Jan 31May 1120,546 cases and 1,669 deaths total1,66920,546

SOURCE: THE GOVERNMENT OF CANADA HEALTH INFOBASE, STATISTICS CANADA POPULATION ESTIMATES Q1 2020

In some cases, agency workers “get emergency pay to get in there earlier and faster, so they’re paid much better than the current PSWs and have a lot more flexibility,” she noted. Sometimes, workers may even prefer agency work because permanent positions are so demanding, she added.

“How do you fix that? You fix that by improving conditions,” said Armstrong.

And while the rationale behind lean staffing may be low labour costs, Caverson said the end result may be exactly the opposite.

“I talked to some of the directors up here from the long-term-care homes, and (agencies) charge them an arm and a leg for one of these staff members to come in,” she said.

“The local health integration network … had charts and everything showing how in debt they were now because it had to pay for all these private staffing people to come in.”

But the scale of the problem remains quantify, even amid a crisis where hard numbers would come in handy, said Laxner. Apart from research efforts like the ones undertaken by Caverson, low-wage care workers are often invisible in workforce data.

“The data gets very, very murky especially the more tenuous the employment relationship,” Laxer said.

Long-term care facilities, for example, report “full-time equivalents” to represent their staffing numbers, which “lumps together all the workers so that it’s impossible to gauge who was working full-time, part time, temporary or agency,” she said.

“I would argue that that’s really important because the employment relationship is a key indicator of the quality of care,” she said.

Now, with capacity stretched more than ever amid a crisis, the government’s ability to restrict mobility — long an unwelcome necessity for many workers — is limited by problems of its own making, said Laxer.

“It was very clear that this model of having people come in and out of facilities, or any environment in which they’re providing care, poses a tremendous risk if there is some kind of outbreak of any kind of infectious disease. That was known,” she said.

“It’s heartbreaking and astonishing that it wasn’t addressed sooner.”

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2019 Research Spotlight: Brad A. Meisner stimulates a dialogue about leisure and community activities and healthy aging

Tue, 06 Aug 2019 14:52:26 +0000

Research Summary

Dr. Brad A. Meisner

This year, YU-CARE Steering Committee member from the School of Kinesiology and Health Science has significantly contributed to studying the important relationships between leisure and community activities and healthy aging.

Meisner's studies, linked below, argue that the meaningful inclusion and involvement of older adults in leisure and community activities are undervalued and underused strategies to promote healthy aging, particularly in late life. His research identifies both motivators and constraints that inspire and inhibit older adult activity participation. It is important to recognize that many of these motivators and constraints are in fact beyond the control of older individuals; yet, these factors support or suppress health-related outcomes over time.

Critically, the investigation of this theme by Meisner and colleagues stimulates dialogue about age discrimination (ageism) experienced by older adults during leisure and community activities as a significant barrier, which, in turn, negatively affects healthy aging.

Read the abstracts of Meisner’s published research below or follow the journal links to access the complete articles.

Abstracts

Taking ‘Steps to Connect’ to later life: Exploring leisure program participation among older adults in rural communities (Meisner, B.A., Hutchinson, S.L., Gallant, K.A., Lauckner, H., & Stilwell, C.L., 2019), .

Abstract: “Steps to Connect is a leisure education program that facilitates participation in leisure activities to enable individuals to connect to themselves, to others around them, and to their communities. The authors’ previous program development efforts were focused on individuals with chronic conditions in rural settings, and now there is interest in adapting it for older adults. As such, the authors explored the perceptions and constraints associated with tailoring leisure activities and programs to older adults living in rural Nova Scotia, Canada. They conducted five focus groups in four rural communities, including 33 participants aged 60+ years. Thematic analysis of focus group transcripts revealed participants’ awareness of how leisure programs promote physical and mental health, social participation, as well as meaningful personal and community experiences. Participants also identified several leisure constraint themes that warrant consideration when implementing leisure programs to promote active aging among older adults living in rural communities, such as Steps to Connect.”

Perceptions of aging and experiences of ageism as constraining factors of moderate to vigorous leisure-time physical activity in later life (Massie, A.S., & Meisner, B.A., 2019), .

Abstract: “Later-life leisure-time physical activity (LTPA) is an identified way to promote active aging. Nevertheless, many active older adults experience LTPA constraints and thus may not experience the full comprehensive health benefits that result from participation. This study explored two potential LTPA constraints pertaining specifically to ‘age’: beliefs that older adults have about aging (perceptions of aging) and experiences of being treated differently because of age (ageism). One-on-one semi-structured interviews were conducted with 15 older adults (60–74 years) who engaged in an average of ≥150 minutes of moderate to vigorous LTPA per week. Data underwent thematic analysis that resulted in three themes pertaining to LTPA: (a) ‘age has nothing to do with it,’ (b) ‘but they do treat us different here,’ and (c) ‘why don’t we have an exercise class?’ Findings provide new perspectives on how aging perceptions and ageism – in both negative and positive forms – can affect LTPA engagement in later life.”

What is and isn’t working: Factors involved in sustaining community-based health and participation initiatives for people ageing with intellectual and developmental disabilities (Spassiani, N.A., Meisner, B.A., Abou Chacra, M.S., Heller, T., & Hammel, J., 2019), .

Abstract: “As people with intellectual and developmental disabilities (I/DD) age, it is important that I/DD agencies are prepared to support healthy ageing in homes and in communities. This study explored supports and barriers to sustaining community‐based health and participation initiatives (CBHPI) for people ageing with I/DD living in group homes managed by agencies. The study utilized interviews and photovoice with 70 participants—35 individuals with I/DD and 35 management/direct support agency staff. Data were analysed through content analysis and triangulation of data where five themes emerged: Agency values and policies related to healthy ageing; resources and staff competencies; communication between management and staff; community/university partnerships; and peer relations. Findings show that I/DD agencies and people with I/DD value CBHPI, but they find them difficult to sustain due to limited resources and lack of training specific to ageing with I/DD. Conducting system‐level research within I/DD agencies to include first‐person accounts of people with I/DD, staff and management provides insight on how to effectively support the needs of people with I/DD to improve their health and community participation as they age.”

Mindful aging: The association between trait mindfulness and expectations regarding aging among middle-aged and older adults (Fiocco, A.J. & Meisner, B.A., 2019), .

Abstract: “Objectives: Positive Expectations Regarding Aging serve as a protective factor of healthy aging; however, negative stereotypes regarding aging continue to dominate popular aging discourse. It is proposed that trait mindfulness (TM) is associated with aging expectations through the cultivation of openness, curiosity, and non-judgment to one’s thoughts, emotions, and sensations, whether they are positive or negative.

Methods: Associations between the Five Facet Mindfulness Questionnaire and the Expectations Regarding Aging Survey (ERA-38) were examined among 201 participants aged 55+ years.

Results: Analyses revealed that higher levels of TM was significantly associated with positive aging expectations, controlling for retirement and socioeconomic status (Rchange2= 14.0%, F(5,192) = 7.17, p < .001).

Conclusion: The development of TM, notably the facet of non-judgment, may be used to promote positive aging expectations to help support healthy aging.”

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