Unregulated and underpaid: New Canadian study takes hard look at health-care aides


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The average health-care aide in a Manitoba nursing home is a middle-aged woman who is dedicated, hard-working and speaks English as a second language.

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Hey there, time traveller!
This article was published 21/01/2015 (2879 days ago), so information in it may no longer be current.

The average health-care aide in a Manitoba nursing home is a middle-aged woman who is dedicated, hard-working and speaks English as a second language.

She has limited training and works without the security or guidance of professional regulations.

She also faces a “worrisome” level of burnout with seniors who are frail and likely as not to suffer dementia. Forty per cent of aides are women of Filipino descent, many of them immigrants. Their patients are mostly Anglo-Saxon.

Phil Hossack / Winnipeg Free Press A class of health-care aides at Herzing College works with instructor Nancy Scott on Tuesday.

That profile emerged from a new study on health-care aides in Alberta, Manitoba and Saskatchewan.

Little is known about the people who bathe, feed and care for tens of thousands of seniors. They may number up to a quarter million, but no one knows for sure.

“We entrust the care of the most complex, frail, vulnerable and challenging charges in our system to this occupational group of workers 24 hours a day. Inaction is not a rational response,” the study concluded.

The study, Who is looking after Mom and Dad? Unregulated workers in Canadian Long-term Care Homes, is believed to be the first of its kind to take a hard look at the health-care aide workforce in Canada.

Led by the University of Alberta and funded by the Canadian Institutes of Health Research, the study saw a team of collaborators and researchers fan out to 36 homes across the Prairie provinces, examining the work lives of 1,381 health-care aides, including 336 in Manitoba. Most of the facilities were in urban settings, the study said.

Published in the Canadian Journal of Aging and publicized this week, the study surprised no one in Manitoba.

A hidden army exists within the ranks of the workforce in Manitoba: the agency workers who fill staffing gaps at public and private facilities. Mostly, they work alone, in private homes as part of the community health sector.

They may have little or no training, and they work for low wages compared to their unionized counterparts, who have higher education levels and were certified at community colleges.

“This hidden army of health-care aides, they are quite hidden, because their job opportunities are limited,” said Kathy Majowski, an instructor for one of three health-care aide training programs offered at privately run Robertson College.

The workers are the same ones who care for foster children in hotels, the situation that raised horrific headlines with Tina Fontaine. The discovery of the 15-year-old’s body in the Red River last summer triggered renewed calls for a national inquiry into missing and murdered indigenous women.

“There was an article about agencies caring for children in foster care in hotels,” said Majowski, recalling the coverage. “That would be considered a health-care agency…. The agency can hire whoever they want. They’re run like businesses. They have the ability to hire whoever they want and pay them whatever they want.”

With most would-be aides now headed for college certification and well-paid union jobs, the agencies face challenges in recruitment, Majowski said.

British Columbia, Alberta, Ontario, Quebec and Nova Scotia now have health-care aide registries that limit such risks. Manitoba and the rest of Canada don’t. That means there are no standards of practice, no codes of conduct and education standards vary, as the study found.

But all that could change quickly. The state of health-care aides is changing in Manitoba to uphold standards and account for new technology, added Majowski.

‘We entrust the care of the most complex, frail, vulnerable and challenging charges in our system to this occupational group of workers 24 hours a day. Inaction is not a rational response’

— new study on health-care aides in Alberta, Manitoba and Saskatchewan

“We’re seeing more and more employers actually paying for their health-care aides to get certified,” she said. “They’re understanding that the amount of technology and amount of responsibility a health-care aide now has surpasses on-the-job training.”

To cover existing gaps, there are several training programs in Winnipeg, offered by Red River College, the Winnipeg School Division through R.B. Russell Vocational High School and private colleges, such as Herzing and Robertson.

The public institutions couldn’t accommodate interviews about their programs Tuesday. Both Herzing and Robertson offer six-month courses, divided between classroom and practicum, as a minimum training program.

“You know, the part about it being poorly regulated is correct. There is no health-care aide college in the country,” said Nancy Scott, one of two health-care aide instructors at Herzing College.

Scott and Majowski, her counterpart at Robertson College, said their training programs are tailored to cover industry shortfalls and raise the standard of care. Herzing, for instance, added a course on Alzheimer’s disease after a comprehensive evaluation a year ago.

“Every two years, we invite facilities, private ones, the Winnipeg Regional Health Authority and community agencies and we ask for feedback,” Scott said. “We take that information very seriously and we change our programs based on that feedback.”

Since there are no codes of conduct, private colleges such as Herzing must write them.

“We teach them what professional conduct is, whether there is a governing body or not,” Scott added.

The province confirmed Wednesday the field is not a regulated profession.

“Each employer or regional health authority is obligated to ensure the health-care aides they hire are competent to perform the job functions,” a provincial health department spokeswoman said in a statement. “One way… is to determine if the individual has completed a health-care aides program. Several organizations offer courses in communities across the province.”



Updated on Wednesday, January 21, 2015 6:48 AM CST: Replaces photo, changes headline

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