While staffing falls short in other provinces, Ontario provides less care than reported by any other province. No other province reports fewer long-term care health care staff per resident (or per bed) than Ontario.

A research report – Long-Term Care Understaffing Fewer Hands in Hamilton – prepared by the Canadian Union of Public Employees (CUPE) reviews the brewing crisis in care and estimates the level of understaffing at Hamilton long‑term care (LTC) homes. It shows that residents in Hamilton’s 17 long‑term care facilities are shortchanged 1,172 hours of health care each day and 427,696 hours a year compared to the rest of Canada. That is an extra 219 full-time health care LTC staff.

For total staff (health care and administrative and support staff in Hamilton long‑term care) there would be an extra 651,045 hours of care and service. That would amount to an extra 333 full‑time long‑term care positions in Hamilton.

The provincial Liberals’ reluctance to establish minimum care standards in Ontario long‑term care homes has left nurses and personal support workers (PSWs) scrambling to fulfil increasingly fragile residents’ health care needs, said Jean Kirby a Hamilton area registered practical nurse for nearly 30 years.

Heath data shows that long‑term care residents are sicker than ever, have a much higher acuity and require much more care. The percentage of residents with heart disease are growing at a rate of 4.5 per cent per year and those with renal failure at a rate of 3.7 per cent per year. Residents with six or more formal diagnoses are growing at a rate of 4.8 per cent a year.

In nearly two decades as a PSW in long‑term care, Heather Nieser in Hamilton said residents’ care requirements have grown. They are older with multiple complex conditions, “but staffing and care levels have not kept pace because provincial funding is too low as research shows. The system relies on the altruism and dedication of direct care staff, like nurses and PSWs who are beyond demoralized because they don’t have time to give residents the level of care they require.”

There are 0.590 health care full‑time equivalent (FTE) staff per resident in Ontario and 0.687 in the rest of Canada. This is equal to 3.15 paid hours per day in Ontario and 3.67 hours in the rest of Canada. The rest of Canada has 16.4 per cent more health care full-time equivalent staff per resident than Ontario. That is over half an hour of extra paid care for every resident each day.

That gap in care between Ontario and the rest of the provinces impacts resident safety, cleanliness, eating, wound dressings and results in conditions that force residents into incontinence, and insufficient infection control, said Nieser. “It’s very sad that we don’t have the time to pause and give residents in the final stages of life the emotional care all of us would agree is humane and warranted.”

The minimum level required to improve quality of care is about 4.5 to 4.8 worked hours per resident per day. CUPE is asking for a legislated 4‑hour daily resident care standard and a funding increase for long‑term care in next week’s provincial budget. Annual provincial funding per long‑term care bed in Ontario is $43,970.77 compared with the rest of Canada (minus Ontario) of $52,185.09.

“Unfortunately need for improved funding, better staffing and higher resident care often comes up through assaults and deaths. With increasing illness of patients, there are aggressive residents. Attacks occur on other residents sometimes resulting in deaths like that of James Acker earlier this spring. Resident safety and higher staffing must be a priority for this government,” said Michael Hurley, president of CUPE’s the Ontario Council of Hospital Unions (OCHU/CUPE).