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When do I need a nurse vs. a personal support worker?

“I need a nurse,” is what Gaye Moffett often hears when she picks up the phone.

But a nurse may not be the level of care you or your loved one needs right now to live comfortably at home for as long as possible.

So how do you know you’re getting the right level of care? 

In Ontario, the first step is to call 310-2222 (no area code required) to find the Home and Community Care Support Service provider in your area.

They’ll assign a case manager to assess your situation and determine whether you need a nurse or personal support worker. Once that’s done you can top up your eligible hours with a family-funded provider like GEM.

Here’s what to expect from the professionals who will be helping you. 

When you need a nurse

As a rule, you don’t need a nurse unless you are acutely ill or injured, or have a chronic condition that requires ongoing nursing support, like having a peg tube that needs to be cleaned regularly to prevent infection.

While there are two types of nurses — registered nurses (RNs) and registered practical nurses (RPNs) — you can rest assured that they’re all registered with the College of Nurses of Ontario. 

For the most part they carry out the same duties, but RNs are typically responsible for planning and monitoring care, while RPNs carry the plan out. 

Care plans could include administering medications, wound care, changing dressings, monitoring blood pressure, administering oxygen therapy and collecting specimens. 

When you need personal support 

Personal support workers, home support workers, and companions are the people who help you live in your home independently, while lowering the risk of illness or injury that could land you in the hospital.

Personal support workers (PSWs) are college-trained, certified professionals who help people with their activities of daily living (ADLs) like bathing and dressing. Sounds simple, but knowing how to transfer someone safely in and out of the tub with a lift requires specific training.

Home support workers (HSWs) are also certified and trained in their field, and assist in all facets of home management, including meal preparation, light housekeeping, and assistance with shopping.

Companions who work for GEM must complete the company’s training course. Sitters ensure the safety and security of a client by assisting with all levels of companionship, emotional support and activity attendance. They are able to accompany a resident to and from appointments and record information as required.

In a world where it’s clear most people want to live at home, and delivering care at home is the most cost effective option for our health system, calling on GEM to make it possible could be the option for you and your family. Call (613) 761-7474 to learn more.

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Buyer beware! Four questions to ask about qualifications before welcoming a home care worker into your home

For seniors and other folks who need support to live at home, finding the right mix of home care services can mean the difference between autonomy and dependence.

That’s why it’s so important to choose the highest quality people to support you.

But how can the average person screen highly-trained health professionals, especially in a world with “disruptors” entering the home care space? 

The good news is that no one can stop you from asking questions, and any agency that doesn’t provide thorough answers is waving a red flag saying “buyer beware”.

Two areas in particular where you need trustworthy information are around qualifications and safety & security. We’re publishing posts that cover each topic, starting with qualifications.

Asking about qualifications isn’t just about understanding an agency’s basic standards. It’s also an opportunity to ask about specialized skills that meet your particular needs. 

Here are four questions we think you should ask:

1.What are the minimum requirements you require to add home care staff to your roster?

The answer to this question will give you a baseline regarding their post-secondary education and licensing requirements. 

You can also use this information to see if the rest of the answers are consistent with their baseline.

2.How does your company verify credentials? 

Look for employers who require their staff to provide proof of their diploma or degree, as well as any specialized certificates they’ve earned. 

They should also be confirming the credential was granted by an accredited institution. 

3.What training requirements do you have for your home care staff?

Here you’re looking for basics like CPR and First Aid., as well as skills that are specific to your particular needs, like mobility assistance.

You’re also looking for in-house training that ensures staff are familiar with internal policies and procedures as well as relevant legislation.

And don’t forget to consider management training. The tone of their responses will show how much experience they have operating within a complex health-care system.

Do they come across as an agency that will take responsibility for problems that may arise, or the kind that passes the buck and blames their staff? 

4.Do you provide professional development and training for the staff on your roster?

A commitment to providing professional development that ensures their skills are up-to-date is another answer to look for. It shows an understanding that investing in their staff is necessary to provide continuous quality care.

It also gives you the opportunity to let a home care agency know they could be missing a particular skill set that a prospective client needs.

There are no cookie-cutter solutions

So consider the answers to these questions to be a starting point. 

Any successful home care plan starts with a thorough assessment from a licensed health-care professional who will link you to the right mix of services to help you stay at home for as long as possible. 

Because the last thing you want is a home care provider who doesn’t know what they don’t know.

* Stay tuned for our next “buyer beware” post about safety and security.

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How to get the right mix of home care services with the resources you have

When the benefits of helping seniors stay at home are so clear, maximizing the home care services you can get with the resources you have makes perfect sense. 

Seniors who age-in-place hold onto their autonomy and independence longer because they’re in a familiar environment and maintain ties to their community. With the appropriate support, seniors can downsize at their own pace rather than being forced to move due to a crisis.

But navigating Ontario’s home care system isn’t as simple as picking up the phone and asking for help. That’s why Gaye Moffett, owner and operator of GEM Health Care Services, often hears from people who are just trying to figure out where to start. 

“This morning someone called and said her father is on a limited income, but needs help doing his housekeeping and laundry,” said Moffett. “I pointed her to the City of Ottawa’s Home Support Services so they can determine if he was eligible for the services they offer.”

Navigating a complex system to get the right mix of services

Moffett has been working in the home care sector long enough to know the ins and outs of navigating a complex system that’s always changing.

Whether you start in the public system or with family-funded home care services, you’ll probably need a bit of help to make sure you’ve got the right mix of services at the right time.

Moffett’s experience running GEM Health Care Services — which currently has a contract with the Ontario government to provide publicly funded, privately delivered services — is why she’s a master at this. 

“I often get people started with family-funded nursing care,” said Moffett. “But if they become eligible for public services, we can adjust their hours to make sure they have the right mix.”

Moffett leverages her nursing background to help her clients maximize their resources. “I once helped a client’s mother get her nursing care covered by writing their insurer a letter,” she said. “Her coverage said the services had to be medically necessary — as a nurse I was able to explain that a PSW can’t manage tube feeding and other care needs that she had.” 

So where should you start if you or your loved one needs home care to “age-in-place”? 

Asking yourself these questions will help point you in the right direction

  1. Are you eligible for publicly funded home-care services? Call Home and community services with the Ontario government to find out.
  2. Do your benefits cover homemaking, nursing or both? You need to ask your insurer how they define “medically necessary.” 
  3. How many family–funded hours do you really to supplement your public services? Talk to a veteran health professional like Moffett to find the right balance, and explain the difference between what’s medically necessary and what isn’t.

Whether you’re on a fixed income, have some benefits for private nursing through your employer, or have enough resources for family-funded nursing care, talking to someone who knows the system like Moffett can give you the confidence that you’re accessing the services you really need with the resources you have.

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Why community PSW’s deserve better compensation

People who receive home care services love their personal support workers (PSWs). 

And why wouldn’t they? PSWs provide the personal care seniors, people with disabilities and other vulnerable populations need to stay in their homes — like bathing, providing medication, meal prep and light housekeeping.

Community PSWs spend more time with home care clients than any other home care worker and become an important presence in their lives. They play a critical role in our healthcare system by significantly improving quality of life for their clients in a cost effective manner — most of the dollars spent on PSWs goes to care rather than on operating an institution. 

So why are community PSWs paid a lot less than PSWs who work in the hospital or long term care? 

Before the pandemic, home care PSWs were paid an average of $16 – $17 per hour. Those who worked in a hospital or long term care facility made $25 to $30 per hour. While the government did increase pay for community PSWs, it’s still falling short by an average of $5 per hour.  

This doesn’t make sense. PSWs in the community need the same skill set and perform the same tasks as those who work in institutions. If anything, home care PSWs have a tougher job because they work alone and in more challenging conditions.

We hire a lot of PSWs and send them everywhere — sometimes almost all the way to Kingston —  but we can’t guarantee them a 9-5 schedule because our clients’ care plans vary and people’s needs are always changing. It’s just the reality of the homecare sector. That’s why a lot of PSWs must work for more than one agency. Understandably, they’ll take whoever can give them the most hours and the best shifts.

The government could help solve this by giving care provider agencies more funds to compensate our PSWs’ for their travel time. We pay a flat rate between shifts, but there’s no incentive for us to pay more for their travel time because we won’t get paid for it. Every time our PSWs need to travel, providers like GEM lose money. 

That’s why we want the Ontario government to invest more in this critical service, so care providers like ours don’t have PSWs leaving us to work for minimum wage jobs that give them steadier work.

The important role PSWs play in our health system has been neglected for long enough.