TORONTO – Five years ago, Nilmini Senewiratne was only getting part-time hours, no benefits and had to rush from client to client in her job as a personal support worker.
Senewiratne was able to live on 30-hours-a-week wages because she was single and had brought savings from Sri Lanka when she came to Canada, but she watched her co-workers struggle as they held down multiple PSW jobs to make ends meet while raising their families.
For her, one of the biggest stressors was not having a manager who would respond when she needed guidance on dealing with issues — from administering medication to concerns about clients’ living conditions — that arose while providing care to seniors in their homes.
“We are the eyes and ears of the clients we go to,” said Senewiratne, a 52-year-old living in Mississauga, Ont.
“If you don’t have good management behind us helping us it is very difficult.”
Senewiratne says life improved dramatically for her and her co-workers when new management took over Nucleus Independent Living about five years ago. They gave their PSWs full-time hours, benefits and capped the driving distance between clients at 10 km so staff wouldn’t constantly stress about being late, she said.
They also provide more training and management has an “open door policy” to address workers’ questions and concerns, Senewiratne said.
Her before-and-after experiences illustrate key steps government, home-care agencies and long-term care homes can take to help PSWs, said Nevena Dragicevic, lead author of a report called “Revaluing Personal Support Work in Canada,” released Wednesday.
The report from the CSA Public Policy Centre, which offers solutions to health, social, economic and environmental challenges, found many Canadian PSWs reported heavy workloads, high emotional stress, low wages and lack of security in their jobs.
The findings are based on the results of an online survey of 380 current and former PSWs conducted in March and April 2024 by research company RKI, as well as input from focus groups.
The survey found 72 per cent of respondents had experienced burnout “at least a few times a month” and 68 per cent regularly suffered from anxiety.
Low pay and lack of job security was another key issue, said Dragicevic, noting workers in community and home-care settings typically earn less than those in hospitals or long-term care homes.
About 47 per cent of the PSWs surveyed said they were “mostly making ends meet.”
Another 16 per cent said they weren’t sure how they were going to pay bills and had debt that would “take a long time to pay off.”
Sixty-three per cent of the PSWs surveyed had either left or seriously considered leaving their jobs in the last two years.
But at the same time, 86 per cent of respondents said their work was satisfying and meaningful.
Those seemingly conflicting results show PSWs like helping their clients but are “ground down” by difficult conditions and feel undervalued, said Dragicevic, who is the manager of the CSA Public Policy Centre.
“This isn’t a workforce that’s lacking passion, but it is a workforce that is being pushed beyond its limits,” she said.
”(PSWs feel) fulfilment around being with clients and with patients and helping them and seeing them progress and get better, or also being with them at really critical and difficult moments in their life.”
More than half of the survey respondents said the emotional toll of witnessing patients declining was one of the toughest parts of being a PSW.
They also cited the physical demands of the job, as well as safety risks such as exposure to infectious diseases and workplace violence as significant challenges.
But most of the PSWs surveyed didn’t feel supported in dealing with all these issues.
“Only about a third said that they had supportive supervisors and leadership,” Dragicevic said.
”(Others) talked about there being a disconnect between what PSWs are experiencing on the job and how that’s being recognized and managed by their supervisors.”
A lack of training on working with clients who have dementia is another significant issue that needs to be addressed, she said.
“It’s not really part of the core curriculum that PSWs have,” Dragicevic said, noting that the education PSWs get before they join the workforce should be consistent across the country.
As the population ages, personal support work is more critical than ever, the report said.
But the survey and focus group results show that the “compounding issues” PSWs struggle with will drive many out of the profession and discourage others from joining, “perpetuating a vicious cycle of deteriorating working conditions and labour shortages.”
Some provinces, including Ontario, have made positive strides in recruiting PSWs, including programs such as subsidized tuition, Dragicevic said.
But there’s a lot of work to be done on the retention side of the equation, she said.
“I think there just needs to be a little bit more focus on how do we create healthy workplaces and also, of course, compensate people fairly for the work that an aging society is increasingly coming to rely on.”
This report by The Canadian Press was first published June 18, 2025.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
