Charlotte, age 50
Continuing Care Assistant
Saskatoon, SK
Yearly salary: $40,388 base pay plus $45,647 in overtime pay
At the end of her shift, Charlotte checks the next day’s schedule at the non-profit long-term care facility where she works with a sinking feeling. She can predict who will be absent since some Continuing Care Assistants work at multiple sites. She’ll try to warn the manager, hoping to confirm who can make it, and find fill-ins for those who can’t. Then she wouldn’t be scrambling, asking somebody to extend their shift or do rounds by herself, leaving people who need two-person assists waiting for help. But that rarely happens.
Charlotte says her long-term care facility is short-staffed nearly every day, and it’s gotten worse over the past three years. There are supposed to be four staff to care for the 32 residents, many of whom need help getting dressed, eating, getting in and out of bed, going to the washroom and more. But sometimes, there are only two or three. On several occasions, Charlotte says she has been the only staff present for 32 residents.
Being short-staffed means that Charlotte has to rush from one patient to the next; it means residents have to wait longer when they need her help; it means she has to ask residents to go to bed sometimes an hour earlier than they’d prefer, just so she can get to everyone.
When Charlotte started 14 years ago, after immigrating to Canada from the Philippines, she could sit and talk with patients she was helping to eat. Now, that’s rare. She’s often feeding one resident a bite and then turning to the next – sometimes she’s helping three patients eat at the same time. “Sometimes you know that this person can eat all of their meal, but when you’re short staffed, you cannot even feed them three quarters of their meal because you’ve been going from one person to another,” says Charlotte. “And then their food becomes so dry, it becomes so cold, and of course their appetite is lost.”
Oftentimes, Charlotte says she doesn’t take her designated breaks so she can complete all the tasks. She hasn’t marked those missed hours as overtime because no one instructed her how to do so, but she is planning to start. “We are not being fed proper information about some rules and policies,” says Charlotte.
Barbara Cape, president of Service Employees International Union (SEIU)-West, says some care homes’ policy is that they only fill absent spots after the second worker calls in sick, not the first. “They have a policy of short shifting, regardless of the fact that the work is incredibly demanding and incredibly complex.”
Cape adds that it’s typical that care aides often feel on their own, with little support. The problem has grown exponentially over the past three years, according to Cape.
Charlotte says she no longer complains about short staffing anymore because she hasn’t seen results. Last year, Charlotte worked 60 hours per week most weeks, earning 1.5 times her hourly rate of $24.84 during the first four hours of overtime and two times her hourly rate after four hours of OT. Charlotte’s hourly rate is the highest in the three-tier pay scale for CCAs, with the lowest being $23.17. Thanks to her OT, Charlotte’s annual salary in 2023 was $86,035. Had Charlotte worked full-time without overtime, she would have earned $40,388.
Cape notes that there are “very few” full-time and permanent care aide positions in Saskatchewan’s long-term care homes. Full-time employment is hard to come by in long-term care homes across the country, too. In Alberta, for instance, 60 per cent of long-term care health workers were employed on a part-time or casual basis in 2020. Naomi Lightman, a faculty member in the Sociology Department at Toronto Metropolitan University who researches living and working conditions of care aides in Canada, says that long-term care home employers “are reluctant to give [care aides] full-time jobs because they would have to pay wages and benefits accordingly. It’s kind of enforced precarity as a cost-cutting measure by employers.”
“It’s kind of enforced precarity as a cost-cutting measure by employers.”
She adds that most care aides in long-term care homes are immigrants, navigating a new culture and language, which makes it difficult to assert their rights.
Julia Smith, assistant professor in Health Sciences at Simon Fraser University, says the precarious nature of long-term care work in particular means many workers feel as though, “I have to work a 16-hour shift because I don’t want to lose my job, or I don’t know if I’m going to have hours next week.”
Charlotte became a CCA because she wanted to care for people with respect and dignity. At first, Charlotte didn’t like the job, but began to love it during her first year. “It is already a part of my culture that we need to really take care of our own grandmas and grandpas,” says Charlotte. She says that her job has “day by day molded” her to “become more compassionate and more empathetic.”
She still goes out of her way to care for her patients, despite the mounting pressures of her profession. Charlotte is especially attentive to the residents who don’t have visitors on special occasions like Mother’s Day.
“Sometimes they will ask me to do their hair, or they will ask me to buy them something from outside, like a pop, and I’ll ask my manager if I can bring that for them,” says Charlotte. Her colleagues question why she gives more of herself to the job than the already extreme amount expected. “Even if it’s just one grandma or grandpa, at least I know that I made somebody happy again.”
Charlotte and her husband support their two teenage children. “It’s like breakeven or sometimes not even breakeven,” she says. “And then you must use your credit card again just to, you know, meet all ends,” says Charlotte. She meticulously plans all her expenses and teaches her children to do the same. When they ask her to buy something she doesn’t feel is necessary, she’ll say, “You know that mom will make one overtime shift for that.” Usually, she says, they let it go.
These stories rarely go beyond staff rooms, beyond disappointment shared among residents in dining rooms. To Lightman, the fact short staffing is most acute in long-term care within the larger health system is “not random.” As she explains, “these are absolutely the most vulnerable workers … but also the most vulnerable clients. These are elderly people. These are people with disabilities. It’s the most vulnerable members of society on both sides of the equation.”
