Canadian long-term care workers risk violence at work

Nearly seven times more likely to experience violence than Nordic counterparts - York University-led study

Toronto (11 March 2008) - A new study led by York University researchers reveals that a staggering number of Canadians working in long-term care facilities suffer violence on the job.

The National Union of Public and General Employees (NUPGE) was among five health care unions assisting in distribution of the study. It is entitled 'Out of Control': Violence against Personal Support Workers in Long-Term Care. Download pdf

(A significant related study on long-term care was published by NUPGE last year. It can be downloaded here: Dignity Denied: Long-Term Care and Canada's Elderly.)

The York researchers found that 43% of personal support workers endure physical violence at work on a daily basis, while another 25% face such violence every week. Most are women, and many are immigrants or from marginalized racial groups.

"What we found is disturbing," says Pat Armstrong, a professor in York's Department of Sociology, a co-author of the study. "Canada's levels of violence towards long-term care workers are significantly higher than the other countries we looked at. The situation is out of control, as one respondent put it."

Workers at 71 unionized long-term care facilities in Manitoba, Ontario and Nova Scotia were surveyed about their experiences of physical violence, unwanted sexual attention, and racial comments. They were nearly seven times more likely to experience such daily violence than workers in Denmark, Finland, Norway, and Sweden.

More relevant comparison

"Most studies will compare our situation with that of the U.S.," says Armstrong. "We felt it was more relevant to compare ourselves with countries that have a public healthcare infrastructure. When we do this, we realize just how behind we really are."

The physical violence experienced by care workers typically includes being slapped or hit with an object. It frequently involves being pinched, bitten, having one's hair pulled, being poked or spit on. Having one's wrists painfully twisted is also common.

One survey respondent noted:

"I've been punched in the face several times. I've been punched in the jaw several times. Getting hit. Having your wrists twisted... Pulling and shoving at you. I mean that's a day-to-day thing. Violence is an everyday occurrence."

Armstrong says most violent incidents go unreported.

"Workers are afraid to report violent incidents, fearing that they will be blamed. Or they simply don't have the time to do so. Alarmingly, workers inform us that they are expected to take such abuse. They are told to 'lighten up,'" she says.

Heavy workloads a factor

The study also establishes a correlation between levels of violence and heavy workloads placed on staff. The main difference between Canada and Nordic countries is staffing levels.

"Most of the violence occurs during daily care activities, which involve intimate acts and sharing of personal space. If such care is rushed, or worse, if it is forced - for instance, when residents are required to get up, get dressed, or bathe before they are ready - this may leave residents feeling threatened, fearful or overwhelmed and prone to retaliate violently," says Armstrong.

Unwanted sexual attention was also commonly experienced by personal support workers surveyed. Approximately one third (30.1%) said they experienced unwanted sexual attention on a daily or weekly basis.

Armstrong notes that 95% of personal support workers are women.

"Violence in long-term care is not just a worker's issue. It's a women's issue. When we speak of violence against personal support workers, we are in effect speaking of violence against women."

Part of larger project

The research forms part of a larger comparative project investigating working conditions in long-term care facilities across Canada and the Nordic countries of Demark, Finland, Norway, and Sweden. To facilitate comparisons between countries, the survey was designed in coordination with Nordic partners to ensure that largely identical questions were asked in both the Nordic and Canadian context.

Besides NUPGE, the four other health care unions involved in the survey were the Canadian Auto Workers (CAW), the Canadian Federation of Nurses Unions (CFNU), the Canadian Union of Public Employees (CUPE) and the Service Employees International Union (SEIU).

The study's authors are Albert Banerjee, Doctoral candidate, York University Department of Sociology; Tamara Daly, Assistant Professor, York University, School of Health Policy & Management; Hugh Armstrong, Professor, Carleton University, School of Social Work; Pat Armstrong, Professor, York University, Department of Sociology and Women's Studies and Canadian Health Services Research Foundation / Canadian Institutes of Health Research Chair in Health Services and Nursing Research; Stirling Larance, Master's Candidate, York University, Department of Sociology and Marta Szebehely, Professor, Stockholm University, Department of Social Work.

The study will be published as part of a forthcoming book on long-term residential care. NUPGE

More information:
? 'Out of Control': Violence against Personal Support Workers in Long-Term Card -pdf
? NUPGE publication: Dignity Denied: Long-Term Care and Canada's Elderly