Hugh Armstrong’s research interests include women and work and the political economy of health and health care.
When you think of dangerous workplaces, long-term care facilities probably don’t come to mind. Yet a 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 study Out of Control: Violence against Personal Support Workers in Long-Term Care found that 43 per cent of personal support workers endure physical violence at work on a daily basis. The researchers, headed by Pat Armstrong, a professor in York’s department of sociology and an adjunct professor of Canadian studies at Carleton, and including Hugh Armstrong, a professor of social work and political economy at Carleton, surveyed workers at 71 unionized long-term care facilities in Manitoba, Ontario and Nova Scotia about their experiences of physical, verbal and sexual violence. What they found was disturbing. Canadian workers were nearly seven times more likely to experience daily violence than workers in Nordic countries.
Since the majority of workers in the survey (95.1 per cent) were women, many of whom are immigrants and women of colour, violence isn’t just a workers’ issue, but a women’s issue. “Despite the fact that most workers and residents in long-term care are women, gendered analyses are usually absent in the research of long-term care….Gendered assumptions—particularly the devaluation of caring labour and the privileging of instrumental tasks over relational care work—have greatly contributed to the levels of workplace violence that we observe,” write the authors.
From being slapped, bitten, hit with objects and spit on to being subjected to racial insults, threats, cursing and sexual advances, personal care workers say they are expected to take such abuse, and often don’t report it because they don’t have time to complete the paperwork, don’t believe anything will be done or are afraid of being blamed.
“The myth that violence is just part of the job may also relate to sexism—specifically the invisibility and normalization of violence against women,” says Hugh Armstrong. “Caring has come to be seen as something that women do naturally rather than a skill that people learn and hone. This myth underlies the poor training personal support workers receive, the lack of resources that are placed at their disposal, the lack of autonomy and flexibility they are given, and the privileging of task-oriented work over building caring relationships with residents.”
The report says that working under extreme conditions constitutes a form of violence in itself—a structural violence that originates in large measure in the way long-term care work is organized and funded. In short, personal care workers have too much to do and work with too little time and too few resources. But comparison with Nordic countries shows it doesn’t need to be this way.
When long-term care is recognized as an essential health service and becomes a national priority, conditions will change. The report recommends that governments legislate and fund adequate care standards to eliminate chronic short-staffing, that employees be empowered and document violence, and that appropriate and accessible training be provided.
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