**Confronting Canada’s Long-Term Care Crisis: An Appeal for Trauma-Informed Work Environments**
The predominant health care crisis in Canada has drawn considerable focus, yet a similarly urgent and persistent concern prevails within the long-term care (LTC) sector. Over five years post-COVID-19, which drastically affected LTC facilities and unveiled significant shortfalls in funding, staffing, and infrastructure, numerous challenges remain unaddressed. These complications lead to acute staff shortages, employee burnout, and inadequate resident care. With Canada’s demographic shifting towards an older population, the need for LTC services is set to escalate, necessitating prompt action from federal, provincial, and territorial governments. A crucial initial measure is to establish trauma-informed work environments that advocate for the mental well-being of LTC personnel.
Most individuals working in LTC are unregulated care aides, including personal support workers and nursing assistants. Typically, these roles are filled by female immigrants, many of whom do not speak English as their primary language. Although they account for over 90% of direct care and are vital to the end-of-life and daily support of residents, they receive low wages and inadequate training. They seldom participate in care planning, find themselves under-staffed, and are faced with hefty workloads while looking after residents with complicated needs.
These circumstances have long taken a toll on workers’ mental health, with research showing increased stress and burnout levels even prior to COVID-19. The pandemic intensified these challenges, placing care aides under greater strain with expanded workloads, significant shortages, and augmented anxiety. The consequences included heightened mental health issues such as anxiety and PTSD, worsened by fears of virus transmission.
Current studies contrasting burnout levels from 2014 to 2024 reveal that the already elevated pre-pandemic figures have yet to stabilize, with emotional exhaustion increasing and professional effectiveness declining. This is particularly alarming in light of ongoing staffing shortages, as burnout fuels absenteeism and high turnover rates, which further compromise care quality.
Addressing burnout to enhance mental health for care aides is essential. Although LTC is primarily a regional responsibility, decisive federal leadership is necessary to tackle this workforce crisis. Governments ought to allocate funds and enact policies that foster trauma-informed workplaces, recognizing trauma and working to prevent it by promoting safe and inclusive settings.
Trauma-informed workplaces acknowledge the widespread effects of trauma, prioritizing safety, trust, collaboration, and cultural awareness. Their goal is to avert re-traumatization and provide support, free from bias and microaggressions. By ensuring fair wages, reasonable workloads, and improved training, workplaces can empower employees and involve them in policy-making decisions. Initiatives, such as stress-management techniques, including coherent breathing, should be advocated to promote mental well-being.
Trauma-informed care is essential to resident care within LTC, as noted in recent guidelines from the Health Standards Organization and Health Canada. Applying this framework to staff will create a supportive work atmosphere, alleviating burnout and encouraging favorable outcomes for both employees and residents. Focusing on the mental health of care aides not only aids the workers themselves but also guarantees superior care for the vulnerable populations they assist.