“We’re talking about voiceless, vulnerable people looking after other voiceless, vulnerable people,” said Bulmer. “And it’s just a big shit show.” Regulation would mean licensing, proper advocacy and ethics boards, and public registries. PSWs would commit to a professional code of ethics and standards of practice; so too would their employers. The public would be able to bring complaints and concerns forward to a professional college, which would, in turn, mete out discipline as necessary—a structure that exists for other professions that are responsible for the bulk of society’s care, such as nurses, doctors, teachers, and so on. Bulmer believes standardization would also mitigate what she calls “scope creep,” which can happen when overloaded facilities begin demanding PSWs do things for which they were never trained. Examples of this might be delegating a PSW to administer medication or change wound dressings, among other things, all of which require a level of medical assessment and are, incidentally, actions that the CAF reported being performed improperly. Bulmer and others have been advocating for regulation for at least fifteen years, stressing the benefits of all-around improved safety and care. If anything could nudge their dream closer to reality, it seemed—from the outside at least—like the pandemic might be it. As cases and deaths tallied higher and higher in care homes across the country, though, that isn’t exactly what happened.
The same day Bulmer officially returned to work, she also saw an email from a company that wanted to create a six-to-eight-week online PSW course. She lost it. How could a truncated online course hope to safely and effectively teach students everything they needed? You can’t change a person’s sheets through a screen, learn how to feed them, lift an unwieldy body into a wheelchair. She also wondered how many companies would try to cash in on the shortage. Bulmer lost it again when Quebec announced its own in-person fast-track program to train an additional ten thousand PSWs for fall. She understood the need to replenish the workforce. Quebec had been slow to enforce a ban on working at multiple care homes, and as a result, the disease had spread fast. By May, around nine thousand PSWs in Quebec had either refused to work or had become sick with COVID-19. But Bulmer doubted the mass of new students could learn how to provide effective care in just a few months, no matter the urgent need. She, and others, also worried about the burden it would place on PSWs already in the field, who had to help train the thousands of new workers. None of this would have happened if PSWs were already regulated, she surmised. More than that, she didn’t think a quick fix would fix anything. After all, the pandemic hadn’t created the mess; it had only exacerbated it.
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Fifty-one-year-old Arlene Reid died on April 27 while her daughter frantically performed CPR. Like many PSWs, Reid worked several jobs: one in home care, one in long-term care, and another in a retirement home. During the weeks before she caught COVID-19, none of them appeared to make her feel safe. Each had a shortage of PPE; her home care job provided two surgical masks every five days. It also took her to multiple locations, in and out of people’s houses and apartments, and at least one of her patients, she’d been told, was tested for the virus. Reid lived with a daughter who was battling cancer. She didn’t want to put her in danger, and besides, the government had told people to stay home, not zig-zag across the GTA. In March, she’d gone on a trip home to Jamaica and, after her mandated quarantine, was hesitant to return to work. She told her employers so. One pressured her to return anyway, or be labelled with job insubordination. Another considered her “resigned.” So she went to the first and she worked, and on April 17 she felt unwell enough to get tested. On April 20, the results came back positive. Reid, who has five children and three grandchildren, moved out of the house with her ill daughter and into the house with the one who would watch her take her last breath.
Initially, Reid had a mild fever and a cough. As she became more sick, she developed a shortness of breath and a higher fever and began vomiting. She also experienced a loss of smell and taste. Through it all, she tried to stay positive, right to the end, telling that daughter, “I’m going to get better. Mommy is going to be okay. I’m going to walk away from this.” And for a while, her daughters said, it did seem like she was getting better. After days of self-isolation in a bedroom inside the Brampton, Ontario, home, her cough had subsided. But the bad breathing stuck, until one night, feeling her condition rapidly decline, she asked her daughter to call 911. By the time the paramedics got there, it was too late. Officially, it’s unknown where she contracted the virus, but her daughters believe it was through work. In addition to the home care, Reid worked at least one shift at one of the long-term care homes that required military support. Her employers, perhaps unsurprisingly, contend they are not to blame. Reid was the second PSW in Ontario to die from the virus, and the third healthcare worker. “My mom died at my house,” her daughter told the Globe and Mail. “She just wanted to get better.”
Gloria Turney woke up to a text about her friend’s death at 5:30 a.m. the Monday morning Reid died. The two had grown up together in Jamaica, and Turney thought of her as more of a family member than a friend. Reid had immigrated to Canada before her, and they reconnected when Turney followed. Like Reid, Turney has been a PSW for twenty years, working in home and community care. Before the pandemic, her day started at 6 a.m. She’d take the bus to her clients’ homes and help them get out of bed, get washed and dressed, make sure they took their medication, help them get their breakfast—whatever it was, Turney helped. On any given day, she might see up to eight people, travelling between homes or between rooms at a retirement building. A visit could take fifteen minutes, or it could take three hours. A work day could end in the afternoon or at 10 p.m. She liked travelling every day, the freedom it gave her, how easy it was to take a break and grab a coffee after a difficult client. As the virus spread through the province, though, Turney decided it was no longer safe to be a “busser.” She requested to work at one location a twenty-minute ride away, a transitional bed facility, where people stay as they’re awaiting a permanent long-term care spot. She was working there when the first PSW in Ontario died; Turney had reached out to their shared union and asked, “What’s going on?” People were putting their lives on the line.
It was even worse when Reid died, fear and grief and shock folding together. Turney knew her; her family knew her. She hadn’t heard about the death from the news, or from a co-worker, but from Reid’s sister. It hit home harder. Now the cost of the disease had a face, shared laughter, a whole life of togetherness, love. She realized anybody could die from COVID-19. She realized she had to get up and go to work. Turney can’t speak for what Reid’s employers should have done. But she knows what she would have liked her company to do if the same awful, tragic, unthinkable thing had happened to her. Say something. Maybe the company doesn’t want to admit fault. Fine. Turney just doesn’t want to see them sweep a life, and a death, under the proverbial rug. The absolute bare minimum an employer can do is send condolence flowers, she added. And sure, she knows that some companies did, although mostly after Turney and her union “got loud” about the PSW deaths. What she’d have liked to see, though, is for any company that employs a worker who died to reach out to the family. To phone them. To get sincere about how truly, terribly sorry they are. To express care for the people they sent to the front line. “All these years of working with you,” she said, “and a bouquet of flowers—is that it?”
Turney is, however, sadly used to the indifference, and even callousness, of companies toward workers. She’s been part of her union’s bargaining committee for years. For a decade, she’s been lobbying for better pay and better treatment. In 2013, her union went on strike to protest the $14 hourly wage for PSWs. They walked away with less than a ten-cent increase. So, they pushed the government. As a result, the hourly wage was bumped to $19, where it was capped, and the increase was rolled out over a number of years. After five years at the $19 cap, Turney and her union went back to
the government and the companies with a simple message: you need to do better. That time, they walked away with a thirty-two-cent wage increase, this time rolled out over three years. In 2020, Turney made $19.13 an hour. It will be 2022 before she sees $19.32. If she hadn’t lived in the same place in Burlington for years, or if she ever lost it, she knows she wouldn’t be able to afford rent in her city. She doesn’t have a pension, and unless she works 1,352 hours in a year, she doesn’t get benefits. This, she told me, is why PSWs work in so many different homes at once. It’s why some of them quit when the pandemic hit; it’s also why some of them couldn’t afford to stop going to work. It’s why patients’ care and living conditions both suffer. The pandemic may have made the situation worse, Turney said, but it also made it unavoidable.
Suddenly, there was nowhere else to look, she told me. “This was the topic of the day—you had to look at it. Now your mothers, your fathers, your grandmothers are affected.” People could no longer look away; they, too, now had a face to put to the problem, the grief, the fear. For Turney it could be frustrating to watch puppy-dog-eyed politicians act aghast, heartbroken. “We’ve been telling you for years that these are the conditions,” she added. “We’ve been asking for years for you to help us to have a voice, and nobody chose to.” Still, she does not regret working through the pandemic. For one, she loves her job. And second, she knows it helped her make it through the worst of the isolating time. She cannot imagine staying alone, inside her home, day after day. In March, she was supposed to go home to Jamaica. Her first vacation in six years would have been to see her sister, who had been diagnosed with Stage I breast cancer. In a normal year, she would have gone to visit her sick sister two or three times. Now, she had to settle for video calls. As much as she helped her clients through the pandemic, they helped her, too. They helped keep her mind off what should have been. Kept her from staying in her house alone. Gave her a purpose.
There is one client in particular who helped Turney make it through. A retired realtor, she, like Turney, was born in December. Turney describes her as witty, with a keen sense of humour. “Nothing you do bothers this woman,” she said. If her body had been adjusted into an uncomfortable position by accident, she made a joke of it: “Okay, why don’t you do that again?” If someone asked if she was good, she’d quip, “You know I’m always good.” To Turney, she was the best. Sometimes they’d joke around so much that, through laughter, Turney would plead, “Behave yourself!” The woman’s family would know when Turney was working because she would help her put on makeup before their FaceTime. Lipstick, blush, her brows—everything. She would go all out. They’d look inside the woman’s jewellery box and find something to match her outfit. The funny thing is, added Turney, she herself hardly wears cosmetics at all, and certainly not every day. But she helped her client because that’s what made her client feel whole, happy. Because that’s what you do when you believe somebody, no matter their age, has the right to dignity, good care, and a fulfilling life.
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In mid-March, a couple of days after the WHO declared a pandemic, the term “Boomer Remover” began trending on Twitter. It had, by then, appeared in more than sixty-five thousand tweets and references to the higher mortality rate among older people infected with COVID-19. The so-called joke riffed off the “OK Boomer” meme of earlier social media fame, and seemed to suggest that the deaths of those in one of the virus’s more susceptible age ranges, fifty-six to seventy-four—a group whom younger generations often characterize as entitled, racist environment destroyers—maybe wasn’t such a tragedy, after all. Around that same time, WHO director-general Tedros Adhanom Ghebreyesus slammed countries that were responding slowly, or poorly, to the virus because they believed it killed only senior or older people. To categorize, and then dismiss, the virus as merely a senior-killer, he added, represented “a moral decay of the society.” In the New York Times, Dr. Louise Aronson questioned the constant use of the qualifier only—as if, she wrote, “COVID-19 didn’t matter much if it was a scourge only among the old.” Indeed, that seemed to be what hundreds, perhaps millions, of us thought.
For many politicians, media members, and, I’m embarrassed to say, those in my own social circles, the word only was breathed as a relief; it felt nearly as potent as a vaccine. It was a way to reassure, a way to say, barely between the lines, that not everybody will survive this virus, but everybody who matters will. Days into his country’s lockdown, the lieutenant governor of Texas even suggested grandparents would be willing to sacrifice themselves for the country’s economic future—a proposed solution that gained surprising ground in the U.S. Ultra-conservative talking head Ben Shapiro said, “If grandma dies in a nursing home at age 81, that’s tragic and that’s terrible, also the life expectancy in the United States is 80.” (For the record, if somebody reaches eighty, they are expected to live at least another decade.) Ukraine’s ex–health minister said those over aged sixty-five were already “corpses.” All around the world, people acted as though, if the elderly died, well, too bad, but not really. All around the world, we called our grandmothers and our mothers and told them to stay inside.
Canada’s own callous, ageist attitudes toward seniors didn’t come with as much punditry as some countries’, but that doesn’t mean they didn’t exist. We saw such attitudes in our early apathetic treatment of those who live in long-term care and in the mirrored treatment of those who cared for them. They materialized again when public discourse shifted around the virus after health officials and common sense each debunked the myths about who COVID-19 affected—yes, younger people can get sick; yes, they can die—often (but not always) making the threat “real” for many people. And we saw our attitudes exposed yet again when, despite the still-unique vulnerability of seniors—their mortality rate remains much higher, and more of them are hospitalized—health policy and collective grief both seemed to favour younger demographics. Take, for example, the observations of twenty researchers, many of them Canadian, who together asked difficult, uncomfortable questions about the ageism and discrimination exposed by our response to the pandemic. “It is revealing that the younger adults who have died from complications of COVID-19 throughout the world have often generated long and in-depth media reports,” wrote the authors, “while the deaths of thousands of older adults have been simply counted and summarized, if they were documented at all.”
As a result, thousands of women’s deaths were reduced to a statistic. What’s more, unlike in other countries, where men account for a greater portion of COVID-19 deaths, the sheer number of long-term care deaths here has tipped the gender balance during the first wave—largely because women comprise a larger share of residents in such facilities across Canada. We’ve been asked to care about their deaths because they could have been our mothers or grandmothers, sweet ladies with cotton-candy hair, flower-scented skin, and kind words. Follow that same logic, and you’re asking someone to care about sexual violence because it could happen to your sisters, daughters, mothers. In both cases, we should care about these women not because of who they were to us, or what gender role they can be neatly categorized into, but because of who they are: extraordinary humans. Ageism would have us believe that most of these women were doddering around in their homes, knitting doilies, drooling, and waiting for death. It would have us believe that their value to society had passed. Beyond being morally reprehensible, those perceptions simply aren’t true. Many senior women volunteer in the communities and in their care centres. They teach younger generations and pass down wisdom. They’re caretakers and creators. And, in many cases, they were trailblazers.
Thelma Coward-Ince was one such woman. In April, she contracted COVID-19 inside her Halifax long-term care home, Northwood. At the time, the facility accounted for most of the province’s virus-related deaths. By the next month, long-term care deaths would encompass 97 per cent of all deaths in Nova Scotia. And by June, fifty-three residents at Nor
thwood had died from the virus. Each of them had life stories. Coward-Ince herself graduated from Mount Saint Vincent University with a bachelor of arts. At sixteen, she began working and, shortly after, joined the Royal Canadian Navy, where she knocked down a domino of firsts. She was the first Black naval reservist and the first Black senior secretary as chief of staff to the admiral. At the National Defence, she was the first Black manager and the only female manager in her unit for more than a decade—there were also fewer than one hundred women working out of a total two thousand members in the division. She served on multiple boards, too, including the Black United Front, the Health Association of African Canadians, the Canadian Ethnocultural Council, and the Nova Scotia Advisory Commission on AIDS. And for twenty years, until she was diagnosed with dementia, she sang with the Nova Scotia Mass Choir.
Northwood’s first outbreak was considered resolved as of July 2020, around the same time the rest of the country’s COVID-19 case counts plummeted. Mere months later, however, the country’s second wave began to crest—and it looked like Canada might fail its elderly again. By fall, cases began to reappear in long-term care centres, including in some that had previously quelled their outbreaks. The facility where Roisin O’Brien worked was one of them. By October, resident cases in Ontario long-term care homes were approaching April numbers at 159 virus-positive patients; at 199, staff cases had already surpassed their April tallies. The province asked the Red Cross to help in several homes, just as the disaster relief organization had done over the summer in Quebec. It was as if the July and August heat had evaporated caution, community regard, and maybe also a little bit of the fear. It also seemed to erase much of the mass outpouring of support for frontline and essential workers, and with it the pressure to better protect them. As the quarantine ended, PSWs were largely forgotten. “Two months ago, we were heroes,” Turney told me toward the end of August. “When have you last heard that?”
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