Exploring the Pros and Cons of Working as an In-Home Care Personal Support Worker
If you are considering a career as a Personal Support Worker (PSW), working in-home care can be a rewarding and fulfilling experience. You get to work one-on-one with clients in the comfort of their own homes, providing them with essential care and support that improves their quality of life. However, like any career choice, there are also some downsides to working as an in-home care PSW that you should consider before making your decision. In this blog, we'll explore the pros and cons of working as an in-home care PSW to help you make an informed decision about your career path.
Pro’s of In-Home Care:
Hands on Job: A more rewarding feeling working directly with a client and knowing that you can offer more help than other health care occupations to the client. You are the nurse, care giver, physio, activation staff, and a friend. You get to see the clients regularly and know that you are making a difference to their well-being and lives.
One of the rewarding feelings is knowing you aid in controlling the care of the client by reporting changes and suggestions on ways to make the clients care the best it can be because you are the one who sees the client the most. You are their eyes and ears and have a large impact on their care. As someone who prefers not to sit in front of a computer all day and enjoys the more hands-on approach, this job is perfect. With the flexibility of working in home you still get the few moments to rest between each client and then get the experience of being hands-on, it’s the best of both worlds.
Room for growth and opportunities: With being a PSW in home or in a long-term care home there is always room for growth and development, it is a career that you never stop learning. Every client’s needs are unique and individual which means you are always changing and adapting your care methods to suit each client. What works for one may not work for another, so you learn to adapt to new methods. There’s also always new courses and programs for PSWs to take to enhance their learning and hone new skills to provide better future care. The world is changing, and the population of clients is changing as well, and this type of career allows you to be flexible and up to date with these changes.
Loss and Grief: This one is a pro and a con. It can be the most challenging part of the job. When you work with clients you start to think of them as an extended part of your family and losing them can be a very difficult thing which can take a toll on you. Luckily there are programs and people you can talk to, to help you work through the loss so you will be able to help the next client. The nurses or other staff members are great to rely on in those difficult moments. Although it is a tragic event, being a PSW and helping them is more than worth it. It can be a bittersweet feeling knowing you were there with them until the end making taking care of them and making this transition as comfortable for them as possible.
I, myself get attached to clients quickly and have found death to be a difficult thing to process but I would never stop being a PSW because the rewarding feeling of knowing you helped them to the best of your ability outweighs the loss and grief. Take pride in knowing you helped them and changed their lives for the short while you are with them.
Flexibility: Working as a PSW doing in home care allows you to have a more flexible schedule as opposed to working in a long-term care home where the hours are set. You can make your schedule as light or as busy as you’d like and can work around other commitments you have in your life. For me it was much easier to have a work life balance, helping clients and still being able to have quality family time with my daughter. I found they are more willing to work with your needs and schedule compared to a long-term care home.
They are also more flexible when it comes to how much time a client requires with a PSW. If they find they are not getting enough time for their visits the company was good to arrange for either a longer visit or adding more visits per week. I found that to be extremely helpful for the clients and their family and even for PSWs because the quality of their care increased and PSWs didn’t feel like they were rushed.
PSW Personality: I really enjoy having the freedom to wear my choice of scrub uniforms from colours to patterns to how I wanted to do my hair or the type of shoes I wore. Some companies were stricter with their uniform choices, but most are pretty relaxed as long as it fits the requirements. I had found that a lot of the clients got as much joy from the colours or patterns from the scrub tops and seemed to elevate their mood during the time spent with them. They always looked forward to seeing what I would wear for their next visit, which in turn got me excited to go back and show them.
It can be the littlest things that can make the day so much better. I’m not going to lie I have a collection of all different colours and pattern scrub tops that it has taken over my entire wardrobe, it can become quite an obsession collecting scrub tops and thinking “Oh my clients would love this one!” It just gives you that extra excitement and enjoyment about the job, being able to express yourself and make others happy in the process.
Responsibility: Working in home care gives you a sense of greater responsibility knowing you are their main source of care and respecting the power and trust you are given to do the best of your abilities. When you do in-home care, you do the visits and care alone with others to aid you over the phone but during the visit you are the one in charge as it is only you. You have to remember to maintain and uphold the code of ethics as well as understand that power and trust can be easily taken away just as it is given.
There is a huge responsibility and at first it can seem very intimidating and somewhat scary but if you do the job properly and give it your best efforts then you will be able to handle it and the more you do it the easier it becomes. When training for in home care make sure you really understand what it takes to give each client you see the best care possible and at the end of your training shifts if you don’t feel ready speak up and voice your concerns.
This is a lot of responsibility, and you need to make sure you feel completely comfortable and ready to do it solo. Companies do not have a problem giving you more training time to make sure you are ready. You are the client’s eyes and ears when taking care of them, it is your responsibility to relay information whether in documentation or a phone call to make sure their care plan is up to date and that changes are being made especially for those who cannot always voice their concerns or changes.
Comfortability: I quite enjoyed working with clients in home, seeing how much happier they were, being able to stay within their homes and still get the quality care they require. The clients seemed more comfortable, less agitated, and willing to do more on their care plans when in their own home. They have more freedom of choice when it comes to their meals, wardrobe and what they would like to do during the visit once everything on the care plan has been completed.
They also get to use their own personal belongings i.e.: personal care, clothing selection etc. I had found that the products used in long term care homes for personal care while effective did not have the most pleasant smell and clients seemed more opposed to using their products. They have less worries and concerns about their personal belongings in their home as they do not have to worry about others going into their rooms and it also gives the clients a greater sense of privacy and security.
Cons of In-Home Care:
Travel: Dependent on which client rotation you get for the day can be frustrating for the drive and travel time. I have found that organizing clients was not the most efficient and caused a lot of extra driving time and gas spent. There would be a client on one side of town and your next client would be on the other side of town just to head back to the side of town you started on to see the next client. I think if this was set up in a more efficient order it wouldn’t be as stressful on the PSWs.
Make it a loop or see all the clients in the same area at once then move onto the further away clients. It can sometimes make the PSW feel rushed or give them the sense they are going to be late for their next client, which is a very upsetting feeling. With the price of gas increasing the pay for travel time between clients does not reflect the increasing cost of gas making PSWs pay out of pocket to do their job.
Another issue is that traffic and weather conditions are not taken into consideration when traveling between clients. Some companies take the google map direction time and that becomes the pay travel but in the busier hours or poor weather conditions it takes longer to get to the next clients home putting PSWs behind. Time between travel should be adjusted, especially in the summer and winter months, to account for traffic and weather so that we can get to the clients home on time.
Shift Reports: When going to a client’s home for the first few times it can be quite intimidating as you don’t really know what to expect when you walk through the doors. Who is going to be there, the state of their home, the client’s condition, especially if they don’t get many visits in a week.
I have also found that the care plans were not always up to date, PSWs don’t always relay every bit of information and when clients have a few visits per week it’s hard to know what has happened in the time between or the state of their condition.
I have noticed there is a drastic difference in the shift reports between in-home and long-term care, the in-home was just a checklist that you mark what you did and that was it there was no reporting or leaving notes for the next PSW to follow. A lot of them did not have a care plan with the checklist and if it was a client that could not describe what they need it left the PSW feeling very confused and overwhelmed. They would also just email the nurse on that shift what they reported but a lot of the time the documentation was unclear and did not make sense or the PSW left out information that would be deemed important to know for the next PSW.
Because PSWs are not monitored by nurses or higher ups as much as they are in long term care facilities, they tend to think they can get away with more. If a client refuses something on their care plan they just accept it and move on so they can leave earlier or sit and do nothing. They do not try the different approach method or try again later, and I find that very heartbreaking.
Some Suggestions:
Care Plans: Having a designated PSW or two to go with the nurse when doing care assessments to new clients would benefit so they understand the care plan and the needs from the client and family members. I find sometimes just being handed a piece of paper to follow can get lost in translation or don’t quite understand how much or little help a client needs (depending on how well the care plan was written) but if there was a PSW to go with they can show other PSWs how to properly take care of the client and to understand the care plan.
A lot of the time the nurse only sees them for the intake and when the care plan needs updated, they rarely see the client and don’t always understand how PSWs do care. If PSWs were to go and sit in on the care assessment, family members of clients who cannot explain themselves can be shown how they do the care or methods they use and can copy/mimic the actions with the family members present. I think this would give the family members a better sense of relief knowing that the PSW is competent and really get a grasp of their care.
It would make the PSWs feel better knowing their tips and tricks and what works better for the client and to ask for clarification from family members. PSWs can ask more probing questions on the intake forms or clarify questions or concerns from the client or family members. If a client requires physio or something of that nature to be there when it is happening when that health care provider is there, I find that they usually leave a piece of paper for us to follow but again we may not be doing the exercises correctly or understand how much to help them IE: leg raises, if they require help how high/ long do we lift their leg in the air.
Medication admin: PSW takes the course for med admin so that if the client needs help, we can provide the help they require. Example: I had a client who could not administer her eye drops herself as her hands were too shaky and could barely lift the bottle up to her eyes and watching her struggle was heartbreaking. I know a nurse comes around to delegate tasks to the PSW so they can help hand the meds to the client, but I think the course would also be beneficial. Might help PSWs get a better understanding of the meds and why times are important and can help the nurse to delegate more tasks where they may not always be able to get there to do their medication.
Meetings: More meetings with PSWs to come together and discuss clients and to make sure we are all on the same page with care, or how we can make suggestions to better the care. One Care did this once a month and it was found to be very helpful. If PSWs cannot attend the meeting because of work or other commitments, have it recorded for them to listen to or typed out in the office I have found that a lot of PSWs either stray or do a client's care differently which can sometimes cause problems for the next PSW. It can make clients favour certain PSWs or resent others (I have witnessed this before). Meetings are beneficial to regroup and bounce ideas off one another. Even to have a monthly meeting with the client to make sure they are still feeling good about the care they are receiving or to help them with any issues they may have with PSWs to keep them happy and keep the care running smoothly.
Documentation: Making sure documentation is accurately documented, create a guideline on how to report or what to report. I found that some were just a checklist that didn’t explain anything, some were emails that were very vague or didn’t make any sense and that can cause a lot of confusion and miscommunication. Have a program like the long-term care facilities where all the clients are all listed, click on their names and go through and select the correct documentation answer for the care task. IE: bathing – did the client have a bath? Yes, no, client refused, washed hair only, and then have a spot to insert reasoning for declining.
If there was a program used across all PSWs the documentation could be easily accessed, PSWs can read up on the previous report and see what needs to be done for their shift. Less confusion and proper documentation. This also allows those in charge and the nurses to get proper reports and can see live time how care is going. It can also allow them to see if there are problems and be able to address those issues quickly. This kind of programming allows PSWs more efficacy and quicker documentation so they can still properly document and be able to see the next client on time. The colour of the task changes from neutral to green when it is completed, if they miss a task or it was not documented it changed to red allowing the PSW to make the correct changes or gave the nurse and other PSWs a heads up that it was missed. This kind of program can be tailored to suit the clients needs and have a spot to document changes in the client.
Care Notice: I think it would be beneficial to have an on-call or backup system for when a PSWs cannot make it to a client so the client does not miss their care. Especially during the winter months when the weather isn’t great or PSWs calling in sick, it would allow another PSW to take their spot. One thing I liked about in-home was an on-call for the night shift as clients are not seen during the night but if they had an emergency a PSW was available to go out and help them or wait with them as EMS arrived and that could also be documented. Having the client give advance notice if they don’t require care for their scheduled time preferably a day’s notice or more. It’s understandable if things come up but it would be nice to have notice so we could help another client or not freak out when we can’t get a hold of the client. Asking them to leave a note or something for the PSW if the client couldn’t give enough notice so we are not worrying why they are not there or answering the door.
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