Fewer health-care providers are working in Canada’s long-term care sector, while the number of Canadians entering long-term care (LTC) homes continues to rise, according to a recent report.
LTC capacity needs to nearly double in the next decade to meet the growing demand from adults aged 85 and older—one of Canada’s fastest-growing age groups, the Canadian Institute for Health Information (CIHI) said in a report released on May 22.
The growth of this population will “accelerate even further in coming years, as the first baby boomer cohorts will turn 85,” Statistics Canada said in a report released April 2022, with the population of those aged 85 and older potentially tripling by 2046.
“This coming decade will be a challenging period for the LTC sector,” the CIHI report says. “Many were already facing staffing and quality challenges before the start of the COVID-19 pandemic.”
CIHI said that there were over 198,000 LTC beds across the 2,076 LTC homes throughout Canada in 2021, and at that time, staffing shortfalls affecting quality of care was reported among 50 percent of those homes.
LTC homes employed an estimated 13.6 percent of the Canadian health-care workforce in 2023, including nurse practitioners (NPs), registered nurses (RNs), licensed practical nurses (LPNs), registered psychiatric nurses (RPNs), occupational therapists, and physiotherapists.
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Recent data indicates that many of these health-care providers are moving to employment positions outside of long-term care settings, CIHI says.
From 2014 to 2023, the number of RPNs working in LTC homes dropped by 42.5 percent and the number of occupational therapists declined by 9.1 percent, the report says. During the same time period, the number of LTC residents with “higher clinical care needs” rose by 4.5 percent, placing a higher demand on health-care providers working in LTC.
“Given that 1 in 5 LTC workers expressed an intention to leave their job during the COVID-19 pandemic, efforts to attract and retain LTC workers remain crucial,” CIHI said.
The institution found that most of the health-care employment vacancies in 2023 were for providers that are commonly employed in LTC settings, including more than 29,000 openings for RNs and RPNs, more than 13,000 openings for LPNs, and more than 26,000 openings for personal support workers (PSWs).
“Vacancies are driven by a number of factors such as retirement, moves to different jobs or creation of new positions,” CIHI says, adding that vacant positions have gradually increased since 2015.
The Canadian Management Information System Database (CMDB) reported that health-care providers working in LTC have logged substantially more sick hours and overtime hours compared to pre-pandemic levels, which CIHI says is costly to LTC homes and may increase pressure on already overworked staff.
CMDB also reported that the number of health-care providers from private agencies that are outsourced by LTC homes has also substantially increased since before the pandemic. The quality of care for LTC residents over time may be impacted by the homes’ needs to depend on workers who lack the same training as regular staff, CIHI says.
“Sustaining the LTC workforce may also require strategies that allow employees flexibility to shape their schedules to suit their lives,” CIHI said, noting factors such as workers’ preferences for full-time, part-time, or rotating work.
