The Invisible Labour Force
Is About to Collapse
From the Table Series: Replacing Senior Housing with Human Infrastructure
In the hierarchy of healthcare, Personal Support Workers (PSWs), care aides, and front-line long-term care staff are the ones closest to the body — and farthest from the budget.
They bathe, feed, turn, soothe, medicate, clean, and witness.
They manage grief without ritual.
They absorb trauma without therapy.
They carry our parents — and our guilt.
And now, they’re walking away.
This isn’t a labour story.
It’s a warning.
Because the people holding this system together are about to disappear. And there is no one coming behind them.
1. THE TREC FINDINGS THEY WON’T PUT IN A PRESS RELEASE
TREC (Translating Research in Elder Care) data across Canada reveals:
- 47% of PSWs say they’re “mostly just making ends meet.”
- High rates of missed care: staff routinely forced to skip critical tasks like hygiene, mobility support, or social interaction.
- Widespread trauma exposure with no formal debrief or support.
- Turnover rates above 20% in many homes — with some regions much higher.
- Language bias: care aides whose first language is not English report lower respect scores from colleagues and residents.
This is not burnout. This is system design failure.
2. THE LIE OF “UNSKILLED LABOUR”
Despite handling more complexity — dementia, incontinence, immobility, trauma — PSWs are still classified and paid as if they are untrained assistants.
This isn’t just offensive. It’s lethal.
When an underpaid, undersupported care aide misses a turning schedule, a resident develops pressure sores.
When they are forced to rush meals, a resident chokes.
When they don’t have trauma training, they retraumatize without knowing.
This is not incompetence. It's cruelty by design.
And yet: these workers stay longer than most professionals.
They know the birthdays.
They know the stories.
They are the only people some elders see every day.
And we have given them minimum wage and maximum trauma.
3. WHAT KEEPS THEM IN PLACE — AND WHY IT’S VANISHING
What held this invisible workforce in place?
- A sense of duty.
- Community belonging.
- Family proximity.
- Flexible part-time arrangements.
But now:
- Duty becomes despair when the ratios are 30:1.
- Belonging dies when they’re treated like expendable assets.
- Proximity is broken when elders are sent out-of-town.
- Flexibility is lost under rigid provincial schedules.
So they leave. Quietly. Without protest.
And when they go, care doesn’t “slow down.”
It vanishes.
4. THE TABLE IS DESIGNED TO RETAIN AND RESPECT
The Table format flips the entire power structure.
- Co-located housing for workers. Live near the job. Stay near your family. Cut commuting costs.
- Embedded trauma and recovery protocols. Coherent breathing, shared debriefs, mental health infrastructure built in.
- Wages tied to land revenue, not just staffing budgets. You’re not just a worker — you’re part of the economic engine.
- Respected as the relational core. Not “support.” Not “help.” You are the system.
The Table doesn’t staff a care home.
It embeds care into the town.
And in doing so, it gives workers three things the current system cannot:
- Belonging — you live where you work, and it works.
- Visibility — your labour is counted and centred.
- Legacy — the families you serve know your name, and they stay.
5. IF THEY GO, THE SYSTEM GOES WITH THEM
This is the part no one wants to admit:
There is no long-term care without PSWs.
No dignity. No continuity. No survivable staffing ratios.
And no one wants to do this job under current conditions.
We either rebuild the role from first principles — or we bury this generation under silence and turnover.
We choose the first path.
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Thanks!
B
Care aides are leaving.
Quietly. Permanently.
Not just burned out — erased.
47% can’t afford to stay.
Most don’t even get trauma debriefs.
You don’t fix that with slogans.
You build something that makes them want to stay.
PS -