Lori Germain and Leigh Merlo from Discerning Seniors chat with Lee Grunberg, President and CEO of Integracare. Together they discuss the crucial role played by personal support workers in the lives of Canadians who need assistance in their daily lives as well as the ways the private industry has been overlooked. They also discuss how the Ontario Provincial Government might have missed an opportunity to assist people who are helping to alleviate the overburdened public system amidst the COVID pandemic.

Lori: Hi, and welcome back to Discerning Seniors Connector. Where we continue to highlight services and issues relevant to today’s senior, my name is Lori Germain, and I’m the President and Co-founder of Discerning Seniors, and I’ll be joined shortly by my partner and Vice President, Leigh Merlo.

Lori: Okay, so I’m excited Leigh today to be talking to Lee Grunberg from IntegraCare. Finding personal support workers is the number one thing we get asked about so, he’s just a great resource for us.

Leigh: He is, and we often turn to IntegraCare as one of our providers for personal support workers because they embody the exact same values as we have, they treat their clients like family. And they treat their personal support workers like gold. The training is impeccable. They have gone above and beyond in trying to address some of the payment and equity issues that the government has now instituted, which he will go into. We just share a common objective that we want all of our clients to obtain a joyful living, and that’s what they’re all about. They have very caring caregivers, so we’ve had excellent, excellent service with them. You and I have had this conversation before, we’ve long felt this profession has been very underappreciated. And not only do caregivers work publically and privately, but they also cast a huge safety net in the community, especially for the elderly people, our clients. These caregivers become parts of our lives and parts of our family. So it’s a very personal relationship, so we appreciate the approach that IntegraCare cares when placing personal support care workers in our client’s homes. So we’ve had a great chat with Lee, and here it is.

Lori: Thanks, enjoy!

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Lori: Thanks Lee, for joining us today. I know this is an incredibly busy time for you. What’s happening out there? Given the COVID situation. How are you ensuring that you’re keeping your caregivers and your clients safe?

Lee: First of all, thank you for having me. It’s such a pleasure and honour, and I love working with you guys, so I’m happy to take the time for sure. How we’re keeping our clients and our caregivers safe is, you know, it’s the number one priority, and it really always has been. But were just under such a finer microscope now to ensure that we take every single precaution to make sure that our caregivers and our clients are safe. I would argue that IntegraCare now is, and the services we provide are safer than ever.

There have been three main reasons, the first is, on March 22, we launched a one workplace policy, and this was a month before the government-mandated their one workplace policy. And we actually spoke to the government at length about introducing this. And so what that means is, if a client is having one of our caregivers in their home, that caregiver is not going to go work with other clients. That’s number one to minimize the spread of COVID and try to prevent it from spreading. And that was tough, that was four days of ripping up all of the existing schedules and rebuilding them from scratch to be able to enable a one workplace environment. And what it’s done, it’s allowed for better continuity and care, but it’s really allowed for a much safer environment.

The second thing is PPE, personal protective equipment. And since February, late February, we started amassing personal protective equipment. And whether that’s masks, gloves, and gowns. Face shields, hand sanitizers, we’ve done it all. Everyone runs into problems on one product or another. But we’ve been able to procure everything that we’ve needed and more. We’ve built a war room if you will, right in the lobby of our head office, so that caregivers can come, and we can hand out PPE, and we also have been delivering them directly to clients and even the caregivers’ homes, so that they would have it. But we’ve ensured that every single visit has an adequate amount of PPE.

The third and final element is education. It’s not enough to just give a mask to someone. We need to explain the reasons why they’re using PPEs, so we’ve had online COVID education, but also how to wear a PPE, how to put it on. That’s certainly with handwashing. We’ve been doing that for 30 years – proper handwashing techniques. So we know what we’re doing, and we’ve been able to keep everyone safe. And thankfully, not one of our clients living in their home, and not one caregiver who’s working in a client’s home, has contracted COVID.

Leigh: That’s fantastic. Given what’s going on out there in Ontario, and I know finally a very great thing to come out of this, the government has finally recognized personal support care workers as essential services. But not for the private industry, so tell us how that impacts your caregivers and your clients.

Lee: It was a bittersweet day when they announced that PSW’s were going to be receiving pandemic pay and that they were an essential service. Why bittersweet? It should have been a day of jubilation. Finally, the personal support worker was going to get the hero level respect, outside of IntegraCare, which they always get it at IntegraCare, but outside of IntegraCare, they were going to get the level of respect they so badly deserved. Pandemic pay is a 4 dollar an hour plus a 250 dollar a month if you work over 100 hours a month, a bonus play if you will, a bravery pay, and it was meant to provide some incentive to get people to work amidst the world’s worse pandemic we’ve ever seen, and unfortunately they announced it before they really thought it out. And all of a sudden it ballooned, and they could not offer pandemic pay, the government could not offer pandemic pay to everybody that in many cases that rightfully deserved it. So, unfortunately, privately retained PSW’s who could very well be working in a retirement home, with COVID in the retirement home, but if they were retained by the family, they were no longer eligible, they would not be eligible for pandemic pay. So IntegraCare and our clients, really our clients, stepped up and we said our caregivers were going to get pandemic pay, paid by IntegraCare from day one. And we started paying it from day one. And to this day, the government still hasn’t caught up and made those payments. Believe it or not, we’re not even going to get reimbursed for PPE that we’ve spent.

Lori: That sounds crazy. And it’s also counterintuitive, isn’t it? If so many people can stay out of publicly funded institutions and they can stay home to get either better, for whatever it is, even if it isn’t COVID, because other illnesses continue to occur, you would want to encourage that wouldn’t you? Wouldn’t the government want to encourage that?

Lee: I’ve certainly tried to make that argument. The homecare association has tried to make that argument, and unfortunately, we were unsuccessful. Luckily many of our clients have saved for the rainy day if you will. And they are getting better care than they’ve ever received. Because they are getting better continuity of care. Unfortunately, their dollar is not going as far in terms of number of hours of care, because they are spending it on pandemic pay and on PPE. In order to keep everyone safe. Unfortunately, I wish it was the case, and I’ve offered all of our clients, if we’re ever able to change the government’s mind on this, we will issue a full refund for all the pandemic payments the clients have had to pay and the PPE. It’s a terrible situation, and we’re just so fortunate, for the most part, our clients have been able to afford it. Unfortunately, there are some clients that have not been able to maintain care because of the increased cost, and their right now going without care and many of them are ending up in the hospital, at a much higher cost to the government then had they paid pandemic pay.

Leigh: For sure, makes no sense. The result of having fewer caregivers rotating around through more clients has been, you’ve had no cases of COVID you said? amongst your clients and caregivers?

Lee: That’s correct. The one workplace policy has been incredibly effective from a safety perspective, but it’s also led to, and this is why we’re going to keep it post COVID, yes it’s more challenging from a coordination perspective, but our clients are getting the best care they have ever received. Because they are getting better continuity of care. Our caregivers, because they are not working through 3-4 different clients, they are able to take the time and really get to know our clients. Get to know their preferences, their likes and their dislikes. Their care plans. And our clients are not only safer, but they’re getting better care then they have ever gotten.

Lori: And also stress. So that reduces stress. Because you don’t have to meet a new person, although your team has been very focused, but in many cases, with PSW’s you never know how you’re going to get and that must be incredibly stressful because it’s a very intimate relationship and one that needs to build over time.

Leigh: Yes, to Lori’s point, it can’t be done hour shifts here and there all over the places anymore. It needs to be more continuous. Lori and I have been receiving a lot more calls from people looking at what are the costs of having caregivers come into the home? How is it determined? Do you have nurses? All these kinds of questions, people are starting to get their minds around the fact that ‘I probably don’t want to go to a longer-term care home, I probably want to stay in my house if this is around for a little while longer. So have you also been noticing a huge increase in interest in your services?

Lee: For sure, there’s been an increase in demand. In the long term care market, I think the vast majority of the focus of the government post-COVID is going to be fixing long term care. And I don’t think it’s going to be, abandon long term care and put all our money into home care, although that’s what I would advocate for, but I do think they really have significant problems in long term care. And I think for many families, first of all, people have been saying, and surveys have shown, people prefer to age in-home, in their place, that they’re familiar with, that their safe, comfortable. Even the move alone is a stressful endeavor and so if we can keep people in their homes, for longer, that they’re familiar with, that their safe and comfortable we want to do that. It is becoming less of a financial discussion, and more of a safety discussion for many. And I know that not everyone has the same level of affluence, and money is an issue, especially in these more difficult times with unemployment at the highest level it’s been in decades. But when it comes to care, and when it comes to the safety of your loved ones, I believe there is no argument. The money that you should be spending is in-home care. And you should be trusting your loved ones to people that have the experience working privately and have the safety of your loved ones and of their caregivers in mind every single visit.

Leigh: You know it’s interesting, I’ve had a couple of clients reach out and they have taken it upon themselves to bring their parent home during this time. and similar to what we’re finding with, young parents trying to homeschool their kids. They have a newly founded appreciation for teachers, I have to tell you, the feedback we get from our clients is oh my goodness taking care of an adult is not like taking care of a child. Like it’s a lot of mental work and a lot of physical work.

Lee: Yes. We’ve actually brought home from facilities, we’ve helped bring home four different seniors, four different families, whether it was procuring hospital beds and lifts, and what have you. But also being able to provide the care, and it’s the same reaction every time, which is we can’t believe the impact and value that your PSW’s or your nurses provide, what a world of difference we’ve seen in our mother, father, aunt, uncle. As soon as they got them back home, and when they got that one and one care, that familiarity, and that independence to build their own schedule, wake up when they want, eat when they want, shower when they want. That regaining of independence from living at home has had an incredible impact on their lives. And the sons and the daughters that have brought them into their homes, have noticed it and provided that feedback to us.

Leigh: That’s an important point. In our business, we don’t sway people either way. We really want to give them the pros and cons and just the lay of the land when they’re trying to decide how they want to care, whether care comes to them or they go to care. But it’s important to know most people are very cost-conscious, but there’s just a such a different quality of care when you can live at home.

Lee: Absolutely. And I hope at this point right now, safety trumps policy.

Lori: I know, it’s a wonderful service, and the people who work at IntegraCare, well the people who do this job in general, you know this is not a knock on the individuals who work in the different types of facilities. These are all really special people, but I think the nugget is really around being able to build that relationship, being able to have consistency in people. I know there are great people who work for the LIN, but the way their schedule doesn’t allow them to do the job the way it should be done.

Lee: Right. Some of our best caregivers came from the LIN, came from the long term care environment. It’s not the caregiver that is prohibiting the quality of the care from the public system or from long term care facilities. It’s the schedule, it’s the facilities, and it’s the reimbursement model. There is so much broken with our public system, that it creates this need for the private care market.

Leigh: You know I’m sitting here thinking when that famous doctor recognized that all he had to do was wash his hands and less babies would die, it was that obvious right. I forget his name. But how the world is kinda going of course you can’t have caregivers going from home to home to home with infectious disease running rampant. Not just this year, but the flu and anything else, the common cold, everything. And it just seems so obvious now. It has to change.

Lee: It has to change. It has to change.

Lori: It’s a tail wagging the dog sort of model, the way it is because it has been filling in holes, it has been trying to fix a very broken system with bubble gum and bandaids, you know, it doesn’t work.

Lee: Well there are many different things that have been changed as a result of COVID and some are going to have short term positive effects, some are going to have short term negative. Some are going to have long term negative and some are going to have long term positive. And I think the review and improvement within the healthcare in all aspects, is a long term positive gain from this nightmare that we’re living through right now.

Leigh: I’m so thankful that all of your clients and caregivers are well, that’s just fantastic.

Lee: You and me both.

Lori: Yes.

Leigh: Wonderful.

Lori: Well thank you so much for coming Lee.

Leigh: Yes thank you, Lee.

Lori: This has been very insightful and informative and we appreciate you taking the time during this crazy time.

Lee: Thank you guys for having me. It’s always such a pleasure to speak with both of you. Especially when I’m telling you that a client that you’ve referred to us is now recovered and doing great, and no longer needs our service.

Leigh: Wonderful.

Lee: Those are the best conversations we can have.

Leigh: That’s wonderful, thanks for the update.

Lori: Thanks, Lee.

Lee: Thank you, guys. Buh-bye.