Granny nannies -

Granny nannies

This new class of caregiver is booming, and quite unregulated


When Esther Heckbert told her mother she wanted to leave the Philippines to work as a babysitter abroad, her mother was leery. “She said, ‘babysitter? You’re done university!’ ” The two were folding laundry at their home in Isabela. Esther, who has a degree in business administration, had high hopes. “I said, a babysitter abroad can make a lot of money. From there, you can upgrade yourself: you can get citizenship.” For decades, thousands with the same profile—young, female, Filipino—have come to Canada to work as babysitters. Twenty-five years since arriving, Esther has helped rear dozens of Canadian tots: first as a nanny and then as the owner of a nursery school. But a few years ago, she sensed a changing wind.

She left babysitting behind, sought retraining, and now works under a more whimsical title: granny nanny.

She joins a growing rank of babysitters-turned-eldercare workers: a nod to shifting demographics. In 2008, just under 14 per cent of the Canadian population was over 65; it will be more than 25 per cent by 2044. At the same time, seniors are increasingly shunning the option once pressed on them: nursing homes. Now, most care to frail, older adults is provided outside facilities, says Norah Keating, human ecology professor at the University of Alberta. As more seniors stay home, we’re racing to import and train professionals to care for them. That dash has created a new class of caregivers, many of whom are undertrained, unregulated and unprotected—and with this a new set of problems.

A sizable chunk of that class comes through the same provision that allows us to bring in people to care for our kids: Canada’s Live-In Caregiver Program. Unlike other temporary foreign workers, live-in caregivers are eligible for permanent resident status after meeting program requirements. More than 100,000 have come since the LCP’s inception in 1992. Most are Filipino. Most stay for good. In the early years, the LCP was effectively a babysitter-recruiting apparatus for parents. But increasingly, seniors are turning to it for 24/7 live-in care. Back in the Philippines, women are catching on. Erwin Pascual, a Filipina immigrant who runs a private career college in Toronto, says more recruiters in the Philippines are marketing eldercare courses. “The demand started going up about seven years ago,” says Pascual. And supply has risen to match. By some accounts there is a backlog of applicants in Manila, biding their time.

It can be a treacherous wait. “There are so many bad agencies out there that are exploiting and taking advantage of these girls,” says Tova Rich, who runs the Family Matters Caregiver agency in Thornhill, Ont. Many charge the women “upwards of $10,000.” (The federal government is reviewing a bill that would ban charging caregivers recruitment fees.) Then there’s the problem of what Rich calls “phantom employers.” The LCP mandates a single-employer contract, and agencies may promise a candidate, and the Canadian government, a job that doesn’t exist, says Rich. By the time the woman finds out, she’s already paid the fee—or moved here. Last year Rich was asked by a Filipino caregiver to help her relative, a woman brought over for a bogus job who, without work, was forced to live in a basement owned by the agency. “We had to rescue this girl at like 10 at night,” says Rich. “We were horrified.

We went in and there were three or four mattresses on the floor. There must have been 10 or 12 girls, all talking and cooking. We said: pack your bags.”
That’s an extreme case. But the reality of Filipinas being recruited into the homes of sick seniors and asked to function as de facto nurses is in itself a sign of a subtler kind of exploitation, says Leah Diana, who works at the Philippine Women Centre of B.C. LCP applicants, she explains, need two years of post-secondary education and relevant experience.

And so, many are professionals: midwives, nurses, and even the occasional doctor. For Diana, that requirement, in combination with a system that makes it tough for foreign-trained nurses to get accredited, means we’ve created a flow of low-cost “unregulated nursing” into Canada. Employers seek out Filipino nurses through agencies, she insists: women who can monitor insulin levels and give injections, in addition to offering personal care. But officially the women are brought in as babysitters—and paid minimum wage. It’s why Diana’s group has launched an “End it, don’t mend it” campaign, aimed at scrapping the LCP. Playing on that slogan, Immigration Minister Jason Kenney has pledged to “mend the program, not end it.”

Deanna Santos, a lawyer of Filipino origin who advises live-in caregivers about their rights, likewise wants to do away with the LCP’s live-in requirement, as well as employer-specific contracts. Both, she says, can bind caregivers to abusive households. “Because of their desire to gain the prized permanent resident status, they endure abuses.” Allegations levelled last spring at Brampton, Ont., MP Ruby Dhalla brought some of these issues to the fore.

Caregivers working with Dhalla’s mother said they were forced to do chores like shining shoes and washing cars: tasks outside the purview of the LCP.

Dhalla has denied the charges. But lately, complaints of this sort have reached the ears of higher-ups. In December, the federal government offered proposals to revamp the LCP, including instituting an employer blacklist.

Of course, potential for abuse existed when the program focused on babysitters. But working with seniors can amplify strains. Dementia patients, for instance—a group projected to grow in numbers, according to a report released this week—are prone to violent outbursts. Albert Banerjee, a York University Ph.D. student, found 90 per cent of facility-based caregivers in Canada have experienced “physical violence.” The situation is similar in home care. Caregivers contacted for this story reported abuse ranging from racial assaults to getting punched in the face. “Many older people were raised in a generation where the Chinese were the enemy—or where blacks were seen as lesser people,” says Charmaine Spencer, a gerontologist at Simon Fraser University. “Many changed their attitude over the years.” But as they age, or develop dementia, “they lose their inhibitions.”

For all the pitfalls, Esther Heckbert found the eldercare field to be an attractive one. And so, a few years ago, as many former live-in caregivers do, she decided to advance to the next level: she enrolled as a student in a personal support worker (PSW) course. The official designation qualifies caregivers to work in nursing facilities, for one, where they provide basic care like bathing and meal preparation. Some Canadians are referred to a certified PSW by a doctor; in such cases their needs are assessed by the Canadian Association for Community Care, which allots an amount of subsidized care. Families can also approach agencies to hire one.

Thousands of Canadians get certified as PSWs each year. But even that process has its hazards, sometimes opening doors to unfit caregivers. Last year, a number of private colleges were busted for selling fake diplomas and graduating woefully unqualified PSWs. A Toronto Star story featured one school that passed students in weeks, versus the year it takes at an Ontario community college. Miranda Ferrier of the volunteer group PSW Canada says she’s had to “break the news” to PSWs that “they can no longer work [because] their certification is nothing. There’s no regulation,” she says. “None.” PSWs have no professional body, no counterpart to the College of Nurses. New trainees are not required to sit for provincial exams. The courses are not standardized, and can be taken at either community colleges or private schools. All this, Ferrier insists, leaves not only seniors, but also their caregivers, unprotected.

“The baby boomers are coming,” says Ferrier. “We need to be prepared. And we’re not close.” She started PSW Canada as a hopeful precursor to an official college. But the Health Professions Regulatory Advisory Council rejected that idea in 2006, deciding Ontario PSWs should not be regulated.

“HPRAC also concludes that the closest alternate form of regulation—a personal support worker registry—should not be implemented,” the report noted. “They said they already belong to agencies and there is a kind of oversight through that,” says SFU’s Spencer. The other view, she says, was that PSWs are too poor to support a regulatory body. “It was kind of a Catch-22. Because without a regulatory body they weren’t in a position to improve their conditions.”

On the job, PSWs are rushing to meet growing demand. Pat Irwin, an eldercare consultant, describes many agencies as “body shops of people,” where hordes of exhausted caregivers are pushed from house to house. The typical time slot for care is one hour. Kirsten Elder, an Ontario PSW, describes a shift: just enough time, if she moves speedily, to give her clients “a bath, make them something to eat, medication reminders for most. Once they’re dressed, the paperwork. That’s usually the hour.” The pay: around $13.

For many granny nannies, whatever their designation, it’s a labour of love. Esther Heckbert, for instance, has a few tricks for working with dementia patients. “I sing. And while singing, I do my work.” What songs? “I have to know the person! I’ll ask them what they like. We can sing together.” Kelly McHaffie, of PSW Canada, still finds time to nickname patients: like “Chickadee,” the lady who eats like a bird. This year, one of McHaffie’s beloved patients died. She went in on her days off to care for the woman: “I got into bed with her. And she put her arms around me and we laid there together. It was comforting for her.”

But often, in the rush of one-hour time slots, the “chemistry” gets lost, says Irwin; agencies are too focused on the “great market opportunity.” Irwin’s inspiration for her career in eldercare consulting—her own father’s struggle to find care—is admirable. But it’s hard not to flinch at what she calls herself: a “rent-a-daughter.”


Granny nannies

  1. There is another angle to consider here: the integration of foreign trained nurses within our regulated nursing profession. Overall, I would say that federal policies related to women working in the caring professions of early çhildcare, eldercare, housekeeping and nursing need a complete overhaul.

  2. If you had asked me years ago how we could ever get men to value women's work at home I would not have guessed it would come through this route. And yet, it is kind of logical. The traditional economy has only valued or counted paid work men do and has taken for granted the care and homemaking roles as 'not work '. Our GDP and our labor force and productivity stats not only ignore work in the home but actually consider it akin to being unproductive and unemployed, even lazy. Yet when women were forced out of the home to get paid jobs, to be 'equal' to men there, someone still had to do the care roles back home. Now we have men's attention because having to pay someone to do a job immediately makes their eyes light up with recognition. Paying sitters, nannies, daycare workers for care of the young and now sitters, nannies and careworkers for care of the elderly has now been noticed as part of the economy. The problem is this – right now we are creating a tax system that does value care 'giving' as long as it is care 'selling'. We still don't value the unpaid woman – or man- at home slogging away losing sleep to feed newborns, handle tantrums of toddlers or feed grandma and keep her from wandering.

    In an ideal world we'd move that one last step and value care WORK, wherever it happens. We'd have our tax benefits for maternity based duh, not on paid work last year but on maternity.We'd have our 'child tax benefits' and child 'care' funding based on the fact a child is being cared for, not on mom's paid employment record away from the child.

    We have this last step to go. It may be with the eldercare crisis men's rose-colored lenses will finally come off and they'll value care work itself.

    • “HPRAC also concludes that the closest alternate form of regulation—a personal support worker registry—should not be implemented,” the report noted. “They said they already belong to agencies and there is a kind of oversight through that,” says SFU’s Spencer. The other view, she says, was that PSWs are too poor to support a regulatory body. “It was kind of a Catch-22. Because without a regulatory body they weren’t in a position to improve their conditions.”

      The concept of a P. S. W. registry and making us Registered Staff is a great idea, as it would give everyone a chance to report neglectful and abusive P. S. W.’s. These neglectful and abusive P. S. W.’s would, in turn lose their jobs and their licenses. After all, we ARE providing basic medical care for those that can’t care for themselves, and a lot of times, whether working in a long-term care facility or in clients’ homes, we need to deal with pressure sores, and other issues. We’re the first people to notice skin breakdown, and good P. S. W.’s will start the process of having a wound care nurse treat the bedsore or pressure ulcer.

      If by “poor”, Spencer means that Personal Support Workers can’t afford to pay the registration fees that come with a professional registry, let’s not generalize. Speaking from personal experience, I will say that, if I was still working in home care, no, I wouldn’t be able to afford the fees to become a member of the P. S. N. O (Personal Support Network of Ontario) and/or P. S. W. Canada. I would never make enough money to pay other bills and maintain my membership with these organizations, not on $13/hour, and certainly not with almost constant fluctuation in client availability (how many client service hours I would work–before I quit the home care agency, my hours would dip below 25 hours/week; totally impossible to make a living on less than $300/pay). But since I now have a more stable job in a nursing home and make almost $19/hour straight time, I can afford the fees. Whether or not a P. S. W. can financially afford to join the P. S. N. O. (Ontario) or P. S. W. Canada (nationwide) depends a lot on how many hours s/he works, how much s/he makes in terms of wages, etc.

  3. I agree with all comments – Importance of PSWs, the amount of work involved, and the value of the role these individuals play in caring for the most vulnerable in our society – children and the elderly. But I would like to address another point: There aren't enough daycare spaces. If this program were cancelled, I would have to quit my job. There is a shortage of spots in licensed and unlicensed "home daycares" in my neighbourhood.
    I respect the rights of my live-in caregivesr. I respect the requirements of the program and the employment standards of my province/country. I have worked hard to help my caregiver get her foreign credentials recognized here in Canada, so she can move on to a better teaching position and make a life for herself in Canada. Please don't scrap this program because there are employers who abuse the system – fix the monitoring system!

  4. Granny nanny? I'm appalled! I am a Personal Support Worker who works in Long Term Care and I feel that this article did NO justice for PSWs! We work HARD! We are in DEMAND! and we need the public to know the truth about PSWs NOT about " granny nannies". We are trained medical Professionals! WE deal with every aspect of a senior or disabled person's life! I feel sorry for the immigrants who come here and get taken advantage of but what about the PSWs who were born and raised here in Canada????? What about US who are taken advantage of? Do we not matter? Amen to PSW Canada being in this article! They have moved mountains for PSWs, I know this because they did for me! I thought I had no one and PSW Canada came to my rescue. The government needs to see the issue in Long Term Care and home care….it's only gonna get worse!!!

  5. this article is very surprising I thought I was going to read about PSW Canada and the woes of the PSW profession, but , it's about Filipinos? and why just Filipinos there are tons of different kinds of immigrants taking caregiver jobs and PSW training in Canada and getting ripped off…you need to look at the bigger picture here. The term 'granny nanny' is demeaning to both PSWs and our seniors.

  6. This is a horribly demeaning article. Just the terminology alone.
    We require those working with children to have college education in ECE, surely our seniors, with complex social, emotional, and physical issues, should have the advantage of our trained PSWs. We need strong men and women, with education and knowledge of geriatric issues, training in moving and lifting frail seniors, to care for our loved ones. We do not need nannies.
    My father, at 5' 10", needed two PSWs to lift him from wheelchair to bed. Not a petite 'nanny'.

    We need regulated and registered workers, who are bonded as they provide intimate care, and work within a loved one's home, with access to personal information.

  7. This article served no justice to the PSW profession. We are health care professionals, and should be equally valued in the multi-disciplinary team of care providers. Our front-line care can make a total difference in the quality of life of those in our care. This profession needs to be regulated. I was hoping this article help out our cause, but instead it just felt demeaning.

  8. I did not feel this article helped our cause at all "granny nannies" I am a hard working PSW who works in an ONTARIO HOSPITAL with all age groups, doing basic care but also helping with rehab. PSWs ARE NOT just glorified babysitters. I spent a year in college and after showing what I studied with many RPNs who did their education about 10-15yrs ago, said the PSW course is pretty much the same as what they did for RPN just with out the pharmacology and injections. This article just made us sound limitied to what we can do. We save the health care field alot of money each year, by lower wages, helping people stay at home and we get treated as if we are worthless.

    Hey instead of doing an article about granny nannies why not do a real story…one about how PSWs are the front line health care workers not only in the community but in LTC facilities and now starting in hospitals. Everyone patients in hospitals, residents in LTC, individuals living in assisted living facilities and group homes, and individuals in the community as well as PSWs need protection and standards.

    I think this article is horrible, and doesn't even begin to understand what a PSW does.

  9. Macleans took a wrong slant on this article. They should have been highlighting the present crisis in health care, our own Personal Support Workers and the organization PSW Canada who has worked tirelessly with volunteers only to get the word out that PSWs are treated badly, that they are being infiltrated by unqualified and fraudulent workers, who make mistakes, and who give us all a bad name.

    PSWs are proud of what they do and give excellent care. We need to give our PSWs our support and a registration group that entitles their clients to the very best personal care, the very best PSWs.

    Hats off to PSW Canada for fighting for the rights of all of us, who know the inside story, who know how hard it is to be a PSW when you are treated like a "throw away galley slave" instead of a valued front line worker.

    One day we will all be on the receiving end of care from a Personal Support Worker. I pray that mine will all be part of a recognized and registered group of health care workers.

  10. I ask the government, why are we allowing foreigners to come in and take over our PSW positions when we have thousands of Canadian born PSW's looking for jobs here?
    Macleans, you have opened a good questions, perhaps one that government will start to care about.

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  12. That's pure hard work and determination right there. It's more than just a nanny actually. I will share this post to a friend of mine.

  13. Do you think Bradley Kyle Family searching for nanny is for real?

  14. I have no idea. Maybe someday they will.

  15. That's an excellent post. Germany has the same problem: More and more people are older than 65 and the nursing homes are …well… they do keep you alive (since they get money for that). But I would never want to be forced to live in one myself. The idea of those nurses is very interesting.