Front-line workers say Thunder Bay's nursing homes are understaffed, even as residents require more attention and increasingly complex care.
"I have come home [from work] and cried," long-time personal support worker Kristine Wilson told CBC News. "You cannot do everything that's expected of you in a day. It's impossible."
Wilson has worked in several municipally run long-term care homes in Thunder Bay for 15 years, but is currently on sick leave with a back injury.
She said when she first started in the field, things were much different.
"You used to have time to spend with the residents," she recalled. "Now you don't."
Wilson said each personal support worker in a long-term care facility is typically responsible for 10 residents, and often more.
She said that not only makes the work exhausting, but also affects the quality of care seniors receive. For example, Wilson estimated she only has 10 or 15 minutes to spend getting each resident toileted, washed and dressed in the mornings.
"[It's] like an assembly line," she said. "It's awful."
'They can't get to the needs of people'
Alice Villa said as a family member, she's concerned about the impact of inadequate staffing on her elderly father's care.
Lionel Trodd suffers from frontal lobe dementia and has lost the mobility on the left side of his body, as well as his ability to speak.
He has been in a Thunder Bay long-term care home for almost a year.
Villa said she believes the personal support workers there are doing the best they can, but because they are so rushed, her father is often left slumped uncomfortably in his wheelchair for long periods of time.
"They can't get to the needs of people like my father in a timely fashion most of the time," Villa said. "It's not that they don't want to. It's that they can't."
The Ontario Long-Term Care Association says seniors entering nursing homes have more complex health-care needs than they used to, as advances in community-based care have allowed people to stay in their own homes for longer.
By the time people must go into a long-term care facility, they tend to be more sick physically, and often suffer from other issues, including dementia or mental illness.
A large union representing front-line workers, SEIU Healthcare, says staffing levels and training are not keeping pace with the increased care demands.
"There's a chronic shortage in staffing," Thunder Bay union representative Bill Joblin said. "Clients are certainly suffering as a result of that."
'Abused by lack of care'
Both Joblin and Wilson said unmanageable workloads mean residents are often shortchanged on important aspects of personal care -- like baths.
Under Ontario's Long-Term Care Homes Act, residents are supposed to get two baths a week.
Although Wilson believes they should be entitled to a bath more often, sometimes, she said, residents don't even get the minimum.
"If you're short-staffed, you have to do what you can," she said. "You might have to put the bath off to another day. [And] most likely it won't get done."
Wilson believes inadequate or rushed care has physical consequences for residents.
"I find ... rashes or bedsores ... a lot more now [than I used to]," she said.
Josie Wallenius, a retired nurse who worked in long-term care homes in Thunder Bay for decades, said she thinks short-staffing also takes an emotional toll on seniors, because there's not enough time to give them the individual attention they deserve.
"Nobody's taking any notice that ... the people in long-term care are abused by lack of care," she said.
More than 1,100 people live in the eight long-term care facilities in Thunder Bay and close to 400 more are on waiting lists, according to the North West Community Care Access Centre.
Although Ontario's Long-Term Care Homes Act says facilities must provide enough staffing to meet the assessed needs of residents, it does not specify how many residents each worker can be responsible for.
"You know sometimes, I ... could just scream," Villa said. "Why are they not getting the resources that they need?"
This is the first of a CBC News series looking at long-term care issues in Thunder Bay. Tuesday's story will focus on safety concerns.