Ontario is getting older and more people are working past 65, often because they have to. A report on home care projects that the province’s 65-plus population could grow by about 650,000 in six years. Another source notes that roughly 22 percent of Canadians over 65 are still in the workforce. For many of them, home care is the only way to balance paid work with caring for aging spouses or parents.
Into that pressure cooker walks the personal support worker who washes, dresses, lifts and comforts seniors. Yet, as Ontario Personal Support Workers Association chief executive Miranda Ferrier has warned, home care is operating with “no regulations, and no legislation” around who can provide this care. She describes parts of the private sector as a kind of wild west where anyone can open a home care company and start sending people into seniors’ homes.
Title protection sits at the centre of this problem. Not everyone can call themselves a nurse, because the title is protected by law and backed by a regulator. By contrast, anyone can call themselves a PSW, even if they lack proper training or vetting. For an 82-year-old with dementia and her exhausted husband, there is no easy way to tell the difference between a qualified professional and a risky gamble.
What often gets missed is that professionalizing PSWs is not only about better jobs, it is about senior quality of life. Stable, regulated roles mean lower turnover, stronger relationships and fewer strangers cycling through a front door at 7 a.m. They mean real accountability when background checks are skipped or care plans are ignored. In short, PSW professionalization is senior safety policy.
There are also wider economic consequences. When home care is unreliable or unsafe, family members scale back their own paid work or postpone retirement. That undercuts the very benefits governments seek when they encourage older Canadians to stay in the labour force and delay public pensions. Treat PSWs as low wage, interchangeable labour and the whole system becomes more fragile.
Three often overlooked insights deserve attention. First, stronger healthcare regulation in home care actually expands real choice for families by making every option safer, not by leaving them alone to do detective work. Second, title protection for PSWs is a simple public signal that the person at the bedside has met a clear standard, just as a nurse or teacher has. Third, secure, fairly paid PSW roles make it easier to recruit local workers who can build long-term relationships in the communities where seniors live.
How this perspective is grounded
This view rests on several concrete pieces of evidence and observation. The warning from the Ontario Personal Support Workers Association about the complete lack of home care legislation and the description of some private providers as a wild west highlights a serious regulatory gap. Demographic projections of a 650,000-person increase in Ontarians over 65 and national data showing that about 22 percent of seniors remain in the workforce underline the scale of demand for home care and respite. The policy tools already used in nursing, such as title protection and professional colleges, provide a practical model for PSW regulation. The interpretation that PSW professionalization will improve senior quality of life and economic stability follows directly from these facts and from lived experience in communities.
For a province that claims to value seniors and working families, the path forward is clear. Legislators must finally regulate home care, protect the PSW title, enforce real screening and training, and build stable, community-based home care teams that include unions, local organizations, and family voices. This is not glamorous work. It is slow, detailed, and often invisible. But it is exactly what it means to build a province that works for everyone, including the people who can no longer stand at the microphone themselves.