PSW Knowledge 2 — Questions and Answers

Question 1: In Ontario, which legislation governs the rights of residents in long-term care homes?

Employment Standards Act
Fixing Long-Term Care Act, 2021 (Correct answer)
Personal Health Information Protection Act
Occupational Health and Safety Act

Correct answer: Fixing Long-Term Care Act, 2021

The Fixing Long-Term Care Act, 2021 (FLTCA) replaced the former Long-Term Care Homes Act and sets out the rights of residents, standards of care, and requirements for long-term care homes in Ontario.

The Fixing Long-Term Care Act, 2021 (FLTCA) is the primary legislation governing long-term care homes in Ontario. It replaced the Long-Term Care Homes Act, 2007, following the COVID-19 pandemic's devastating impact on LTC homes. The FLTCA establishes a Residents' Bill of Rights that includes the right to be treated with courtesy and respect, the right to privacy, the right to be informed about care and treatment, and the right to participate in care planning. PSWs must be familiar with these rights and ensure their daily care practices uphold them. The Act also increased inspection requirements, staffing standards (including a target of 4 hours of direct care per resident per day), and enforcement measures.

Question 2: What does the term 'scope of practice' mean for a PSW?

The geographic area where the PSW can work
The range of tasks and responsibilities a PSW is trained and authorized to perform (Correct answer)
The number of clients a PSW can care for at one time
The types of facilities that employ PSWs

Correct answer: The range of tasks and responsibilities a PSW is trained and authorized to perform

Scope of practice refers to the specific tasks, activities, and responsibilities that a PSW is educated, trained, and authorized to carry out in their role.

Scope of practice defines the boundaries of what a PSW is trained, competent, and authorized to perform. Unlike regulated health professionals (RNs, RPNs) who have scope of practice defined in legislation, PSWs are unregulated in Ontario, so their scope is defined by their education (the PSW Program Standard), employer policies, and the tasks delegated by regulated professionals. Common tasks within scope include personal care, mobility assistance, meal preparation, vital signs measurement, and reporting observations. Tasks outside scope include administering medications by injection, performing wound care assessments, changing sterile dressings, and making clinical judgments. When in doubt, PSWs must consult their supervisor before performing a task.

Question 3: Which of the following is a PSW's legal obligation under the Occupational Health and Safety Act (OHSA)?

Diagnose workplace hazards independently
Report unsafe conditions to the supervisor or joint health and safety committee (Correct answer)
Purchase personal protective equipment with personal funds
Accept all assigned tasks even if they feel unsafe

Correct answer: Report unsafe conditions to the supervisor or joint health and safety committee

Under the OHSA, workers have a duty to report workplace hazards, unsafe conditions, and equipment defects to their supervisor or the joint health and safety committee.

Ontario's Occupational Health and Safety Act (OHSA) establishes three key worker rights: the right to know about hazards, the right to participate in health and safety decisions, and the right to refuse unsafe work. Alongside these rights, workers have duties including: working in compliance with the Act and regulations, using required protective equipment, reporting hazards and defects to the supervisor, and not removing or disabling safety devices. PSWs must report any unsafe conditions — wet floors, broken equipment, aggressive client behaviour, inadequate staffing — to their supervisor or the joint health and safety committee (JHSC). Workers are protected from reprisal for exercising their rights under the Act.

Question 4: What is the purpose of a care plan in PSW practice?

To provide a daily schedule for the PSW's personal tasks
To outline the client's individualized care needs, goals, and the interventions to achieve them (Correct answer)
To serve as a billing document for the healthcare facility
To list the medications the client takes

Correct answer: To outline the client's individualized care needs, goals, and the interventions to achieve them

A care plan is a document that outlines the client's specific needs, goals, and the planned interventions or care activities required, guiding all members of the care team.

The care plan (also called a plan of care or service plan) is a foundational document in healthcare that individualizes care for each client. It is developed by the interprofessional team — typically led by a nurse or care coordinator — with input from the client, family, and all care providers including PSWs. The care plan identifies the client's needs and problems, sets measurable goals, specifies interventions (what care to provide, how, and when), and establishes evaluation criteria. PSWs must read, understand, and follow the care plan, provide care as directed, and report any changes in the client's condition that may require care plan updates. In Ontario LTC homes, care plans must be reviewed and updated at least every 6 months or when there is a significant change in the resident's condition.

Question 5: A PSW suspects that an elderly client in a long-term care home is being financially abused by a family member. What should the PSW do?

Confront the family member directly
Report the concern to the supervisor immediately (Correct answer)
Ignore it because financial matters are not the PSW's responsibility
Tell other staff members informally

Correct answer: Report the concern to the supervisor immediately

PSWs have a duty to report any suspected abuse — including financial abuse — to their supervisor. Under the FLTCA, there is a mandatory duty to report abuse or neglect of LTC residents.

Under the Fixing Long-Term Care Act, 2021, every person who has reasonable grounds to suspect that a resident has been or is being abused or neglected must report it immediately to the Director appointed under the Act. This is a mandatory reporting obligation — failure to report can result in fines. Financial abuse is one of the recognized forms of abuse, alongside physical, emotional, verbal, and sexual abuse. The PSW should not confront the alleged abuser (this could escalate the situation or compromise an investigation), should not discuss it informally with colleagues (this breaches confidentiality), and must never ignore suspected abuse. The correct action is to report immediately to the supervisor or administrator, who will initiate the facility's abuse reporting protocol and contact the appropriate authorities.

Question 6: What does the abbreviation 'ADL' stand for in PSW terminology?

Advanced Daily Logistics
Activities of Daily Living (Correct answer)
Assisted Dietary Levels
Administrative Duty Log

Correct answer: Activities of Daily Living

ADL stands for Activities of Daily Living — the basic self-care tasks that individuals perform daily, such as bathing, dressing, eating, toileting, and mobility.

Activities of Daily Living (ADLs) are the fundamental self-care tasks essential for everyday functioning. The six basic ADLs are: bathing/showering, dressing, eating, toileting, transferring (moving between bed and chair), and continence management. A related concept is Instrumental Activities of Daily Living (IADLs), which are more complex tasks needed for independent community living: managing medications, preparing meals, housekeeping, managing finances, using the telephone, and transportation. PSWs primarily assist with ADLs and some IADLs. A client's ability to perform ADLs is a key indicator of their functional status and level of care needed. Assessment tools like the Katz Index of Independence in ADLs are used by healthcare professionals to measure ADL capacity.

PSW Knowledge 2

In Ontario, which legislation governs the rights of residents in long-term care homes?