A Thunder Bay, Ont., woman says her publicly funded home-care provider has regularly missed scheduled visits, and she even suffered a leg gash in a fall while trying to get into her power chair earlier this year. 

The accident happened after she received just one of her four scheduled twice-daily visits one weekend this winter, said Alyssa Kirk, who has significant mobility impairments affecting her hips, back and shoulders.

"I was left so long having to do stuff on my own [that] when I was trying to get into my power chair, I tripped over the footplate," she explained. 

"I was so physically exhausted, and I had about an 11-inch [29-cm] gash that was really deep, and they had to give me stitches inside and out."

Kirk said Home and Community Care Support Services Northwest arranged for her to receive home care from ParaMed around a year ago, and she was relieved at the thought of finally having help with daily living.

The company is supposed to send a personal support worker (PSW) each morning to help her get up, wash, dress, take her medication and provide assistance with basic tasks, she said. 

Someone is also supposed to return each night to help her get ready for bed. 

"I've lost count how many visits I've missed," Kirk said. 

According to Kirk, three or four visits per week were being missed before a manager stepped in after her accident and promised to monitor her service. 

But that service deteriorated again, and on the weekend of July 9, she received only two of her four scheduled visits. 

Even when staff show up, she said, they don't provide all the services she was promised.

"Basically all I really get is changed, meds and out the door," Kirk said. 

"Sometimes even when I'm talking to them, they're already rushing out the door." 

Kirk said she has written messages on the whiteboard of her room in her seniors' living facility asking for help with tasks like applying deodorant and doing her dishes. But she said only one worker has ever provided that help. 

ParaMed is owned by Extendicare, a company that has faced legal action over its handling of COVID-19 in its long-term care homes in Ontario. 

The company's home-care division, which includes ParaMed, reported a profit of $49,557,000 in the 2021 fiscal year.  That's a change from $99,916,000 in 2020. 

Extendicare told CBC in a statement that the company takes seriously its responsibility to ensure scheduled care visits are completed as expected.

However, the company said, the home-care sector is experiencing a staffing crisis made worse by the pandemic.

That crisis is particularly severe in northern Ontario, which is affected by acute staffing shortages and long distances between some appointments, the spokesperson said. 

The company, the statement said, does not receive payment for missed visits.

A statement from Home and Community Care Support Services North West says complaints about home-care services have increased during the pandemic, but she did not provide specific numbers. 

The chief executive officer of Home Care Ontario said that, before the pandemic, nursing acceptance rates in home care were at around 95 per cent.

"At last count this spring, those acceptance rates were hovering around 55 per cent provincewide. That means home-care providers are unable to effectively serve five out of every 10 people who require nursing care," Sue VanderBent said. 

"Meanwhile, PSW acceptance rates have fallen to only 40 per cent."

The union representing the majority of Ontario's home-care workers says the solution to the staffing crisis is to improve compensation.

"These home-care workers honestly cannot afford to do their jobs anymore," said Sharleen Stewart, president of SEIU Healthcare. 

Most ParaMed PSWs in the Thunder Bay area currently earn between $19.50 and $22 per hour, according to Bill Joblin, SEIU Healthcare's local union representative. 

That includes the $3 wage increase introduced at the start of the COVID-19 pandemic .

But PSWs are only paid the enhanced wage during the hours they provide hands-on care, not during their travel time, Joblin said. 

The union is calling on the province to legislate a minimum wage of $25 an hour for PSWs, and to mandate the provision of benefits, paid sick leave and adequate compensation for travel. 

Right now, PSWs earn more working in hospital settings and long-term care than they do in home care, leading many to leave home care for other positions, Stewart said. 

"Some of them have even [gone] to Tim Hortons," she said. "They get paid wages and benefits there."

In April, the province committed an extra $1 billion over three years to home-care funding, which VanderBent, of Home Care Ontario, called "a great first step."

The money, she said, would help stabilize the sector after the upheaval caused by the COVID-19 pandemic and allow it to recruit more front-line workers. 

A spokesperson for the provincial Ministry of Health said in a statement that Ontario's annual support for home care totalled approximately $3.08 billion in the 2020-21 fiscal year.

In addition to the aforementioned $1 billion in new funding, in the fall economic statement, it committed $548.5 million to the sector to help hospitalized patients continue their recovery at home.

It has also pledged $342 million to add more than 5,000 new and up-skilled registered nurses and registered practical nurses, and 8,000 PSWs to the health-care system.

CBC asked the ministry if it would commit to mandating higher wages and benefits for PSWs, but it did not provide a direct response. 

The ministry spokesperson said home-care clients experiencing problems with their service can provide complaints to their care co-ordinator at their Home and Community Care Support Services organization.

If the co-ordinator fails to resolve the complaint, it can be escalated to a manager.

Clients can also file complaints with Ontario's patient ombudsman or request, at no cost, the services of an independent complaints facilitator by calling 1-866-876-7658.

ParaMed promised to improve its care of Kirk after she informed them she was speaking with the CBC, she said. 

The home-care worker who visited her on Friday morning helped her with housework and even offered to bring her a coffee.

But Kirk said she's reluctant to get her hopes up.

"After everything I've been through, it's really hard for me to trust that it's going to stay this way."

Heather Kitching reports on northwestern Ontario for CBC Thunder Bay. You can reach her at heather.kitching@cbc.ca.

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