MONTREAL — Recent news that a Quebec hospital repeatedly posted notices seeking a “white woman” caregiver has sparked a debate about how to care for mentally ill seniors who refuse to be treated by people of another race.
The heads of two placement agencies in Quebec say those kinds of requests usually come from racist patients who have dementia or Alzheimer’s. They say Black and other racialized workers are sent to care for other patients for safety reasons.
But experts in the health field say trying to protect workers of colour by replacing them with white people is patronizing and paternalistic.
“That is racism, that’s rationalization, said Bharati Sethi, a social work professor at King’s University College at Western University. Focusing on transferring racialized health-care workers instead of looking at bigger institutional issues downplays the problem, she said in an interview Friday.
“Bluntly, we have to stop rationalizing, look at the problem at the root and do something about it,” Sethi, who worked as a personal-support worker before becoming a professor, said.
Earlier this week, Montreal La Presse reported that a hospital in St-Eustache, Que., north of Montreal, sent 10 requests to placement agencies asking for a “white woman only” or a woman with “white skin.” The hospital had reportedly sought a white woman to care for a patient with dementia who was disruptive in the presence of racialized staff.
In response, the regional health authority in Quebec’s Laurentians region said it has opened an investigation.
Jill Eusanio, president of Comfort Keepers Quebec, said her placement agency receives requests for white workers a few times a year. She said, however, the issue is more complex than it may seem.
“Usually, these requests are for senior citizens, clients, that are racist, and who have a mental disease that’s set in, like Alzheimer’s or dementia, and they’re mean to the worker,” she said in an interview Thursday.
“What do I do?” Eusanio said. “Do I put a Black worker in this environment who will be verbally abused, who could be physically hit?”
Eusanio, whose placement agency provides personal support workers, nurses and nurses aids for home care, long-term care facilities and hospitals, said she would never promise to send a white worker. But, she said, if one of her employees is being abused by a patient because of their ethnic background, she said she would switch them.
Helene Gravel, head of Sherbrooke, Que.-based placement agency Agence Continuum, said requests for white workers are “very, very rare.”
Gravel said those kinds of requests are intended to ensure employees aren’t placed in difficult situations when dealing with patients suffering from conditions like dementia and Alzheimer’s who have difficulty dealing with people who are different.
In some cases, however, she has received requests from people recovering from surgery or other medical procedures who need temporary home care but don’t want a Black person helping them.
In those cases, she said, she refuses to serve the client. She said she doesn’t tolerate racism.
Sethi recently conducted a study on racism against personal-support workers at an Ontario nursing home. She found that Black workers frequently experienced racism from patients and their families, and in some cases, from colleagues.
If personal-support workers are subject to racist abuse and believe they will be replaced by white people, then that might encourage them to stay silent out of fear of losing work, Sethi said.
Dr. Sophie Zhang, who oversees 15 long-term care centres in Montreal, said she has had patients who are openly racist against workers, adding that it can be challenging to manage those patients when they’re suffering illnesses such as dementia.
Regarding requests for white-only workers, Zhang said there are two issues involved: one is about accommodations in the workplace, while the other is about hiring discrimination.
“For me, discriminating at the time of hiring is unacceptable,” she said in an interview Friday. “That, I don’t think we can make any excuses for.”
Sometimes, however, when a decision needs to be made about who will be assigned to a patient, accommodations may have to be made, she said.
“This is not because we want to ‘give in to racism,’ but it’s because sometimes the safety of the worker is at risk because there has been abuse, there has been verbal and physical abuse.”
But she said it’s the last resort. When patients are able to be reasoned with, she said, the first step is dialogue.
“My first reaction is to tell them that we don’t accept racism,” Zhang said. “That all our health-care workers are competent, are qualified, will take good care of them no matter what race they are, and that any sort of verbal or physical assault is not tolerated.”
Sometimes, Zhang said, the patient ends up trusting the worker who takes care of them, adding that overall, she has had to manage few cases where people have demanded to be treated by non-racialized people.
“It’s a very small number of cases where we have to intervene and make these accommodations.”