The late afternoon sun angles through Pearl Meyer’s kitchen window as she arranges her medications in a weekly pill organizer. At 87, she’s lived in her farmhouse outside Drumheller for over six decades, determined to stay despite her increasing mobility challenges.
“I couldn’t manage without Amanda coming three times a week,” she says, referring to her health care aide who helps with bathing, meal preparation, and light housekeeping. “She knows me, knows how I like things. I worry about these new changes they’re talking about.”
The “changes” Pearl references are Alberta’s recent announcement to create a regulatory college for health care aides (HCAs) – workers who provide essential personal care for elderly, disabled, and chronically ill Albertans. While the move has been praised by professional organizations as a step toward quality standardization, it has sparked concerns in rural communities where these workers are already scarce.
Last month, the provincial government announced HCAs will be regulated under the Health Professions Act, with Minister of Health Adriana LaGrange stating the change will “strengthen accountability and patient safety.” Currently, approximately 24,000 HCAs work across Alberta in settings ranging from hospitals to personal homes, yet they remain one of the few health worker categories without formal professional regulation.
For Amanda Jennings, who has worked as a health care aide in rural Alberta for fifteen years, the announcement brings mixed emotions.
“I’ve wanted recognition for the work we do for years,” she tells me as we chat between her client visits. “But I’ve got real concerns about what this means for small communities like ours. Will it push out the experienced aides who’ve been doing this work for decades but don’t have the formal training? We’re already stretched thin.”
Her concerns echo throughout Alberta’s rural communities, where health care aide shortages have been documented by the Rural Health Professions Action Plan. Their 2022 report found that 68 percent of rural continuing care facilities reported persistent aide vacancies, compared to 41 percent in urban centers.
Dr. Esther Tailfeathers, who practices medicine in rural southern Alberta, explains the complexity of the situation. “Health care aides are the backbone of community care in rural areas. Many provide culturally appropriate care for Indigenous elders who want to age in place. Regulation is important, but if implemented without rural-specific considerations, it could inadvertently reduce access.”
The government’s plans include implementing standardized education requirements, a code of ethics, and a complaint process – elements typical of health profession colleges in Canada. According to Alberta Health, aides will have a three-year transition period to meet new requirements, though specific details remain forthcoming.
When I visited the small community of Oyen near the Saskatchewan border last week, I found the topic dominating conversation at the local seniors’ center. Marjorie Kusch, 92, expressed concerns similar to Pearl’s.
“My care aide drives 40 minutes to reach me,” she said while working on a quilt with other seniors. “She’s a farm wife who does this part-time. She’s wonderful, but I don’t know if she’ll continue if there’s a lot of new hoops to jump through.”
Alberta is following provinces like British Columbia and Ontario, which have already implemented similar regulatory frameworks. According to a 2021 study published in the Canadian Journal of Nursing Leadership, regulation improved quality metrics in those provinces but created initial workforce shortages, particularly in remote communities.
In Cold Lake, Bernadette Cardinal works as a health care aide for several Indigenous elders. With soft-spoken intensity, she explains her perspective. “I learned caregiving from my kokum [grandmother]. I got formal training later, but the traditional knowledge about care is something you don’t learn in a classroom. I worry the new system won’t value that.”
Marlene Walsh, director of the Alberta Continuing Care Association, acknowledges these concerns but believes regulation will ultimately benefit rural areas. “Standardization will create career pathways that could actually attract more workers to rural settings,” she explained in a phone interview. “But implementation must include supports for existing workers, especially in underserved communities.”
For their part, Alberta Health officials insist rural concerns will be addressed in the regulatory framework. A ministry spokesperson noted via email that “geographic barriers and the unique needs of rural communities will be considered during the transition period,” though specific accommodation measures weren’t detailed.
Back in Drumheller, Amanda completes her daily notes before heading to her next client. “I just wish they’d talked to more of us before making these decisions,” she says, glancing at her watch. “The people making the rules should spend a day doing what we do – driving these country roads in January, being the only daily visitor some folks get.”
As Pearl waves goodbye from her porch, the tension at the heart of this issue becomes clear: how to improve professional standards while preserving the intimate, community-based care that allows rural seniors to age with dignity in their homes.
For thousands of Albertans like Pearl, the success of these regulatory changes won’t be measured in credentialing statistics, but in whether they can continue living where they choose, supported by caregivers who know not just their medical needs, but their stories.
