Podcast: How a Canadian Personal Support Worker Uses CPI Training to Increase Home Visit Safety

A stethoscope and a mask laying flat.

One day Walter Comer woke up to find that the factory he had worked in for 30 years was no longer in business. So, a challenge was thrust upon him—how to reinvent himself at 50 years old? To make a new start, Walter looked to his past. His mother was a home care aide known as a personal support worker, or PSW, and his sister is a nurse. So, according to Walt, caregiving is in his blood.

He enrolled at Medix College in Brantford, Ontario after securing admission by passing an aptitude test for the PSW course. The first thing he noticed was that he was the oldest student in class, and in fact he even had a couple years on the teacher. After some initial trepidation, it was evident to Walt he was in the right place. “By the end of the first week, I knew in my heart that it was the right move, and it’s just excelled since then,” he says. It was at Medix that Walt was first received CPI’s Nonviolent Crisis Intervention® training, a program that included skills that would prove to be remarkably helpful during home visits.

How the Victorian Order of Nurses Provides Invaluable Home Care

Personal support workers are employed through a nonprofit organization called the Victorian Order of Nurses, or VON. Today, the VON is one of the largest personal care services in the world, with forty regional sites, 6,400 healthcare workers across the eastern provinces and over 6,200 community volunteers across Ontario and Nova Scotia. The VON has been pioneering care at home for over 120 years. They are a trusted resource that works with clients, employees, volunteers, and partners to provide innovative clinical, personal, and social support through home visits to people who want the comfort and peace of mind of living in their own homes and communities.

PSWs provide help for Canadian families in a variety of ways. Maybe a person living with Alzheimer’s/dementia needs looking after in the home. A PSW will be there. Maybe a family has a child on the spectrum who requires special attention. A PSW will be there. Maybe a caregiver needs respite to avoid burnout. A PSW will be there. For these and many other scenarios where a support worker is needed for home visits, the Canadian government has provided a program whereby people and families in need have the security of knowing a capable, caring PSW will be at their door to help them when they’re in need. Because of the challenging behavior they often encounter, home visit safety is of paramount importance to PSWs.

home visit safety
Photo: Alexander Raths / Shutterstock

In the Home Alone—and Prepared to Ensure Home Visit Safety

One constant in all the scenarios that PSWs face is that they are in the home alone, without backup from other government personnel. Walt identifies this reality of home visits as the primary reason CPI training is essential: “We are there to support the client themselves and we do everything from like I said, autistic children, we do mental patients that are having mental breakdowns. So, we help them and support them and that's why CPI is very important to us because we go into homes and we are alone. We are literally alone. We can be alone with a client that's not in his right mind and decides to grab a hold of you or take a cane to you or whatever the case may be. So, the course that I teach with CPI of course is a course that is very important to us because it helps us protect our nurses and protect our PSWs, so they don’t get hurt on the job.”

Walt finds both the verbal and physical skills taught in CPI training to be essential skills for PSWs on home visits. “If somebody grabs a hold of us, we have to be able to protect ourselves so that we can either get away to call 911 or we get away to call the loved one,” say Walt. But he makes it clear that verbal de-escalation is also essential: “I really, really push, push, push the verbal de-escalation because if you can calm somebody down without them grabbing a hold of you then nobody gets hurt,” explains Walt.

CPI Training at Medix—and Beyond

At Medix college, Walt has a variety of training courses. In addition to GPA, or Gentle Persuasive Approach, Walt was received CPI’s Nonviolent Crisis Intervention® Training. According to Walt, “When I got taught CPI, it stuck with me because it’s a self-defense course that works—physically and mentally, it works.”
In fact, Walt found CPI training so effective and useful in his work as a PSW that he concluded that other VON workers should also receive it. His supervisor agreed, and in 2017 Walter became a CPI Certified Instructor. Since then he has gone on to train over 200 VON employees, ranging from other PSWs, to nurses, to managers. And he has been a persuasive advocate for the spread of CPI training to other regions serviced by the VON.

Walt began training PSWs in Haldimand, Norfolk, and because of his success there, he was approached by the VON management team and asked to train nurses in Hamilton, Ontario. From there, management decided to spread CPI training across Ontario, Quebec, and as far as Nova Scotia. According to Walt, “CPI (training) is so versatile in what we do and how we do our work that this course is being pushed out all the way to Nova Scotia now and covering every branch of the VON that we can cover.”

home visits
Photo: thodonal88 / Shutterstock

In my interview with Walt, you’ll learn:

  • A few key facts about the remarkable history of the Victorian Order of Nurses (2:45)
  • The essential role that Canada’s personal support workers (PSWs) play in helping to maintain public health (9:58)
  • Why CPI physical skills are critical to PSWs (13:24)
  • How a student of Walt’s used CPI physical and verbal skills to avoid injury when a client put her in a hold (14:09)
  • How Walt’s belief in and capability facilitating CPI training has helped it spread through Canada via the VON (16:43)
  • Why Walt finds CPI’s Verbal Intervention™ Training indispensable and “fantastic” (19:30)
  • Why Walt loves the work he does now and how it is the culmination of his identity (21:30)

“CPI is a course that is very important to us because it helps us protect our nurses and protect our PSWs, so they don’t get hurt on the job.” — Walter Comer

Further Listening

After you enjoy Walter Comer’s interview, check out episode 73 of UnrestrainedHow Training Can Help Prevent Workplace Violence in Healthcare Settings, featuring CPI president Susan Driscoll. According to Ms. Driscoll, “We are experiencing an unprecedented time of workplace violence in healthcare.” In the interview, she describes 7 meaningful steps healthcare organizations can use to curb workplace violence.   

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Episode Transcript

Terry:       Hello and welcome to Unrestrained, a CPI podcast series. This is your host, Terry Vittone. My guest today is Walter Comer. Hello and welcome, Walter.
Walter:    Hello, and how are you today, Terry?
Terry:       I'm very well. Thanks, Walter. I'm glad that you joined us. Today Walter works—
Walter:    Good morning to our listeners too.
Terry:       Oh, yeah. Right. Right on. And to our listeners, let me explain. Today Walter works as a CPI Certified Instructor and a personal support worker for the Victorian Order of Nurses in Canada but he took an interesting route to get where he is today. Walter, can we start today by having you tell that story for us?
Walter:    Sure, sure. Not a problem at all. I was...I've had many, many careers in my life. I'm a 57-year-old man. Started in the working world when I was 16 in a construction business with my father and then I ended up going into a factory for the better part of 30 years and my factory closed. And due to the factory closure, unemployment here in Canada had offered me basically any schooling that I wanted to increase my education and to do whatever career that I chose to do.
And so I looked at a bunch of different careers and I've been in the nursing world and in the personal support world for the better part of my life. My mother was a personal support worker. My sister was a nurse. It's sort of in my blood I guess you might say.
Terry:       I see.
Walter:    So I went to Medix College in Brantford, did an aptitude test to get into the PSW course, walked into class and in my class I was older than the teacher. At 50 years old I went into the class. The closest student to me was in her 30s and the teacher was 49. Didn't know what I was doing in this class at this age and whether this was a right move, but by the end of that first week I knew in my heart that it was the right move and it's just excelled since then.
Terry:       That's great. So you really found this whole, meaningful second career at 50?
Walter:    This is definitely my calling. That's for sure. And I've been told that by many, many, many people that this is what I was trained to do and this is what I love to do.
Terry:       That's tremendous. I'm glad you're going to share it with us today. Let's go next, Walter, to tell our listeners about the history and mission of the Victorian Order of Nurses. It's a pretty special organization, I think.
Walter:    Yeah, the VON is a not-for-profit charitable organization here in Canada. We were founded in 1897 in recognition to Queen Victoria's Diamond Jubilee for the purpose of home care and social services. VON was established because there was a shortage of nurses, doctors and hospitals in remote areas and in sometimes smaller cities and smaller towns. There was just no...there was no doctor there at all. So Lady Ishbel Aberdeen, she was the wife of our Canada's Governor General at National Council Meeting for women in 1896 wrote stories about how mothers and children have died while their husband was gone to get aid for them in pregnancy and in childbirth and so on and so forth. So the VON was given a hearty approval in 1897 by Sir Wilfrid Laurier. The VON is the catalyst and pioneer of building the community home care service.
There have been many different programs amongst us. Forty regional sites, 6,400 healthcare workers across the eastern state or the eastern provinces and 6,200 community volunteers across Ontario and Nova Scotia. So that's basically what our mission is and how it started back in 1897.
Terry:       So you provide a very essential public service to people in sometimes remote areas where they might not have access to healthcare.
Walter:    Oh, yes. We go down as far as the lake where there's absolutely no hospitals, no doctors. Well, there is now but back in the...or even the early 70s there wasn't the healthcare like that there is now. I mean, we have other companies within our region now that do the exact same thing we do but we were the first to do it. We have 120-plus years working in home care—strictly in home care—and we own a hospice, which is end of life care.
Terry:       So you have had a long history of sustained service and...
Walter:    Oh, very, yeah. The longest in home care there is. The longest there is.
Terry:       Wow. Now you started with the Victorian Order of Nurses over seven years ago, and what was your role when you started and how has it evolved since then?
Walter:    I guess my role, when I first started, I was just a basic...not even part-time. I was a basic casual worker in the city of Brantford. I started out taking care of people in Brantford, going to apartment buildings and going to homes because that's where we were established was in Brantford. And a year after I was into the business actually headhunted by the VON to come and work for them, I was into the business about a year and they moved us down here to what we call Norfolk County, which is where I was born and raised was in Norfolk County and we cover...if anybody in the States knows the province of PEI, Norfolk County is the same square mile as PEI, as the island of...Prince Edward Island.
Terry:       Prince Edward Island. Okay. I'm thinking that's eastern?
Walter:    Yeah. It's in the eastern states or in the eastern provinces. It's an island right beside Nova Scotia and Norfolk County which is in the southern Ontario area, close to the Erie border, close to Detroit, we're in that area. Norfolk County is bigger than PEI as far as square mileage is concerned. So they moved us down here to Norfolk County and I became a full time employee for VON.
Terry:       Now was your role then a personal support worker?
Walter:    Yeah, just as a personal support worker. I was just a personal support worker. I went into full time and then my boss actually approached me about taking a course called Montessori for dementia and Alzheimer's. So VON sent me away to school to learn and be taught on how to control and handle Alzheimer patients and dementia patients through Montessori. And if anybody knows what Montessori is, Montessori is a school course that was brought out for children basically in preschool and grade one, grade two, pre-grades and it's a repetitious education where kids learn how to speak and they learn how to talk and they learn how to count, they learn the ABCs. Well, they've integrated that into the Alzheimer patients.
Terry:       So you were trying to use the same methodology they use with kids with people who are experiencing Alzheimer's?
Walter:    Yeah, we use...because as anybody that's in the nursing world...they know that Alzheimer patients...it is a memory thing. It is to do with the brain. It is a shrinkage of the synapses and how the firing is not working properly. So you do repetition. So you go into somebody's home as a home care agent. I go into their home and if they are not recognizing their children anymore, well, then you take a picture of their child when they were younger to the child when they were older and you show these pictures back and forth as far as...I've done DVDs for some of my patients so that they can watch their children as they grow and it brings back their memory of what their child is. So when the child comes to visit their mother or father, they remember who they are. And you can actually bring that...some of that memory, you can draw it out and bring it back into the light of day.
Terry:       And when did CPI training enter the picture for you?
Walter:    So CPI training I took actually in my first...when I...I originally took my course at Medix. Medix teaches CPI. That is one of the self-defense courses that they teach at Medix, and when I got taught CPI, it stuck with me because CPI is a self-defense course that works. It actually...physically and mentally, it works. It makes sense on what you guys do and how it's taught and so it stuck with me. So then two years or three years ago now our Ministry of Labor down here or up here in Canada sorta made a mandate that they were going to bring across. They still haven't...they brought it across but they haven't made it a mandate yet, they haven't made it law, that every healthcare worker needs to have some kind of self-defense course. So my boss came to me and she said, "Walt, we teach GPA which is general persuasive approach. We teach it now but it's a course that it's not all necessary for healthcare workers. They don't need as much as they do...as much as they teach in GPA." Not to turn away from GPA because we still have a few people that still use it. It is a general persuasive approach that you can talk to people, but CPI is much easier to remember and understand. So I said to my boss, Shauna, I said, "Shauna, I think this course would be a good course."
So we took both courses and we did the do's and the don'ts and the approvals and the not approvals and we've come to the conclusion that CPI was the best way. And Shauna said, "Well, it was your idea, Walt. We're sending you to school to become an Instructor." And the rest is history.
Terry:       Great. Now fill me in a little bit on the basic responsibilities of a personal support worker. So you go right into the homes of people requiring care. This is a service that the government provides. So if I'm a Canadian citizen, I can...this is provided for me. Is that accurate?
Walter:    Yeah, it's a free service that we provide through the Canadian government or through our tax dollars. It's through what's called the LHIN (Local Health Integration Network). The LhIN is actually the... is the one that runs this course, this program. And within this program we have four or five different companies that actually do the hands on work. VON is one of the bigger ones of the bunch.
So what we do is we go into people's homes. We cook meals, we do showers. We've taken care of babies when mothers are sick, when new mothers are sick or we go in and spend time with the baby to give the new mother a break from the baby. We do healthcare respite. So we go in, if you have a husband and a wife and one has Alzheimer's and the wife needs to get out and buy groceries or get her hair done or whatever, then we stay with the husband for the two or three hours that the wife needs to get out of the house to do stuff or to just get away and have a break from it so we don't get what we—they don't get what's called caregiver burnout.
So we are there to help caregivers. We are there to support the client themselves and we do everything from like I said, autistic children, we do patients that are having mental breakdowns. So we help them and support them and that's why CPI is very important to us because we go into homes and we are alone. We are literally alone. We can be alone with a client that's not in his right mind and decides to grab a hold of you or take a cane to you or whatever the case may be. So the course that I teach with CPI of course is a course that is very important to us because it helps us protect our nurses and protect our PSWs so they don't get hurt on the job.
Terry:       You kinda just answered my question, which was...next question, which was why are de-escalation skills so important when you go into private homes alone?
Walter:    No, the de-escalation skills are a little different because that's verbal. So you can go in to a house and actually...I can see where there's a client that has just had a fight with her husband and she's in a very upset state, and I can sit down and just verbally de-escalate her and calm her down without anybody getting hurt and without any punches being thrown or anything, you know...any traps, any grabs, anything like that. I can just sit down and calmly talk to somebody, get down to their height which is what they're taught and what we are taught is to get down to the heights of the people that are in the chair or standing position and we verbally deescalate them just in a calm, soothing voice. So verbal de-escalation to me is actually very important and it is a course that I teach part of with the blended course of the connect and disconnect that CPI teaches.
Terry:       So there...so actually to that...see, but this wasn't clear to me but I'm glad we made it clear that the personal support workers sometimes will use holding skills or go hands on with people who are exhibiting challenging behavior.
Walter:    We have to.
Terry:       Okay.
Walter:    If somebody grabs a hold of us, we have to be able to protect ourselves so that we can either get away to call 911 or we get away to call the loved one. So there...I mean, there is times where somebody has, you know, got...grabbed a hold of and the holds and the disconnects that I teach in the CPI course along with the verbal de-escalation, to me it's more important to deescalate verbally than it is to get into the grabs and the connects and disconnects. I really, really push, push, push the verbal de-escalation because if you can calm somebody down without them grabbing a hold of you then nobody gets hurt, and that's my...my mandate is to try and get either not our workers hurt and especially not our clients getting hurt.
Terry:       Excellent. I understand that. So this will kind of illuminate what you said, I think. A personal support worker recently used their CPI skills to de-escalate a client who had them in a physically threatening position without compromising anyone's privacy. Can you tell that story for us?
Walter:    Yeah. Actually I was...I had just taught a girl the CPI, not the verbal de-escalation but the CPI...the blended program or the Flex program as we call it in Canada. And she was in one of my classes and I had taught her the class, and she had come back the next week, the following week to...she was just in the office when I was there teaching another class and she'd come into my class and she said, "Mister Comer," she said, "I gotta say is that what you teach me makes so much sense and I've already used it in my job because I had a gentleman that had me in a pretty compromising position and I was able to...between disconnecting my way and talking my way out of it and nobody got hurt. He didn't get hurt. I didn't get hurt." You know, she said, "I did report it like you told me we should do is report it to our supervisors, but nobody actually got hurt because of the situation and the way that you taught the course and the way that CPI..." Because it makes so much sense, it sticks with you. It's not something that you have to practice every day. It's not something that...it's a know. You gotta know how to talk to people. You gotta know how to handle people and she said, "It just comes natural and it's a natural way." CPI is just a natural way of protecting yourself.
Terry:       Well, that probably speaks a lot to the skill of the Instructor as well, I would imagine.
Walter:    But I mean, the...
Terry:       I mean you.
Walter:    Yeah. but even to sit down and just read the CPI manual, the blended manual or to watch the videos that you guys put out there, it makes such sense on how you...like some of them I surprise them in my teaching them, you know. I'll show a disconnect hold and they'll say, "Holy, I never even thought about it that way and how easy it does work." And it's just stuff...because you think it's such a good idea, it sticks in your mind. It's just something that stays with you without practice. It stays with you.
Terry:       I see.
Walter:    And that's why I so wholeheartedly believe in CPI and we are pushing and pushing and pushing to get this mandated throughout VON.
Terry:       And I was gonna...that leads me to my next question now. You became a CPI Certified Instructor back in 2017 and since then you've trained well over 200 employees and I understand there are now plans to introduce CPI training to Canada's eastern provinces, Nova Scotia, New Brunswick.
Walter:    And Ontario and Quebec.
Terry:       Ontario and Quebec and...
Walter:    Yeah, we are.
Terry:       And that you personally have been instrumental in the Victorian Order of Nurses embracing CPI training. Tell our listeners about that, if you would.
Walter:    Well, I guess what it is is because I'm a...I talk the talk and walk the walk I guess you might say. I can get my point across and I can make it seem so easy that I have actually taught not only PSWs. I started out teaching PSWs in Norfolk, Haldimand, Norfolk and then I was asked...I was approached by our management team to come and teach in Hamilton at our Hamilton nurses...to start teaching the nurses. And then our manager got a hold of me up there in Hamilton and now she's pushing to get it all the way across Ontario, and I do believe...don't quote me but I know we have a few Instructors already out in Nova Scotia that are teaching in Nova Scotia or that have just taken the training course in Nova Scotia and they're gonna start training out there in Nova Scotia also. And working, the way you guys at CPI work with me... and I gotta bring Katie (CPI Inside Sales Representative Team Lead Katie Polzin) into this. She has been fabulous with me, Katie Polzin. She has talked to her team, I have talked to my team, and together we've sort of put a program together that answers all the questions that VON needs and it answers all the questions that CPI needs to train our staff in...because, as I said before, we're a not for profit organization. So when it's not for profit, you gotta teach...you gotta train as cheap as you possibly can. And I don't know if it's down here...if it's down in the States but up here in Canada we have a very short...we got real shortage of PSWs and nurses up here, not as much nurses but personal support workers here in Canada. There is very much a shortage up here. So we can't take too many people off the road to teach them this course. So with this course I can teach two, I can teach four, I can teach six, I can teach one. If that's all they can get off the road that day, [00:20:00] I go in and I just teach one person, and that's why CPI is so versatile in what we do and how we do our work that this course is being pushed out all the way to Nova Scotia now and covering every branch of VON that we can cover.
Terry:       Excellent. And just for...so our listeners know. Katie Polzin is a CPI employee, a professional. She is a training coordinator for Canada and she's been very helpful to you as you've indicated.
Walter:    Extremely helpful, extremely.
Terry:       She'll be glad to hear that. Now, Walt, you are trained to facilitate CPI's Nonviolent Crisis Intervention® (training) and you also started recently training CPI's new Verbal Intervention™ or VI training. Maybe, would you tell your impressions of Verbal Intervention™, the VI training so far?
Walter:    The...what I like most about the verbal, and I've said that before earlier in this interview, the verbal de-escalation that I use and that I teach is so... I connect it right up with my Montessori for dementia course that I've also been taught. So I've connected the two together. So verbal de-escalation with somebody that has Alzheimer's is much easier than trying to grab a hold of their wrist or trying to sit them down in a chair or...if you can talk somebody into sitting down themselves and calming them down verbally, it is so much better for you and for the client and for tempers and then for, you know, WSIB, which is our workers compensation board up here in Canada. It really helps to try and verbally de-escalate somebody instead of physically de-escalating somebody because if you verbally de-escalate, nobody gets hurt. So the course that you guys have put out for the verbal de-escalation is fantastic in this sight of the way the VON looks at how to calm people down.
Terry:       Excellent. Well, Walter...go ahead.
Walter:    I wholeheartedly believe in that course.
Terry:       Great. And we're glad that someone with your hands-on experience endorses it. It's working I think just as people...as it was designed to do, as you described it.
Walter:    Again, it makes sense. The whole thing makes sense.
Terry:       Right. Now to close today, Walt...and thank you for being so generous to grant CPI this interview. As you told me in our pre-interview, you absolutely love your work and you found yourself kinda completely in it. I didn't understand that you had a sister and a mother also in the nursing and healthcare fields. But what...so I can understand how resonant it must be to you. But what...tell me what do you find so rewarding about it?
Walter:    I have been a catalyst of helping people all my life. I have gone into people's houses and painted their living room because it needed to be painted and they were too weak or too old or too elderly or too sick to paint a living room. To brighten up their day, I would go in and just go in and paint the living room for them for free of charge. I've done the healthcare system...been in the healthcare system all my life. At 20 years old I took care of two stroke victims on my own without any formal training because I believe I'm put on this earth to help people the best I can. And so when I first took the course in PSW, the PSW course in Brantford, like I said, when I walked into that class and everybody there was younger than me I thought, "What am I doing here?" Once I was in it a week, I knew what I was doing here.
I worked in a factory for 30 years and it's not that I hated getting out of bed but I wasn't happy to get out of bed to go work in that dirty old factory. When I get up and go to work here, I can't wait to go to work. And I mean, my bosses and my managers and everybody else will tell you the same thing is if there is somebody in need, I am the first to step forward and say, "I'll do it," because I absolutely love my job, and because I love my job it comes across that I love my job. So when it comes to my Instructor training, training CPI and training my Montessori, that passion comes out in my work and in my training and I do believe that that's why the VON has grabbed the CPI like they have. Yes, a lot of it is because of the passion that I have for the job and the love that I have for the elderly and the love that I have for the underprivileged children and autistic children and I mean, everybody that I work with. Like I said, I drive from one end of this county to the other. I put between 80 and 150 miles on my car a day to go help people.
Terry:       Wow, that is very inspirational, Walt, and thank you for sharing with us, and thank you for appearing today on Unrestrained. It's been a pleasure to have you.
Walter:    Thank you very much, Terry. I appreciate the call and when I talk to Katie, I'll thank Katie because I do believe Katie's the one that gave you my name and...
Terry:       Yes, she was.
Walter:    …and made the connection between the two of us and I do appreciate people taking my view and my attitude and I just hope that it just makes the world a better place.
Terry:       Thank you, Walt, and thank you all for listening.

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