The Role of PSWs in Home Care vs. Institutional Care

Looking ahead to your job options after personal support worker training? Still deciding which kind of healthcare setting would best suit your particular preferences and skill set?

PSWs commonly work in clients’ private homes as well as institutional settings like nursing homes, hospitals, and retirement residences. While the work is similar in both environments, there are some unique differences students should be aware of.

In this post, we’ll walk you through the responsibilities, challenges, and rewards of home care vs. institutional care so you can make an informed decision about which setting is best for you.




Personal support workers in institutional settings work with elderly people, helping them maintain as much independence and quality of life as possible as they cope with chronic conditions and the natural effects of aging.

These PSWs work as part of a team and follow set schedules and protocols due to the needs of multiple residents.

Typical hospital, retirement home, or nursing home PSW duties include:

  • Assisting residents with personal hygiene practices like bathing, grooming, and toileting
  • Providing additional personal care support with activities like eating and moving around
  • Helping to administer prescribed medications
  • Changing wound dressings if needed
  • Assisting with any therapeutic exercises included in residents’ care plans
  • Ensuring the residents’ rooms are tidy and well-organized
  • Recording and reporting changes in residents’ behaviour or condition

Shannon McGrath began working at Cité Parkway Retirement Residence right after finishing the PSW program at Herzing College. Her facility provides a wide range of care depending on residents’ needs.

“Some clients are more independent, so I just provide assistance with laundry, bringing meals if they’re sick, and helping them get downstairs,” she told us.

“For residents who need total care, I feed them, bathe them, do laundry, put them in lifts to transfer them, etc. I really enjoy the work.”



Personal support workers in home care, sometimes called home support workers, will find themselves working with clients of all ages, from babies and young children with special needs to young adults with debilitating diseases or temporary injuries—and of course, elderly folks who prefer to stay in their homes rather than move into a long-term care facility.

In many ways, these PSWs become part of the family and are trained to take charge of household management tasks their clients can no longer do independently.

Home care support worker responsibilities include tasks like:

  • Helping with personal hygiene and other aspects of personal care, including eating and mobility
  • Planning meals and going grocery shopping
  • Cooking and other light housekeeping tasks
  • Ensuring clients take their medications as prescribed
  • Providing emotional support and companionship
  • Taking clients to community activities, appointments, etc.
  • Coordinating with family members

PSW helping a senior man stand upHome care PSWs help clients with mobility, cooking, and much more



Understanding the unique challenges of home care vs. institutional care for PSWs can help you choose the work environment that best suits your personality and preferences. Here are some things to consider:

Physical and Safety Concerns

Every PSW job is physically demanding. PSWs often lift and transfer patients from beds to wheelchairs, chairs to toilets, etc. They can also be injured by physically abusive or violent patients.

However, home care workers often carry out their duties alone, lacking the immediate support network of colleagues readily available in an institution. This can raise additional safety concerns.


As a home-based PSW, the number of clients you visit in a day will depend on the policies of the company you work for and whether you work full- or part-time hours. In some cases, you might support a single client for an extended period.

In a care facility, you’ll look after a certain number of assigned residents each shift. The resident-to-PSW ratio can vary depending on the setting and even the time of day, but you will typically be responsible for more residents than you would in a home care setting. This can lead to time constraints and challenges in providing personalized care.

PSW supervising breakfast in a retirement residencePSWs in institutional settings are often responsible for many residents

Structure vs. Autonomy

In home care, each environment is unique, requiring PSWs to adapt to different layouts, resources, and client preferences. On the other hand, care in institutions is more regimented, with less flexibility for PSWs to tailor their approach to different needs.

Travel Requirements

One of the challenges of working in home care is that you will be travelling to clients’ homes each day. That means you will need a driver’s licence and a reliable vehicle. Keep in mind that you may not be paid for your time driving between locations.

As a PSW in a nursing home or hospital, you’ll remain at one facility for an eight- or 12-hour shift, so travel is less of an issue.



Any PSW work environment comparison should also include the benefits! The sense of making a positive impact is a common thread for PSWs in both settings, but the specific rewards and satisfaction factors can differ. Here’s a breakdown of the rewards of working as a PSW in home care vs. institutional care:

Home Care

  • Building relationships: The personalized nature of home care can lead to close bonds between PSWs and clients.
  • Flexibility: Home care often allows for more flexible scheduling and working hours, allowing for better work-life balance.
  • Variety: Each client’s situation is unique, offering a diverse range of experiences and challenges that can keep the job interesting.
  • Autonomy: Home care workers often enjoy a higher level of autonomy and independence in their work, making decisions about routines and problem solving on their own.

Institutional Care

  • Higher pay: According to a study released by the Ontario government in 2020, PSWs in institutional settings, particularly hospitals, make significantly more than those in home care.
  • Teamwork: Working as part of a healthcare team provides a sense of camaraderie. Collaborating with nurses, doctors, and other healthcare professionals can be professionally rewarding.
  • Professional growth: Although home care companies do offer job-related training, institutional settings often provide more opportunities for learning and professional development.
  • Immediate support: Having immediate access to other healthcare professionals and resources can make it easier to handle difficult situations and provide comprehensive care.

“For me, the most rewarding part is seeing my clients happy with the care that I provide for them,” says Herzing graduate Krizia Mae Macusi, who landed a job at long-term care facility Hillel Lodge immediately after finishing her program. “And being a PSW gives you a broader perspective on life, both the negative and positive aspects.”



Your ideal personal support worker job setting depends on your personal preferences. If you value close relationships, autonomy, and flexibility, you may find home care more rewarding. If you prefer teamwork, structure, and access to resources, you might be happier in an institutional setting.

Both work environments demand very strong time management skills, patience, compassion, and rigorous attention to detail. In both career paths, you will need to learn and follow company protocols, communicate effectively with loved ones, and take care of your own health.

“To be a PSW, you should have compassion for others and a deep desire to help people,” advises Krizia. “Having patience is also very important—I was surprised how much patience I had when I started this career. And you must be willing to continue learning each and every day.”



Consider Herzing College’s Personal Support Worker training, delivered at our Ottawa and Toronto campuses. Click below to browse program details and chat live with an admissions advisor. We’re here to help!

Explore the Personal Support Worker Program in Ottawa

Explore the Personal Support Worker Program in Toronto

hard hat icon

Herzing Skilled Trades Training


Most Read