PSW vs RPN vs RN: Who Should Be Caring for Your Parent?

Q: What's the difference between an RPN and an LPN?

They're the same role with different names. Ontario uses RPN (Registered Practical Nurse). Most other provinces — BC, Alberta, Manitoba, Saskatchewan, and the Atlantic provinces — use LPN (Licensed Practical Nurse). The training, scope of practice, and regulation are essentially equivalent. If you're reading home care information from different provinces, just know that RPN and LPN are interchangeable.

Q: Can I hire a PSW independently instead of through an agency?

You can, and it's often $5-10/hour cheaper. Independent PSWs advertise on job boards, community Facebook groups, and caregiver networks. The tradeoff: you become the employer. That means handling scheduling, backup coverage when they're sick, payroll deductions, and liability. Agencies cost more but handle all of that for you, and they carry insurance. If your parent needs consistent daily care, an agency is usually less stressful for the family. If you just need a few hours of help a week, an independent PSW can work well.

PSW vs RPN vs RN: Who Should Actually Be Caring for Your Parent?

Your parent needs help at home. Maybe they just got discharged from the hospital. Maybe they’ve been slowly declining and you can’t keep pretending everything is fine. Either way, someone told you to “get home care” and now you’re drowning in acronyms: PSW, RPN, RN. What do they actually mean, and which one does your parent need?

Here’s the short version: it depends on what kind of help your parent needs. A PSW (Personal Support Worker) handles daily living tasks like bathing, meals, and companionship. An RPN (Registered Practical Nurse) handles medical tasks like wound care, injections, and medication administration. An RN (Registered Nurse) manages complex medical situations, develops care plans, and supervises everyone else.

The wrong level of care wastes money. The right level keeps your parent safe. Let’s break it all down.

Quick Decision Table: PSW vs RPN vs RN

Before we dig into the details, here’s a cheat sheet. Find your parent’s situation and you’ll know where to start.

Needs help with bathing, dressing, meals, toileting, or mobility → PSW
Lives alone and needs companionship or light housekeeping → PSW
Has dementia and needs daily routine support → PSW (with RPN oversight)
Needs medication administered (injections, eye drops, suppositories) → RPN
Has wounds that need dressing or monitoring → RPN
Needs catheter care, ostomy care, or vital sign monitoring → RPN
Just had surgery and needs post-operative monitoring → RN (stepping down to RPN/PSW as they recover)
Needs IV therapy, complex pain management, or tube feeding → RN
Needs a full care assessment and care plan development → RN
Has multiple chronic conditions that require clinical judgment → RN

Most families end up needing a combination. An RN might visit once a week to assess and adjust the care plan, an RPN might come three times a week for wound care, and a PSW might be there daily for personal care. That layered approach is how home care in Canada usually works.

What a PSW Actually Does Day-to-Day

A Personal Support Worker is the backbone of home care. They’re the person who shows up every morning to help your mom get out of bed, get dressed, and eat breakfast. They’re also the person your dad chats with over lunch when he hasn’t talked to anyone else all day.

Here’s what PSWs typically handle:

Personal hygiene: Bathing, showering, oral care, hair care, shaving
Dressing and grooming: Helping your parent get dressed, put on compression stockings, manage incontinence products
Meal preparation: Cooking meals, feeding assistance, ensuring proper nutrition and hydration
Mobility support: Helping with transfers (bed to wheelchair, wheelchair to toilet), walking assistance, fall prevention
Light housekeeping: Laundry, dishes, tidying up, changing bed linens
Companionship: Conversation, card games, walks, accompanying to appointments
Cognitive support: Cueing and reminding (taking pills from a pre-filled dosette, daily routine prompts)
Observing and reporting: Noticing changes in your parent’s condition and flagging them to the family or care team

What a PSW does not do: anything clinical. They don’t assess medical conditions, administer medications by injection, change sterile dressings, or make clinical decisions. They’re trained in personal care, not medical care.

That said, a good PSW is worth their weight in gold. They see your parent more than anyone else on the care team. They notice when something is off — when your dad isn’t eating, when your mom seems more confused than usual, when there’s a new bruise. Those observations often catch problems before they become emergencies.

What an RPN Does (and Why It’s Not the Same as a PSW)

A Registered Practical Nurse (called an LPN — Licensed Practical Nurse — in most provinces outside Ontario) sits between a PSW and an RN. They’re a regulated health professional with clinical training, which means they can do things a PSW simply can’t.

An RPN in home care typically handles:

Medication administration: Giving injections (insulin, blood thinners), administering eye drops, ear drops, suppositories, and topical medications
Wound care: Cleaning and dressing surgical wounds, pressure ulcers, diabetic foot wounds, and skin tears
Catheter and ostomy care: Inserting, maintaining, and troubleshooting urinary catheters and ostomy appliances
Vital signs monitoring: Blood pressure, pulse, temperature, oxygen saturation, blood glucose checks
Tube feeding: Administering feeds through a nasogastric or PEG tube (in stable situations)
Symptom monitoring: Assessing pain levels, watching for signs of infection, tracking chronic disease symptoms

The key difference: an RPN can make clinical observations and carry out a care plan, but they work within a framework set by an RN or physician. They don’t independently develop complex care plans or make major clinical decisions on their own.

If your parent needs OHIP-funded home care in Ontario, the care coordinator will determine whether your parent qualifies for RPN visits. Many families also hire RPNs privately when the public system doesn’t provide enough hours.

What an RN Does (The Top of the Home Care Pyramid)

A Registered Nurse has the broadest scope of practice. In home care, they’re the quarterback — they assess, plan, and oversee everything.

Here’s what an RN brings to the table:

Comprehensive health assessments: Full physical assessments, cognitive evaluations, fall risk screening, pain assessments
Care plan development: Creating and adjusting the overall care plan based on your parent’s changing needs
IV therapy: Starting and managing intravenous lines, administering IV medications and fluids
Complex wound management: Wound vacs, deep tissue wounds, post-surgical complications
Medication management: Reviewing all medications for interactions, adjusting dosages (with physician orders), managing complex drug regimens
Post-hospital transitions: Managing the critical first days after a hospital discharge when things are most likely to go wrong
Supervision: Overseeing and delegating tasks to RPNs and PSWs, ensuring care is delivered safely
Palliative care: Managing end-of-life symptoms, pain, and comfort measures

You don’t necessarily need an RN at your parent’s bedside every day. In many cases, an RN visits weekly or biweekly to assess the situation and adjust the care plan, while RPNs and PSWs handle the daily work. Think of the RN as the architect — they design the plan. The RPN and PSW execute it.

Training and Regulation: How They’re Different

This matters more than you might think. The training gap between these three roles is significant, and it directly affects what they’re legally allowed to do with your parent.

PSW (Personal Support Worker)

Training: Certificate program, typically 600-700 hours (about 6-8 months) at a community college or private career college
Regulation: PSWs are not regulated by a professional college in most provinces. Ontario has been working toward a PSW registry, but as of 2026, there’s still no mandatory registration
What this means: Quality varies. A PSW from Conestoga College with a clinical placement at a hospital is not the same as a PSW from a 4-month online course. Ask about training when you hire

RPN (Registered Practical Nurse) / LPN

Training: Diploma program, typically 2 years at a community college, including extensive clinical placements
Regulation: Regulated by the College of Nurses of Ontario (CNO) in Ontario, and equivalent colleges in other provinces. Must pass the Canadian Practical Nurse Registration Examination (CPNRE) or the new REX-PN exam
What this means: There’s accountability. If an RPN makes a serious error, they can lose their license. You can look up any RPN on the CNO’s public register

RN (Registered Nurse)

Training: 4-year Bachelor of Science in Nursing (BScN) degree from a university, including over 1,300 hours of clinical practice
Regulation: Also regulated by the CNO (or provincial equivalent). Must pass the NCLEX-RN exam
What this means: The most education, the broadest scope of practice, and the highest level of accountability. RNs can work autonomously and make independent clinical decisions

Cost Comparison: What You’ll Actually Pay in 2026

Let’s talk money, because this is usually where the real decisions get made. These are typical rates for private home care in Canada in 2026. If your parent receives publicly funded home care through Ontario Health atHome (310-2222) or your provincial equivalent, the clinical services are covered — but the hours are limited.

PSW: $25-35/hour (private agencies). Some independent PSWs charge $20-28/hour
RPN: $35-50/hour (private agencies). Independent RPNs may charge $30-45/hour
RN: $50-75/hour (private agencies). Specialized RNs (wound care, palliative) can be $65-85/hour

Here’s what that looks like in real life. Say your parent needs 4 hours of help every morning with bathing, dressing, breakfast, and medication reminders from a dosette. A PSW at $30/hour is $120/day or $3,600/month. An RPN at $45/hour for the same 4 hours would be $180/day or $5,400/month — an extra $1,800/month for clinical skills you may not need.

That’s why getting the right level of care matters. Overshoot and you’re burning money. Undershoot and you’re putting your parent at risk. For a full breakdown of what home care costs across Canada, read our senior home care cost guide.

Common Scenarios: What Does Your Parent Actually Need?

Theory is fine. Let’s get practical. Here are the situations we hear about most from families.

“My parent has dementia and is still living at home.”

Start with a PSW. Most of what a person with dementia needs is daily routine support — help with bathing, meals, cueing for activities, companionship, and safety supervision. A PSW trained in dementia care can handle all of this. You might also need an RPN for medication management if your parent takes multiple drugs and can’t manage a dosette independently. But the primary caregiver, day-to-day, is the PSW.

“My parent needs wound care after a hospital stay.”

You need an RPN. Wound care involves sterile technique, assessment of healing progress, and knowing when something isn’t right. An RPN can change dressings, monitor for infection, and escalate to an RN or physician if needed. If the wound is complex (wound vac, deep surgical wound, significant tissue damage), you may need an RN to manage it directly.

“My parent just had hip surgery.”

In the first 1-2 weeks, you’ll likely need an RN for post-surgical monitoring — watching for blood clots, infection, managing pain medications, checking the surgical site. After things stabilize, you can step down to an RPN for ongoing wound checks and medication management, and then to a PSW for recovery support — mobility exercises, personal care, meal preparation. This stepdown approach saves money and matches care to actual need.

“My parent has diabetes and needs insulin injections.”

An RPN can administer insulin injections and monitor blood glucose. If that’s the only clinical need, an RPN visit once or twice daily for injections, combined with a PSW for personal care, is the most cost-effective approach. Some provinces also allow PSWs to assist with insulin under specific delegation protocols — ask your care coordinator.

“My parent is in the final stages of life.”

Palliative care at home typically requires an RN for symptom management, pain control (especially if injectable medications are involved), and care plan adjustments. PSWs provide the personal care and comfort — repositioning, mouth care, keeping your parent clean and comfortable. This is one situation where having the full team matters.

Can a PSW Give Medication? The Grey Area

This is one of the most confusing questions in home care, and the answer depends on your province.

In Ontario, PSWs can remind a client to take medication and can assist by handing them a pre-filled dosette (those plastic pill organizers sorted by day and time). They can also apply non-prescription creams and lotions. But they cannot administer medications — no injections, no crushing pills into food, no eye drops, no medications that require any clinical judgment.

In Alberta and BC, the rules are slightly different. Under specific delegation from a regulated nurse, some PSWs (often called Health Care Aides in Alberta) may assist with a broader range of medication tasks. But this requires formal delegation, training, and documentation. It’s not a blanket permission.

The safe rule of thumb: if the medication task involves anything beyond handing someone their pre-sorted pills, you need at least an RPN. If you’re unsure, ask the home care agency directly — and get the answer in writing.

How to Figure Out What Level of Care Your Parent Needs

Don’t guess. Get an assessment.

If your parent is in Ontario, call Ontario Health atHome at 310-2222 (no area code needed). A care coordinator — usually an RN or social worker — will visit your parent’s home, assess their needs, and recommend a care plan. This service is free and can connect you to publicly funded home care.

In BC, contact your local health authority. In Alberta, call Health Link at 811. Every province has a referral pathway.

If you’re hiring privately, most reputable home care agencies will do a free in-home assessment before starting service. They’ll send a supervisor (usually an RN) to evaluate your parent and recommend the right combination of PSW, RPN, and RN hours.

Here’s what to prepare for that assessment:

A current medication list (all prescriptions and over-the-counter medications)
A list of diagnoses and recent hospital stays
A description of what your parent can and can’t do independently (be honest — now isn’t the time to downplay)
Any safety concerns (falls, wandering, leaving the stove on)
Your own availability — how many hours per week can you realistically help?

That last point matters. The assessment isn’t just about your parent’s needs. It’s about the gap between what they need and what the family can provide. The home care team fills that gap.

Find Home Care Providers Near You

Whether you need a PSW, RPN, or RN, finding a reliable provider in your area is the first step. AgePlaceHub lists home care agencies across Canada, searchable by city, so you can compare options and find providers who offer the level of care your parent needs.

Start by searching your city:

Frequently Asked Questions

Can a PSW replace a nurse for home care?

A PSW can handle all non-medical personal care — bathing, dressing, meals, companionship, mobility support. But if your parent has any clinical needs (wound care, injections, catheter management, or medical monitoring), you need an RPN or RN. Many families use a PSW for the majority of hours and bring in a nurse only for specific clinical tasks. That combination gives you the best care at the most reasonable cost.

Does OHIP cover PSW, RPN, and RN home care?

Yes, but with limits. Ontario Health atHome can provide publicly funded PSW, RPN, and RN visits based on your parent’s assessed needs. The catch: the hours are often not enough. A typical allotment might be a few hours of PSW care per week and periodic nursing visits. Most families with significant care needs end up supplementing with private care. Our OHIP home care guide explains exactly what’s covered.

What’s the difference between an RPN and an LPN?

They’re the same role with different names. Ontario uses RPN (Registered Practical Nurse). Most other provinces — BC, Alberta, Manitoba, Saskatchewan, and the Atlantic provinces — use LPN (Licensed Practical Nurse). The training, scope of practice, and regulation are essentially equivalent. If you’re reading home care information from different provinces, just know that RPN and LPN are interchangeable.

How many hours of PSW care does my parent need per day?

It depends on their level of independence. Someone who needs help only with bathing and meals might need 2-3 hours per day. A person with moderate dementia who can’t be left alone safely might need 8-12 hours. A bed-bound parent who needs repositioning, feeding, and full personal care could need 24-hour coverage, which usually means two or three PSWs working in shifts. The in-home assessment is the best way to determine the right number of hours.

Can I hire a PSW independently instead of through an agency?

You can, and it’s often $5-10/hour cheaper. Independent PSWs advertise on job boards, community Facebook groups, and caregiver networks. The tradeoff: you become the employer. That means handling scheduling, backup coverage when they’re sick, payroll deductions, and liability. Agencies cost more but handle all of that for you, and they carry insurance. If your parent needs consistent daily care, an agency is usually less stressful for the family. If you just need a few hours of help a week, an independent PSW can work well.