Security Guard vs. PSW vs. Sitter: Who Does What in a Care Setting?

Three Roles, Three Purposes

Facilities often ask whether a resident needs a PSW, a sitter, or a security guard. Each role is different, and the right choice depends on the need.

Personal Support Worker (PSW)

PSWs provide hands-on personal care: bathing, dressing, mobility, toileting, meals, and daily routines under a care plan, supervised by nurses. They are part of the care team.

Sitter or Companion

A sitter offers company and light supervision for a person, such as conversation, activities, and reassurance. A sitter does not provide security duties and typically does not have security training.

Licensed Security Guard

A licensed guard is responsible for safety and security: controlling access, preventing wandering and exits, deterring theft or trespass, responding to disturbances, and supporting staff when situations escalate. In a care setting, a guard can also provide 1-to-1 observation for a high-risk resident. Guards in Ontario must hold a valid licence under the Private Security and Investigative Services Act (PSISA).

Quick Comparison

• Bathing, dressing, mobility, meals: PSW
• Company, conversation, reassurance: sitter / companion
• Wandering or elopement risk: security guard (1-to-1 or entrance coverage)
• Agitated resident or visitor, staff safety: security guard
• Overnight access control: security guard
• Medical decisions and medication: nurse / clinical team

Working Together

These roles complement each other. A guard keeps the unit safe so PSWs and nurses can focus on care, and a PSW or nurse tells the guard what the resident needs. Clear role boundaries keep everyone protected.

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