Many argue that Canada has a shortage of care workers and this shortage is expected to become much more acute with the aging of the population. In addition to the aging of the population, others point to how the aging of care workers will create an even greater challenge to the sustainability of health care. One of the responses to this concern over a shortage of care workers has included the tapping into of the existing resources of immigrant care workers. The full extent of the roles immigrant care workers play in the delivery of care in the context of an aging society in Canada is relatively unknown.

Objectives of this Research

The aim of this research was to address some of the important gaps in our knowledge about the role of immigrant care workers in the care of older adults in the home and long term care sectors in Canada, with the broader intention of providing comparative data to the situations in the U.K., Ireland and the U.S. We focus in particular on:

• the factors determining the demand for immigrant or foreign born workers in the care of older adults;
• the migration and work experiences of foreign born care workers;
• the impact of foreign born workers on the structure of care, on older people’s experience of care and on perceptions of quality of care; and
• the most effective and ethical policies to regulate the admission, employment and integration of skilled and less-skilled care workers.

Methodological Overview

The proposed project has several components in two broad categories:

A. Background Contextual Analysis. We reviewed immigration policies regulating the entry, employment and integration of foreign care workers in Canada. The contextual analysis also addressed the structure and demand for home and long term care for the elderly in and the examination of the statistical evidence on the roles native and foreign born workers play in the provision of health care services in Canada presently and future projections.

B. Empirical Studies of Immigrant Care Workers, Employers and Recipients of Care in a range of health care institutions, home care agencies and private households in three provinces: Hamilton/Toronto Ontario, Vancouver/Victoria, British Columbia and Montreal, Québec. We secured interviews with 75 immigrant care workers, 23 employers and 29 care recipients. In addition to the employer interviews, we set up an online survey for employers to complete which largely mirrored the questions from the interview guide. A total of 149 employers filled in the online survey of which 102 answered the full set of questions related to the employment of immigrant care workers.