The main components of the older adult care service delivery systems in Canada include home care and community based services and institutional care in long term care (LTC) facilities. Neither are not publicly insured services under the Canada Health Act and as a result each province has developed its own terms and conditions under which these services will be provided. The balance among these components and the range of services within each vary from province to province.

Home Care/Community Based Services

Although each province has organized care differently, there are some common features: entry into all home care services is by way of provincially designated public or quasi-public agency, eligibility for home care services is based on need as determined by a provincially uniform assessment and care planning process, a case management service and each feature above has a single regional or provincial administrative structure. Currently, all provinces provide three types of home care—post-acute, supportive care for the chronically disabled and end-of-life care—within one umbrella program.

Residential Care Facilities for Older Adults

The two main types of residential care services are chronic care hospitals or chronic care units within hospitals, and long-term care facilities that provide multiple levels of care that cover clients at intermediate and extended care levels.

Across these two sectors, there is very little information on the extent of foreign born workers, though we do know that recruitment and retention of home and long term institutional care is a longstanding issue. Working conditions are typically poor and most care workers are only employed part-time. As increasing numbers of patients with high levels of acuity are being redirected to home and institutional care, there is question as to whether there will be sufficient numbers of well-trained health professionals to meet their needs.