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 people;
• 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.

On the Issue of Country-Specific Terminology

Terminology is critically important to clarify in this domain and particularly in the Canadian context. As noted above internationally educated health professionals (IEHPs) are those who have received training outside of Canada (or the U.S.) regardless of place of birth, and who have decided to immigrate to Canada. Some are recruited directly to work in their profession, many migrate with the hopes of doing so, whereas some migrate with work as a secondary consideration. Another term used in this report is immigrant care worker which we use interchangeably with foreign born care worker; we do not use the term migrant care worker adopted in the reports on the U.S., the U.K., and Ireland as this is not reflective of the status of most foreign born care workers in Canada in that they tend to have landed immigrant status or Canadian citizenship. Some of these care workers may have international training as health professionals, some may have local training and some may not have any specific training as well, depending on their role in the care sector. We discuss this more fully in the findings below.