In sum, despite the fact that the Canadian healthcare sector increasingly relies on immigrant care workers as one solution to its labour shortages, our study found that the role of immigrant care workers in home and long-term care sectors for the elderly is very complex. This complexity stems from the influences that the immigrant’s ethnic/racial background, language, racial and cultural differences stemming from it, have on the carer/client relationship.

First, we found that recipients of care and immigrant care workers generally agree on ‘good carer qualities’, describing these as entailing the following attributes. To mention just a few: being passionate, patient, compassionate, capable of understanding and responding to the needs of his/her patients, and committed to his/her job. Still, some of the care recipients saw the immigrant care providers as culturally incompetent and as such unable to adequately respond to their caring needs.

Second, we drew out three types of relationships between immigrant care workers and the older people for whom they cared: the ‘professional relationship’, the ‘friendly relationship’ and the ‘discriminatory relationship’. While the first two types of relationships are very important to our understanding of relations between immigrant carers and older clients, the most interesting and illuminating insights are offered by the discovery of the discriminatory type of relationship. The latter sheds light on the negative (and sometimes positive) discrimination experiences in relationships between clients and immigrant workers in Canadian care settings for the elderly - the issue that has not been sufficiently addressed by previous research. In addition, our research also revealed that some of the older people tended to see immigrant carers as better workers because their cultures display more positive attitudes towards caring. Still, some older people questioned the quality of foreign training and the credentials of immigrant care workers. Such findings broaden our understanding of difficulties that immigrants face in the Canadian context by showing that their credentials are questioned not only by the legal licensure systems, but also by their clients in the micro processes of interacting with them.

Moreover, we found out that immigrant care workers’ role in the Canadian sector for the elderly is also complicated by language barriers between themselves and their clients. Our findings suggest that language barriers go both ways – not only on the part of the workers, but also the clients, subsequently influencing the quality of their relationships. In turn, the quality of care illuminates our understanding of this issue in the Canadian context. Still, linguistic skills stemming from the racial/ethnic background of immigrant care workers and care recipients are not the only ones complicating the immigrant carer/client relationship and diminishing the overall quality of care.

Finally, we found that the shortage of staff and supplies in long-term care settings (in particular in nursing homes) has a negative impact on the quality of immigrant provider/old person relationships and quality of care. Such findings help us to better understand how current reform of healthcare restructuring in Canada affects this particular type of relationship and the quality of care.