Complementing this background contextual analysis, we report here on the data from the interviews with current and prospective care recipients in regards to their preferences for health and social care services. We asked first, who they thought should be providing care. Several of our participants felt that the government should be responsible for elderly care and that this was important to have a consistent minimum level of care:

“I think that we need to level the playing field. I think that the government should pay for more.” (BC Care Recipient 4)

Despite having this preference, many seniors voiced concerns over issues surround lack of funding and cut backs that were affecting their care or the care of relatives. Some noted the ‘horror stories’ that were told about poor public facilities. Others felt the government was doing a poor job of planning for the demand for care.

“Well ... the population is getting older and the problem is that governments wait for the problem to happen before trying to do something. ... We’re seeing it all the time where the reaction is when the problem is there instead of forecasting it down the road and saying okay, what facilities can we put together to assist these people, you know.” (BC Care Recipient 5)

Overall, many participants stressed the important role that the government should play in the provision of care for the aged despite the present limitations.

The provision of care was also considered by many of our participants to be a family responsibility. Many of those interviewed cared for their elderly parents at some point in their lives; however, they mentioned that it can turn out to be difficult as the elder parent’s condition deteriorates:

“If one has a parent who has reached the age in life where they need some additional care, the onus right now is, in most cases, is probably put on the family. And as that person progresses in the aging process it can become a lot more difficult. ” (QUÉBEC Care Recipient Mar 19)

Because of this, several participants expressed a preference to be cared for by a professional rather than by their children:

“I love my children very, very much but I’d still like a ... caregiver ...looking after me...” (Older person - BC 4)

A couple interviewees mentioned that many years ago, the family was responsible for care of their parents; however, this has changed over the years because everyone is busy with their own lives.

Related to who should be providing care, we also asked about preferences for where care should be provided. Not surprisingly, a majority of the interviewees mentioned that they preferred to be cared for in their home, some emphatically so, for as long as this was possible. The home was a preferred place for care largely because it was considered to be the most comfortable:

Interviewer: And where should people be cared for?
Respondent: In their homes. That's where they're happiest. In their home environment is probably the best. The healthiest, yes, because you almost feel more comfortable at home. You know, you're familiar with the surroundings and you feel more at ease ... I would say home, definitely, if possible. (QUÉBEC Care Recipient Mar 19)

They noted that if it came to a point where care in the home was proving to be difficult because of illness, they would not mind being placed in a nursing home as the last resort. By and large, however, many of our interview participants expressed that they would not like to be placed in an institution because it is more confining than being cared for at home. Many respondents also voiced concerns over the issue of flexibility and accommodation of the elderly in institutions. They mentioned that the rooms were small and the elderly were restricted from going outside to get fresh air, hence, the environment is very important:

“I wouldn’t like an institution type place. I think I’d be worried about ... open spaces for seniors ... and greenery and flowers cause people love that stuff. ... That’s kind of nice to get out and do a little thing that they like to do best ‘cause not everybody wants to sit and knit.” (Older person - BC 4)

Some respondents mentioned that some institutions were not able to cater to health care needs of the elder resulting in the elderly person being “shipped” back and forth from the hospital to the nursing home. Several respondents also complained that there is a staff shortage in institutions which can be problematic with respect to the quality of care.

“I would say one of the biggest issues is that there’s not enough staff, that they expect the staff to do so much in so short a period of time that even if they wanted to spend just a couple of minutes more trying to understand a patient, they’re required to go off somewhere and make beds or look after another patient because they’ve got 30 patients to look after in a one hour period. I think it’s the ratio of caregivers to patients that is not good. That’s the biggest one.” (BC Care Recipient 3)

Some also complain of institutions not being regulated properly, hence, causing abuse of the elderly.

“Well this one that I'm thinking of, the large institution where this abuse was ongoing, the family complained when they suspected something was going on and they were ignored by the administration and they put a hidden camera, the family put a hidden camera in and had the evidence and that's when things came to a head. It shouldn't have to get to that point.” (QUÉBEC Care Recipient Mar 19)

Clearly, current care recipients and those who will be seeking care in the future have strong preferences for where and who should provide them care, in terms of formal and informal services. In the sections that follow, we further discuss some of the preferences and experiences of care recipients specifically regarding their views and experiences with immigrant care workers.