Immigrant care workers play an increasingly important role in home and long-term care in Canada, yet the full extent of their relations with older persons in those settings is relatively unknown. This article examines the role of immigrant care workers in both home and long-term care sectors, with a focus on relations with older clients and implications for quality of care. The data are derived from interviews with workers, employers, and older clients conducted in various home and long-term care services for older adults across three Canadian provinces: Ontario, British Columbia, and Quebec. Factors stemming from immigrant care workers' ethnic/racial background, language barriers, and contextual factors such as staff shortage in different care settings for older adults complicate the relationship between immigrant care workers and their clients. In some cases, these factors diminish the quality of care. We point to some policy alternatives that our findings suggest should be considered.

Canada is unique among the countries included in this volume with regards to the immigration status of care workers; they are much more likely to be immigrants or permanent residents rather than temporary workers (migrants). One program specific to Canada that enables care workers to migrate to Canada is the Live in Caregiver Program (LCP). Through this program workers are able to migrate without having to meet the qualifications of the immigration points system or family sponsorship. One of the key requirements is that they work for at least 24 out of 36 months as a care worker in the home of their client who in turn is their immigration sponsor. Though this has typically been a means to bring in care workers to work with children, increasingly care workers are attending to elderly clients. Interviews we conducted with 19 immigrant care workers in the home and long-term care sector who came to Canada through the LCP, contributed to a broader understanding of the way in which this recent shift in focus can help to address the growing need for care of older persons in their home. However, it has been implemented with little of the additional resources needed for this increasingly complex clientele. This program holds clear potential, but not without it being better customized to meet the needs of older persons and their care workers.