By Carol Goar, Toronto Star,  Jan 13 2011

The change crept up on us. We haven’t thought about it, talked about it or done anything about it. Over the past decade, the number of live-in foreign caregivers entering Canada has increased by 400 per cent. No other category of immigration has grown as fast.

It is not because more young parents are seeking nannies; it is that more middle-aged couples are looking for caregivers for their aging parents.

Canadian-born workers don’t want these jobs. The pay is low, the shifts can be brutal and caring for older people, especially those with disabilities or dementia, is physically and emotionally draining.

So Canada, like other western nations, is turning to migrant caregivers.

Inside the sector, this is an acknowledged reality. The managers of nursing homes, retirement homes, home care agencies and private nursing companies see Asia (primarily the Philippines) or the Caribbean as their main source of workers.

But outside the sector — except for the occasional news story about abuse of live-in caregivers — we haven’t paid much attention to the changing face of elder care.

The International Organization for Migration has. The Geneva-based agency, which represents 132 nations including Canada, has just released a report entitled The Role of Migrant Care Workers in Aging Societies. It looks at four western democracies — Canada, the United States, Britain and Ireland — to see how they are dealing with the challenge of caring for an aging population.

The study was written by a team of researchers at Oxford University, the University of Ottawa, Georgetown University and the National University of Ireland. Its principal conclusion: Importing foreign caregivers is a stopgap, not a solution. What is needed is an overhaul of the adult care system.“The increasing reliance on recent migrants can be seen as a symptom of the structural and funding challenges our social care systems are experiencing.”

The authors compared the four countries, using their differences to weigh various policy options. But they found the similarities among them much more striking than the divergences.

All four were unprepared for the demographic wave bearing down on them. All said they were too “constrained” to invest in new social programs. None was making a serious attempt to tackle the problems that have already emerged, from discrimination against non-white caregivers to a lack of standards and oversight in the sector.

Canada was the only country with a specific immigration program for live-in caregivers. (It was developed in the 1990s to address the shortage of child care.) Although the authors applauded the idea of a dedicated entry stream, they stopped short of endorsing the Canadian model, warning that it leaves live-in caregivers vulnerable to abuse and denies them full protection of the Charter of Rights.

The U.S. was the most dependent on “unauthorized” immigrants. Twenty per cent of its domestic workforce is in the country illegally. This makes it virtually impossible to monitor or maintain the quality of elder care, the author pointed out.

Britain and Ireland used recruiting agencies more extensively than their North American counterparts. Although this increases the inflow of migrant caregivers, it drives up the cost and raises unrealistic expectations, the authors warned. Before going down this path, countries need to ensure employers can deliver on the commitments being made on their behalf.

In short, no one is very good at importing caregivers.

But that is not the fundamental problem, the researchers stress. What is wrong is that western governments are seeking quick fixes for a long-term problem. Rich countries are looking abroad, not within, for the compassion and work ethic that will allow their citizens to age in dignity.