ivy lynn bourgeault: the live in caregiver program

8/11/2019 Ivy Lynn Bourgeault: The Live in Caregiver Program

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CIHR/HEALTH CANADA CHAIR INHEALTH HUMAN RESOURCE POLICY

THE LIVE IN CAREGIVERPROGRAM

Ivy Lynn BourgeaultApril 2012


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Overview

The Live In Caregiver program

Experiences of LICs in Older Adult Care

Consequences for sending countries

Cross-cutting gender lens


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LIVE IN CAREGIVER PROGRAM


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LCP

Canadas shortage of care workers available to live inthe homes of the client for whom they are providingcare, and this is expected to become more acute withthe ageing of the population.

The LCP, established in 1992 (a replacement of the pre-existing Foreign Domestic Worker programme in placesince 1981), is a variant of the economic classprogramthat enables workers to gain entry to work inCanada without having to meet the qualifications of theimmigration points system, family sponsorship or

refugee status.


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LCP

The term live-in caregiver as defined in theImmigration and Refugee Protection Regulations is aperson who resides in and provides child care,senior home support care or care of the disabledwithout supervision in the private household in

Canada where the person being cared for resides.


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LCP Requirements

a job confirmation letter from HRSDC to the employer whichoutlines its opinion about the labour market situationnecessitating a live-in caregiver;

a written contract with the employer;

successful completion of an equivalent of Canadian secondary

school education at least six months of recognized formal full-time training in a

field related to the job, or at least one year of full-time paidwork experience (including six months with one employer) inthe field related to the job within the three years precedingthe application;

good knowledge of English or French; and

a work permit before entering Canada (CIC, 2009).


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Recent Changes to LCP

One of the key requirements of the LCP for transition topermanent residency status was that they had to workfor at least 24 out of 36 months as a care worker in thehome of their client.

Recent changes that have come into effect April 1, 2010

include: a one-year extension to the period allowed to complete the

employment requirement,

the option for an hours-based calculation of the employmentrequirement based on 3,900 hours within a minimum of22 months, and

the assessment of medical examination at the work permitapplication stage with a long term view and the elimination ofmandatory medical examination at permanent residenceapplication stage


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Demographic Data

The number of people who come to Canada under LCPis substantially smaller when compared to some otherimmigration categories, its overall increasing trendssuggests its growing significance in solving the problemof shortages of elderly and childcare workers.

The number of LCP workers who became permanentresidents has increased from around 2,000in 1996 to6,717in 2007 (CIC, 2008)

The vast majority of workers coming through LCP werewomen from the Philippines(83%), followed by those

coming from Britain (2.3%), Slovakia (1.6%) andJamaica (1.7%) (Spitzer and Torres, 2008).


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Concerns

Previous research has documented concerns that arisewith the status and working conditions of workers.

Arat-Koc (1999), for example, characterized the LCPas a program that requires more from domesticworkers, without offering them rights and privilegesavailable to other workers, and further that itenables Canadian employers to obtain higherqualified labour for less pay.


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Responses

Many positive changes have been made to addresssome of these concerns including easier transitions topermanent residence, enhanced protections to live-incaregivers from potential exploitation and abuse,including an LCP hotline and emergency processing of

new work permits for LCP victims of abuse in theemployers home.


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LICS IN OLDER ADULT CARE


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Granny nanniesThis new class of caregiver is booming, and quite unregulated

by Katie Engelharton Thursday, January 14, 2010

When Esther Heckbert told her mother she wanted to leave the Philippines to work as a

babysitter abroad, her mother was leery. ...Twenty-five years since arriving, Esther has helped

rear dozens of Canadian tots: first as a nanny and then as the owner of a nursery school. But a

few years ago, she sensed a changing wind. She left babysitting behind, sought retraining, andnow works under a more whimsical title: granny nanny. She joins a growing rank of

babysitters-turned-eldercare workers: a nod to shifting demographics. ...
http://www2.macleans.ca/author/katieengelhart/http://www2.macleans.ca/author/katieengelhart/http://www2.macleans.ca/author/katieengelhart/


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The Role of Migrant Care Workersin Ageing Societies: The CanadianContext(2007-9)

The factors determining the demand for foreign workers

in the health care of older people; The impact of foreign workers on the structure of care

and independent living of older people;

The impact of foreign care workers on older people andtheir families and quality of care

The migration and work experiences of foreign care

workers: the means and motivation for migration, roleof recruitment agencies, choice of employment andworking life

A Canadian component to an internationalcomparative study examining the followingissues in the U.K., Ireland and the U.S:

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Host Country Direct/Social Care

Workers

Nurses & Professional

Care Workers

Canada Philippines, other

Asian, Sub-Saharan

Africa

Philippines,

Caribbean, Latin

America, Europe

Ireland Poland, Philippines,

Nigeria

Philippines, India

United Kingdom Philippines, Poland,

Zimbabwe, Nigeria

Philippines, India, Sub-

Saharan Africa

United States Mexico, Philippines,Caribbean

Philippines,Caribbean, Sub-

Saharan Africa

Recent migration routes


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Migrant Caregiver Perspectives

Caring for older people is often social and cultural normfor workers from some cultures

Some patterns of differential treatment were reported,more weekend shifts, etc.

Language can be challenging difficult

I dont know if my English is good enough ... So my firstchoice I chose the nursing home. Easier? Yeah. Thatsmy start. So after that I get used to it and I knoweverything about the nursing home. And so I thought Ishould try hospital.

Some see LTC nursing and social care as a steppingstone to other health jobs


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Some Take Home Messages

Care system is the primary source of problems

Underfunding of the sector impact on wage levels(staffing account for >60% of running costs)

High turnover and low retention create shortages inlong-term care occupations

Immigrant care workers make a substantial contributionto older adult care, but double isolation

Workers have few opportunities to socialize with host

country citizens Compounds difficulties with social/cultural integration


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Gender Dimensions

The relative invisibility of the conditions of olderadult care can be seen as being mirrored in theinvisibility of the work and living conditions oftheir immigrant care workers.

Not insignificant that both are predominantly women


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IMPACT OF LCP ON SENDINGCOUNTRIES

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Impact/Consequences


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Source Country Concerns/Issues

Bifurcation of concerns

coping with the consequencesof outmigration of needed human resources forhealth

whereas some (most notably the Philippinesand India) are using the migration of healthworkers as a development tool


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The Issue of Remittances

The most frequently cited is the hard currency returnedas remittances to family members by migrant healthprofessionals working elsewhere.

Remittances to India have been argued to be 2%ofGDP

Remittances in the Philippines constitute nearly 10%of the GDP

Though these funds are substantial and may improve

household incomes, they do not translate into fundsfor health systems sustainability


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Key Principles in the Canadian companiondocument to WHO 2010 Code

strive to create aself-sufficienthealth workforce

aim for transparency, fairness and mutuality ofbenefits

all aspects of the employment of international healthpersonnel should be without discriminationof anykind

WHO Global Code of Practice on theInternational Recruitment of Health

Personnel


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WWW.HEALTHWORKERMIGRATION.COM

Reports from previous studies

Video clips from YouTube on HWM

Bibliography on HWM (coming soon)

Key links

ivy lynn bourgeault: the live in caregiver program

Documents