Canada is facing a critical shortage of care workers and personal support workers (PSWs) at the same time as our population is rapidly aging. In the next few years, seniors (aged 65 and older) will comprise roughly one quarter of the country’s population. By 2075, that number could be as high as 32%. This demographic shift is driving an increased demand for home care and long-term care (LTC), with not nearly enough staff to provide those services. By next year, Ontario alone will face a projected shortfall of 30,100 personal support workers (PSWs). Immigrants have historically played a large part in filling these roles in Canada, constituting nearly 80% of the PSW workforce in Toronto alone. Despite this demand for care workers, the immigration pathways for these occupations are anything but stable. In December 2025 the government paused the Home Care Worker Immigration Pilots, the most recent program to provide permanent residency to immigrant care workers. This pause leaves many caregivers in immigration limbo and ultimately reduces the quality of care that Canadians receive. 

Since 1992, Canada has had a series of migrant care worker programs to bring in immigrants to support the healthcare system and provide live-in care services. Permanent residency was not always a guarantee, and these programs had their own share of problems. Nevertheless, for over three decades there were programs intended to bring in caregivers to support Canada’s healthcare and broader care ecosystem. 

The most recent of these programs were the Home Care Worker Immigration Pilots, launched in 2024 under then-Immigration Minister Marc Miller. Cid Cabillan, former senior policy advisor to Immigration Ministers Marc Miller and Sean Fraser, describes the policy design of the 2024 program as “precedent-setting”, because unlike past programs, it did not require applicants to have any Canadian work experience. These pilots also lowered language requirements, removed post-secondary education requirements, and expanded employer eligibility to institutional settings. Priority for the program was given to caregivers already working in Canada, in line with the Minister’s agenda to reduce the percentage share of temporary residents in Canada’s total population. 

In December 2025, Immigration Minister Lena Diab paused intake in the Home Care Worker Immigration pilots to “prioritize processing of existing applications” due to extremely high demand for the program exceeding available spaces. According to Cabillan, “in 2024, caregiver inventory was sitting at over 30K applications with planned PR admission[s] of around 8-10K. The misalignment with the caregiver inventory and the planned PR admissions [resulted in] longer processing wait times.” Indeed, in the 2026-2028 Immigration Levels Plan announced by Prime Minister Carney’s government, there are only 8,000-9,000 permanent resident spots reserved per year for all Federal Economic Pilots. This means caregivers are lumped together with immigrants coming through the Agri-Food Pilot, Community Immigration Pilots, and Economic Mobility Pathways Pilot. And there is no indication that the Caregivers Pilots will re-open anytime before 2028. 

The only remaining pathway for caregivers advertised on the Canadian government’s webpage for home care workers is the Temporary Foreign Worker Program (TFWP). Canada’s TFWP has been labeled as “a breeding ground for contemporary forms of slavery” by the UN Human Rights Office of the High Commissioner. The TFWP allows businesses to file a Labour Market Impact Assessment (LMIA), asserting that they cannot fill a position with Canadian labour and need to seek employees from outside the country. Immigrant workers who arrive under the TFWP program are more likely to be exploited than other migrants with open work permits, since their ability to stay in Canada is intrinsically tied to their employment, thereby allowing employers to control both the labour conditions and migrant status of these workers. Not only is this a stain on Canada’s human rights record, but it also impacts the standard of care that Canadians receive. 

This decreased prioritization of care workers demonstrates a disconnect between the significant demographic pressures Canada will face in the next decade, and what the federal government is willing to do to solve it. The government’s own occupational projections system predicted a “strong risk of shortage” of personal support workers in the period 2023-2033, with 49% of PSWs aged 50 and over.  

PSWs and other caregiving roles such as health care aides, personal care providers, or continuing care assistants, provide care in private homes, hospitals, and residential care homes including LTC homes. Caregiving is a critical part of the healthcare system to reduce the burden on hospitals and provide older adults and people with complex needs the opportunity to receive care where, when, and how they need it. A majority of Canadians over age 50 wish to remain in their own home for as long as possible, yet in 2024 only 48% of older Canadians needing home care were able to access it. 

Long-term care homes also play a critical role in providing ongoing care for elderly patients who do not need care in a hospital. The Covid-19 pandemic exposed massive gaps in Canada’s LTC system, including staff shortages and burnout impacting the quality of care. As of 2023-2024, the average wait time for a spot in an LTC home in Ontario was 200 days (72 if coming from a hospital). By 2033-2034, an estimated 55,000 more Ontarians will require LTC placement compared to 2023-2024. Long wait times for LTC placement contribute to “hallway healthcare”: patients waiting for a hospital bed in an emergency department or other unconventional space. In Ontario that number is around 1000 people per day. 

PSWs play a key role in residential care in Canada, providing up to 80% of direct care in LTC homes. Yet these jobs are demanding and come with significant physical and emotional tolls. Staff are often overworked, and turnover is high; recent research shows that over half of PSWs are considering leaving their position in the near future, and PSW positions make up 1 in 5 healthcare job vacancies. Heavy staff workloads impact the quality of care provided in LTC homes. Staff shortages and the complex care needs of patients have led to disturbing outcomes: in 2024-2025, 1 in 4 LTC residents received antipsychotic medication without a diagnosis of psychosis, and 1 in 6 had a fall in the 30 days prior to assessment. 

The data paint a stark picture of the caregiving crisis facing Canadians. While recent investments in long-term care promise to improve the situation, they will not magically create more staff to provide care. We also cannot ignore the care provided to Canadians in private homes. The Canadian Labour Congress estimates that unpaid care work, such as caring for children, aging parents, or people with disabilities, is worth up to $860 billion. Funding directed toward the care economy, they say, is “an investment in a powerful economic engine, and a foundation that supports every other strategic sector.” 

Care work is already an extremely taxing job. When stress levels are high, PSWs and other care workers experience burnout, and the quality of patient care suffers. Increasing the precarity of immigrant caregivers by jeopardizing their ability to stay in Canada in the long term puts additional pressure on this already strained system. This presents a problem for both caregivers and Canadians needing care now or in the future. It’s in the interest of all Canadians to ensure we have a robust immigration program that prioritizes the care workers needed to provide high-quality, sustainable care across the country. Will the Canadian government recognize this need and respond? 

Key words: healthcare, immigration, Canadian labour force, healthcare wait times, Canada’s healthcare crisis, caregivers, PSWs, personal support workers, skilled immigrants, immigrant labour force