Trajectory of Immigrant Caregivers

WHO ARE THEY?

Immigrant caregivers are people born outside of Canada who provide care and support to one or more family members or friends with a temporary or ongoing incapacity or disability (physical, psychological, psychosocial or other).

The care recipient — who may or may not have been born in Canada — can be a parent, child, spouse, partner, friend, or any other person with whom the caregiver shares a significant bond. They may live nearby, but not necessarily; they might also live in a different city, another province, or even outside the country altogether.

As with all caregiver populations, immigrant caregivers play a key role in the life of the care recipient by serving as a major source of support. Their support can take many forms: financial or administrative assistance, accompaniment to medical appointments, help with household chores, transportation, personal care, medication management, or emotional support. However, for this group, certain responsibilities are more directly associated with their migration journey. This can include acting as informal interpreters to facilitate the care recipient’s access to services, providing support remotely, or even making frequent trips abroad to care for a loved one who still lives in their home country (3).

As a group, immigrant caregivers are heterogenous and in constant evolution, with multiple identities that reflect a vast array of profiles and migration experiences.

Immigrant caregivers may:

• Be racialized or not.
• Be able to communicate in English, French, or neither of these two languages.
• Hold temporary or permanent resident status, be undocumented (non-status), or have obtained Canadian citizenship.
• Have left their country of origin by choice or by obligation, recently or years ago.

For more information on how these various elements affect the trajectory of immigrant caregivers, see the section, Factors influencing the trajectory.

GENDER

In Canada, recent data show that gender representation among immigrant caregivers is fairly equal (31). This differs from trends among the Canadian-born population, where women are significantly more likely to assume the role (8).

Within immigrant communities, men, like women, often step into primary caregiving roles. This may be due to a lack of other options, but can also be driven by the sense that caring for a loved one is “natural” or a way to “give back” to their elders (3, 7, 25) — values that can carry particular resonance within certain ethnocultural contexts.

When caregiving responsibilities are shared within a family, the division of labour depends on more than just gender or preference: it is also shaped by structural constraints. Often, the role of primary caregiver falls to the family member with the most flexible work schedule or the strongest command of the local official language (3, 25).

Gender does, however, influence how a caregiver’s involvement is recognized and supported. The role of a male caregiver is often minimized or misunderstood by family members and professionals alike, which can limit their access to resources and cloud their own sense of identity as a carer (3, 25). Conversely, women’s caregiving may be seen as “natural” or simply taken for granted — a perception that risks rendering their specific needs invisible.

Religious and spiritual beliefs

Not all immigrant caregivers adhere to a religion or engage in spiritual practices. Nonetheless, for those who do, these dimensions can affect their caregiving trajectory in various ways (3), both positively and negatively, including by:

• Providing an emotional anchor that makes hardship easier to accept and gives meaning to day-to-day experiences.
• Helping to guide difficult decisions related to the care of a loved one.
• For practices involving group activities and gatherings, serving as a source of social connection and tangible support.
• Influencing perceptions of illness (e.g., interpreting a disability as divine punishment or giving it spiritual significance).
• Shaping care practices and the perception of treatments.
• Making acceptance of a medical diagnosis difficult, delaying consultation with specialists, or complicating symptom identification.

Religious or spiritual affiliation does not automatically influence the caregiving experience; spirituality in particular is deeply personal, experienced and expressed differently by each individual. However, diverging perceptions and beliefs between caregivers, care recipients and healthcare professionals can sometimes lead to misunderstandings, especially in the absence of open communication (3). Still, attributing difficulties in accessing care and services solely to these differences risks obscuring the structural obstacles faced by immigrant caregivers, which can include language barriers, financial insecurity, and the administrative complexities of the public healthcare system (3).

Socioeconomic situation

While immigrant caregivers are statistically more likely to be employed and hold higher levels of education than their Canadian-born counterparts, they are also more likely to face financial difficulties (26, 28).

Many experience precarious living conditions that expose them to multiple overlapping vulnerabilities. Migration is an also inherently costly process, generating financial pressures that are further compounded upon arrival by Quebec’s high cost of living. Furthermore, immigrants tend to earn a lower average weekly wage than those born in Canada — a disparity that persists regardless of their years of residence in the country (3).

Occupational downgrading

Professional and financial consequences of caregiving

The demands of caregiving often compel individuals to reduce their working hours or exit the workforce entirely, significantly eroding household income. At the same time, financial aid for caregivers is rarely enough to bridge the gap and remains out of reach for many, especially those sidelined by migration status or other circumstances.

Caregivers must also shoulder significant out-of-pocket expenses for such items as transportation, residential care or home care services. These costs can be difficult to absorb, making essential support difficult to access — if not completely unaffordable — and creating a state of constant financial pressure that can leave both caregivers and their loved ones in a vulnerable position (3).

Minority group affiliation

Immigrant caregivers may also belong to other minority groups, such as racialized, 2SLGBTQIA+, or official language minority communities. The intersection of these identities and their associated vulnerabilities can significantly complicate the caregiving trajectory. Indeed, immigrant caregivers who belong to several minority groups are multiply marginalized, rendered even less visible than other caregivers and prone to greater stigmatization. Beyond the inherent demands of caregiving, this compounding of systemic oppressions creates acute precarity and intensifies the barriers these individuals must navigate (9, 10).

Being part of a racialized group can also influence the caregiving trajectory; while not all immigrant caregivers are racialized, those who are may face greater challenges (3). For more information on how racism and/or discrimination affect immigrant caregivers’ access to services, see Racism and discrimination.

Language is another key barrier to access. In Quebec, for example, immigrant caregivers who do not have sufficient French to communicate effectively with service providers face significant hurdles. This adds a further layer of difficulty to an already complex caregiving trajectory, compounding the burden and distress they experience (3). To further explorer this topic, see Language issues.

Developing this trajectory revealed a gap in the knowledge about 2SLGBTQIA+ immigrant caregivers. Generally speaking, 2SLGBTQIA+ caregivers face greater vulnerability, less visibility, and higher levels of distress than their heterosexual and cisgender peers. Considering the lived experiences and family contexts of this community is therefore vital to provide support tailored to their specific reality (11).

Relationship to the care recipient

The nature of the caregiver–care recipient relationship profoundly influences the caregiving trajectory, shaping daily experiences, needs, access to services and more. This relationship can take different forms within immigrant communities, with each situation presenting its own challenges.

As in the general population, immigrant caregivers most often support a parent. However, they are slightly more likely than their Canadian-born counterparts to provide care for a child (31).

It must be noted, too, that not all immigrant caregivers are related to the person they support. In Canada, 14% of immigrant caregivers provide care to a friend or someone with whom they have no marital or family ties (31).

Regardless of the nature of the relationship, immigrant caregivers tend to identify primarily through their bond with the person they support — as a child, parent, or friend — rather than as a “caregiver.” This self-perception can make it harder for their role to be formally recognized (3).

Migratory status

In Quebec, access to public healthcare and services varies widely based on migration status and eligibility for social safeguards. These disparities have a direct impact on the trajectories of immigrant caregivers and the loved ones they support. Constraints tied to legal status add layers of difficulty to the caregiving role, often resulting in financial, emotional and administrative repercussions.

Immigrant caregivers must often contend with a complex healthcare system and exacting bureaucratic procedures, both of which add to an already heavy burden. Those who lack public or private insurance coverage may also need to pay high upfront costs. For precarious or non-status immigrants, fear of deportation can be a major barrier to seeking services — a situation frequently exacerbated by a lack of awareness of their entitlement to certain services or a fear of jeopardizing the immigration process. Consequently, many immigrant caregivers find themselves with unmet healthcare needs, both for themselves and their loved ones (3).

While certain groups fall under the federal Interim Federal Health Program, most healthcare eligibility is determined by provincial regulations, which vary significantly across Canada. For a detailed look at how migration status affects access, the CoSaMi eligibility table (2026, available in French only) offers a representative model of the dozens of immigration sub-categories that dictate a caregiver’s access to support.

Social networks

Social networks are a lifeline for immigrant caregivers, yet these networks are often limited, if not entirely absent. The migration journey is a decisive factor: a person’s support system may have remained in their country of origin, be scattered across the globe, or simply be unavailable. This is compounded by the demands of caregiving, which can leave little time or energy for maintaining existing social relationships or forging new ones, thereby worsening isolation. For recent arrivals, the likelihood of a limited support network is even higher (3).

While some immigrant caregivers share a home with or live close to their support network (e.g., in intergenerational housing), others must maintain social connections from afar with loved ones who are geographically dispersed (3).

A well-developed, engaged support network makes the caregiving trajectory significantly more bearable. A restricted network, by contrast, is often unable to provide the respite needed to lighten the load. When combined with limited access to formal services — as is frequently the case for immigrant caregivers — this lack of support can have significant repercussions on the carer’s physical and mental health (3).

Geographic location

Where a caregiver lives directly influences their access to care and services. In large urban centres, resources are generally more varied and plentiful, which facilitates the caregiving journey. By contrast, caregivers in rural or remote areas face challenges inherent to their location, such as limited service availability, long travel distances, staff shortages, inadequate public transportation and extended wait times. Such geographical disparities create significant inequalities among all caregivers (3, 12).

These gaps are even more pronounced for immigrant caregivers, who often struggle to find services tailored to the specificities of their situation. Resources such as respite care, psychological support, or support groups sensitive to the migratory experience, already scarce, are notably difficult to access in rural areas or underserved neighbourhoods (3).

ENTRY INTO CAREGIVING

Entry into caregiving marks the beginning of the period in which one individual provides significant support to another. For immigrants, the decision to take on this role is shaped by a unique convergence of factors.

As is true for most caregivers, immigrants often view their role as “natural” or self-evident, rooted in family ties and emotional bonds (3). However, among immigrant populations, this sense of duty can be even more pronounced — sometimes by choice, and sometimes as a result of migration-related constraints and structural barriers. Such commitment is often deepened by a profound sense of responsibility, devotion and reciprocity, along with deep intergenerational bonds. Ultimately, in a context where the alternative would be simply inconceivable, caregiving becomes a moral obligation (13).

Caring for a loved one, especially an elder, can thus be perceived as a mark of respect and a privilege — a way of “giving back” that, for many, serves as a significant source of pride (14). However, researchers and practitioners can place a disproportionate emphasis on this cultural dimension to explain why immigrants are so deeply involved in family care. Too often, this focus serves to justify the underutilization of formal services (3, 15). In reality, becoming a caregiver is frequently a necessity rather than a preference, driven by the absence of strong social networks together with a lack of affordable services that are adapted to their lived realities (3).

The lack of choice is often a direct result of structural constraints within the healthcare system that serve to increase the burden on immigrant caregivers — language barriers, racism and discrimination, care and service organization, incomplete information, and so on (3). Research indicates that when families underuse formal health services, it is primarily due to access barriers, a lack of available or culturally adapted services, or a failure on the part of professionals or providers to recognize the vital role these caregivers play (3, 29, 30).

The caregiver’s role in this context is also shaped by the sponsorship process. When a caregiver has sponsored a family member, they often see caregiving as a natural extension of their responsibilities in this area, continuing the administrative and navigational support they provided during the migration process (3). At its core, their involvement remains an expression of deep commitment to their loved one’s security and well-being (3).

ARRIVAL IN QUEBEC

When caregiving precedes migration

• In some cases, caregivers immigrate to Quebec specifically to join a family member already established there and who requires support (25).
• When the care recipient lives abroad, caregivers may seek to bring them to Quebec through family reunification. However, lengthy immigration procedures can often mean that the person’s health has deteriorated significantly by the time they arrive. This immediately increases their support needs, thereby intensifying the caregiving role (3, 5). Furthermore, sponsors face heavy legal and financial obligations: they are responsible for their loved one’s costs, especially since the newcomer is not immediately eligible for coverage under public health insurance. Consequently, even if support was previously provided from a distance, reunification often marks a sharp increase in caregiving demands (3).
• Sometimes, immigration is motivated by the desire to access a structured, professional healthcare system that is better equipped to support a loved one’s care needs (25). However, this goal often conflicts with immigration selection criteria, since a person’s health status is subject to medical assessments that can constitute a barrier to admission (16).

When migration precedes caregiving

The onset of caregiving can occur at any point after arrival: sometimes immediately, sometimes only years later. The care recipient may have immigrated alongside the caregiver, arrived at an earlier date, or been born in Quebec (3).

While selection criteria and medical screenings mean that newcomers often arrive in better health than the Quebec-born population, this advantage can quickly fade (16). The migration process itself is a profound stressor; where displacement is forced or marked by past violence, the physical and mental toll is even more acute (17). These pressures, compounded by the precarious living conditions that many face upon arrival, can steadily undermine well-being (3, 16). Ultimately, this decline in health can force families into unanticipated caregiving roles, making migration itself a primary trigger (3).

In this context, family and community networks become essential sources of support, and caregiving responsibilities may emerge or intensify over the course of the migration journey (3).

RACISM AND DISCRIMINATION

For many immigrant caregivers, racism and discrimination — both lived and anticipated — are major barriers to accessing health and social services. These experiences drive some caregivers to supress any mention of their cultural identity, language or beliefs during clinical interactions for fear of being misunderstood or treated differently (3).

Some even feel forced to alter their physical presence — such as lowering their voices or suppressing natural gestures — to counter being perceived as “aggressive.” This constant vigilance is mentally taxing and adds an extra layer to the already heavy burden of caregiving (3).

Unconscious biases and stereotypes held by some professionals lead to tangible consequences: symptoms are minimized, tests are dismissed as unnecessary, and concerns are not taken seriously. Caregivers often feel they must repeatedly insist to have their loved ones’ needs recognized and addressed. Some report being treated as less legitimate partners in care, or even ignored (3).

In some cases, bias can lead professionals to apply different standards based on origin or appearance. For example, racialized mothers have reported feeling judged on their parenting skills rather than supported, particularly when professionals attributed certain child behaviours to a lack of discipline or “poor parenting” rather than to actual developmental needs (3).

SERVICE ORGANIZATION AND ACCESS DIFFICULTIES

Accessing services is often a complex process, particularly for immigrant caregivers. However, securing initial support is only the first step; maintaining these services over time and adapting them to the evolving needs of the care recipient represents an equally significant challenge. The reality of a siloed and disjointed health and social services system — particularly daunting for newcomers — frequently leaves caregivers to their devices as they struggle to determine whom to contact, how to secure services, and how to ensure continuity of care (3).

Various structural obstacles also stand in their way, such as high staff turnover, whose consequences are twofold: it hinders the development of trusting relationships; and it often results in inadequately trained personnel who are less equipped to meet family needs (3). Furthermore, caregivers may lose access to support due to staff leave, reassignment or administrative reorganization. Maintaining continuity of care is particularly challenging for immigrant caregivers in linguistic minority settings, especially when professional interpretation is unavailable (3). Long waitlists, underfunding and the unpredictability of home care services compel some caregivers to turn to the private sector for lack of suitable alternatives.

The system’s inflexibility presents further hurdles. Eligibility criteria are often restrictive and fail to account for the complex realities of immigrant caregivers. For example, a caregiver supporting multiple loved ones simultaneously may only be eligible for respite for one of them. Moreover, as a caregiver’s involvement increases, formal services are sometimes reduced — a discouragingly counterproductive outcome. Finally, the scarcity of culturally appropriate services, including those offered in languages other than French or English, further limits the options available to immigrant caregivers (3).

ACCESS TO INFORMATION

For immigrant caregivers, unfamiliarity with the health and social services system (and public services in general) is a major barrier to accessing support. Many are simply at a loss as to where to begin: what services exist, whom to contact, how to obtain a diagnosis, how to navigate follow-up between various professionals? While this lack of knowledge is especially pronounced for newcomers, it can often persist for years after settlement (3).

The system itself is fragmented and can be difficult to navigate, characterized by complex forms, long waiting lists, poor communication between services, and a lack of follow-up from staff. When procedures are unclear, some immigrant caregivers end up discouraged and will abandon their efforts to find help. The underuse of services does not always stem from refusal or a lack of need; it can also simply reflect a lack of awareness of their existence. Along with reasonable levels of digital and health literacy and relative fluency in English or French, knowing someone who is familiar with the system can make a considerable difference in accessing information and services (3).

The lack of information also extends to knowledge about the illness or disability itself. Incomplete understanding of these conditions on the part of the caregiver or care recipient can complicate interactions with staff, making decisions more difficult and undermining the relationship of trust with professionals. Such knowledge gaps generate a feeling of powerlessness and further increase the caregiver burden (3).

LANGUAGE ISSUES

For immigrant caregivers who do not speak the prevailing official language, language is one of the most significant barriers to accessing care and services. Even for individuals with a certain level of English or French proficiency, specific contexts or conditions (stress, emotionally charged situations, etc.) can impair their ability to understand and assimilate information at any given time (3).

Language barriers manifest in various ways. First, information about available services is often inaccessible when it is not provided in a language spoken by the caregiver or the person being cared for. Second, some medical terms may not have equivalents in the caregiver’s native language, which complicates understanding the medical condition. Communication with professionals then becomes difficult, making it harder to establish a relationship of trust. These difficulties intensify and further complicate existing barriers within the health and social services system (3).

Language barriers have concrete consequences for caregivers: risks of medication errors, infringement of the right to informed consent, and breaches of confidentiality. In some cases, caregivers are forced to turn to lower quality or more expensive services because they cannot access services in a language they understand fluently (3).

In the absence of professional interpretation services, which remain largely inaccessible, caregivers often find themselves acting as translators for their loved ones. This responsibility is burdensome in several respects. First, because they are not trained in medical interpretation, errors or misunderstandings can occur with serious clinical consequences. Second, the dual role of caregiver and translator creates an emotional strain: some may intentionally omit or downplay difficult information — such as a terminal diagnosis or bad news — to shield their loved one from painful realities. Finally, this role often forces caregivers to take time off work to attend appointments, leading to further loss of income. Acting as an ad hoc translator generates significant stress and distress, adding to the already heavy burden of caregiving (3).

CAREGIVER RECOGNITION

Few immigrant caregivers identify with the formal label of “caregiver.” For many, providing care is seen as a natural extension of family life; accordingly, they identify first as a parent, sibling, spouse or friend. Many experience difficulties accessing information, leaving them unaware of their rights, of legislation such as the Quebec Act to recognize and support caregivers, or even of the term “caregiver” itself. Such a lack of self-identification obscures their own needs, ultimately delaying the search for personal support services (3).

Regardless, these caregivers still desire validation from healthcare professionals as true partners in care. Unfortunately, they frequently report feeling “used” or taken for granted, regarded by staff only when a specific task is required of them (3).

Furthermore, many tasks performed by immigrant caregivers — providing interpretation during medical appointments, for example — are often overlooked as caregiving duties. Indeed, professionals may perceive the caregiver merely as a companion or translator, a bias particularly common when the caregiver is male (25). In reality, translation is a major responsibility that imposes a significant cognitive burden, not least since any misinterpretation can lead to serious consequences for the care recipient’s health.

The needs and concerns expressed by immigrant caregivers are also frequently hindered by a broader lack of recognition. Healthcare professionals may minimize, question, or sideline their requests for support — for both themselves and their loved ones — due to language barriers, differing cultural perspectives on care, or implicit biases (3). Such dismissals can delay critical assessments and diagnoses, as well as access to appropriate services, ultimately increasing the caregiver’s burden and further complicating their navigation of the health and social services system (3).

COMMUNICATION AND PARTNERSHIP WITH CARE TEAMS

Communication with professionals can be a major challenge for immigrant caregivers. The difficulties extend beyond language barriers; even those fluent in English or French have reported that medical jargon hampers understanding of the care recipient’s condition or of the support required. Further complicating matters are the difficulty of reaching staff, a lack of follow-up, and at times, unempathetic attitudes. This can discourage caregivers from seeking help, as they may feel judged or perceived as “demanding,” giving rise to a sense of unease and a hesitation to speak up (3).

These communication gaps are not inconsequential: they can foster a deep-seated mistrust of services and, in some cases, lead to medical errors with significant repercussions (3).

When communication breaks down, it also undermines the care partnership. Inconsistent follow-up, inaccessible information, and a sense of being unheard can fracture the relationship of trust, causing caregivers to become less active in the care process (3). This highlights how vital a relationship of trust with professionals is to the immigrant caregiver’s experience. Strong trust facilitates collaboration, encourages open communication, and can have a profoundly positive impact on the entire caregiving trajectory for both the caregiver and the person they support (3, 24).

SEEKING AND ACCESSING SUPPORT FOR THE CARE RECIPIENT

Finding and accessing services for the care recipient represents a key juncture in the immigrant caregiver’s trajectory; as with all caregivers, their own well-being is deeply intertwined with that of the person they support (3). Generally, immigrant caregivers find that when the care recipient’s needs are met through reliable, accessible and tailored services, their own quality of life improves and their caregiving experience becomes significantly more manageable (3).

Numerous studies indicate that immigrants are less likely to utilize services, a situation attributed to several factors (3):

• Some immigrant caregivers prioritize family-based care over formal health and social services. This may stem from a desire for privacy, the stigma associated with certain physical or psychological incapacities, or differing cultural perceptions of illness and disability.
• Low service uptake is also linked to a lack of information, unawareness of their rights, language barriers, and overly complex administrative procedures. These challenges manifest as linguistic, administrative, financial, and sometimes racial barriers that limit recourse to existing services.

Furthermore, health professionals often presume that immigrant caregivers receive ample family support, due to perceived norms of family solidarity. In reality, these caregivers are often isolated and face significant financial hardship. The absence of an extended family network due to migration, combined with socioeconomic instability, can leave immigrant caregivers profoundly vulnerable. Even when a social network exists, it is not always involved in providing care. Such professional perceptions can ultimately delay access to essential support (3, 15).

Diagnosis

• Information gaps: A lack of information, particularly when it is unavailable in the native language of the caregiver or care recipient, complicates the diagnostic process. This is often aggravated by limited knowledge of specific diseases and unfamiliarity with how the health and social services system functions — a challenge that is magnified for recent arrivals. Professionals must encourage caregivers to ask questions and share relevant information, taking the time needed to build trust (3, 19).
• Lack of access to professionals: Due to precarious immigration status or other systemic barriers, many caregivers lack access to a family doctor or are unable to consult specialists (3).
• Differing perceptions of illness: Varying understandings of certain conditions can lead to mutual mistrust between professionals, caregivers and care recipients. For example, within some minority communities, neurocognitive or mental health disorders may be heavily stigmatized (3, 20). In such cases, accepting a professional diagnosis can prove difficult for both the patient and the caregiver.

Residential care

Studies show that immigrant caregivers are reluctant to consider moving the care recipient into residential care (e.g., long-term care facilities, private retirement homes, assisted living) (20, 22). This hesitation is primarily driven by a fear that the person’s needs — particularly regarding dietary or religious practices — will not be understood or respected (22). However, it may also stem from a general mistrust of public institutions and professionals, or from a fear of experiencing racism or discrimination (20).

Consequently, immigrant caregivers often prefer to keep the care recipient at home, despite significant support needs. This choice increases their burden and can negatively impact their physical and psychological health. A lack of access to tailored, affordable home support services makes these caregiving responsibilities even more difficult to manage (3, 23).

Seeking alternative forms of support

Faced with numerous barriers to formal care, many immigrant caregivers seek to fill systemic gaps or supplement existing services with alternative forms of support.

Remote consultations

Various factors — communication barriers, the difficulty of building trust with professionals, long waitlists, and the high cost of private services — lead some caregivers to seek treatment for their loved one in their country of origin, where wait times may be shorter and care more culturally appropriate and affordable. Others opt for remote medical consultations. While these solutions help bypass certain barriers, they bring their own challenges. For example, obtaining comprehensive information on the care recipient’s health status becomes more difficult, and a sense of powerlessness due to the distance can set in (3).

Community organizations

Immigrant-serving organizations (ISOs) play a central role for caregivers struggling to navigate the health and social services system. Acting as gateways to formal services, these organizations support newcomers by providing information, referrals, and assistance with integration and accessing services in their own language. By building a foundation of trust, ISOs bridge the gap between immigrant communities and the host society. Therefore, promoting these organizations’ services to both immigrant caregivers and health professionals is crucial (3).

Religious organizations

Support networks

When available, family and social networks are a valuable resource for immigrant caregivers facing barriers to formal services, as they help distribute caregiving responsibilities more effectively. Support from these networks can take many forms (emotional, financial, or practical) and help alleviate the caregiver's burden. However, these networks are often fragmented or nonexistent in the migration context, limiting this option for many caregivers (3). To learn more, see Social networks.

SEEKING AND ACCESSING SUPPORT FOR CAREGIVERS

Enhancing support for the care recipient

Providing adequate services and resources for care recipients remains one of the best ways to help immigrant caregivers, as it directly eases their workload. This support is particularly vital in light of the converging factors that often render the burden for immigrant caregivers especially heavy: a sparse or absent support network, language barriers, financial insecurity, and the challenges of navigating a health and social services system that is frequently ill-equipped to support their specific realities (3).

Services for caregivers

Despite their needs, immigrant caregivers are generally less likely to seek support for themselves (3, 25):

• They may struggle to recognize or articulate their own needs, which delays the process of seeking support.
• They often set aside their own well-being to focus entirely on the person they support.
• The sheer weight of their responsibilities can limit their ability to find and access services (e.g., due to a lack of time).
• They are more likely to be unaware of their rights or of the specialized resources and services available to caregivers.
• Even when aware of the available services, they often face obstacles to access, such as strict eligibility criteria, complex administrative procedures, language barriers, or services that are not adapted to their needs.
• Previous negative interactions with public services may make them reluctant to reach out again.

Psychosocial support

Under strain from the burden of caregiving and multiple intersecting vulnerabilities, immigrant caregivers have a pressing need for psychosocial support tailored to their situation (17).

Such support must account for the specific challenges — mistrust of institutions, fear of judgment, the need for interpretation, or precarious immigration status — that can deter them from seeking help. Support should be provided within a safe, non-judgmental framework and, whenever possible, in the caregiver’s native language (3).

However, these caregivers often fall through the cracks of specialized caregiving services, which may not fully consider the complexities of the migration experience. Long waitlists for public services constitute an additional barrier. As a result, community and settlement organizations frequently become their primary (and sometimes only) point of access for psychosocial support (3). Others may choose to seek psychological support remotely, such as from resources in their country of origin (25).

Financial support

In Canada, immigrant caregivers face significantly greater financial strain than non-immigrant caregivers (28) and are twice as likely to report a household income below $20,000 (28).

Many immigrants face significant financial vulnerability due to costly immigration processes, underemployment and other systemic barriers. For those with precarious or no legal status, this situation is even more acute, limiting their access to both the labour market and essential social safety nets.

Caregiving responsibilities can rapidly exacerbate financial instability by necessitating reduced working hours, relocation, home adaptations, or reliance on private services (3). Regarding the existing financial assistance, immigrant caregivers often fail to accumulate enough working hours to qualify for benefits — such as Employment Insurance (EI) or caregiver tax credits — because they are unable to work full-time (3). Consequently, there is an urgent need to both develop financial supports that better reflect their reality and streamline or relax often-stringent eligibility criteria.

Respite

Respite is a critical need for immigrant caregivers, who often face heightened social isolation due to the geographic dispersal of their natural support networks. Especially for those who have recently arrived, the lack of a local circle of care means they often cannot delegate tasks to friends or family, leaving them with very little time for themselves (3).

Respite services must be flexible and personalized to be effective, and a relationship of trust must be established between the caregiver and service providers to help alleviate the guilt associated with taking time for oneself (3).

In some cases, the care recipient may refuse outside help, forcing the caregiver into an even more demanding role — especially if the care recipient does not speak English or French. It is therefore essential to adapt services for the care recipient, particularly regarding home support, to prevent the full weight of caregiving from falling on the caregiver (3, 27).

Spirituality and religion

For many immigrant caregivers, spirituality and religion are vital sources of support and solace. Places of worship often function as community hubs where caregivers can build social connections and offer mutual aid (3, 18). This support can take many forms, including direct assistance with caregiving tasks, respite, referrals to accessible community resources, or advice on navigating psychosocial support and the healthcare system (18).

Spirituality can help caregivers find meaning in the often-challenging experience of providing care. It can also guide decision-making and provide much-needed opportunities for personal renewal and reflection (3).

END OF CAREGIVING AND POST-CAREGIVING

As with non-immigrant caregivers, there is no single or “typical” path out of caregiving for immigrant caregivers. This transition can take many forms: the death of the care recipient, the arrival of others in the support network who can share responsibilities, or the return of the caregiver or care recipient to their country of origin. The nature of this transition varies depending on the care recipient’s specific health needs and their relationship with the caregiver.

Reflecting broader demographic shifts toward an aging population, immigrant caregivers are increasingly called upon to provide end-of-life care. For instance, data from Montreal indicates that the vast majority of older adults born outside of Canada age and die in their adopted city (7). This reality raises unique challenges for the caregivers who support them through this final stage.

Palliative and end-of-life care

Access to palliative care and related services remains highly unequal across Quebec and the rest of Canada. Research has shown that immigrants, particularly older adults at the end of life, have less access to palliative care than non-immigrants (24). A diagnosis of a serious illness does not guarantee access to these services, which are frequently concentrated in hospitals and remain difficult to access without a terminal prognosis. Furthermore, many incurable conditions — including neurodegenerative, pulmonary, and age-related illnesses — are not consistently recognized as life-limiting, which limits eligibility for care. This option is also rarely discussed with families, due in part to the difficulty of establishing a prognosis or a failure to communicate it in a timely manner (3, 24).

Conversely, even when palliative care is offered, immigrant caregivers may be reluctant to use it. This hesitation may stem from differing understandings of what palliative care entails — for example, perceiving the discontinuation of treatment as abandonment — or from varying beliefs and values regarding life and death (3, 24). It may also be rooted in a fear that their requests and concerns will not be respected, or that the care provided will fall short of their needs (3, 24). Inaccessible or inflexible care, particularly when language interpretation is unavailable, fails to support immigrant caregivers and instead adds to their overall burden (3).

The decision to accept palliative or end-of-life care can give rise to new challenges. Certain misconceptions among providers can create barriers, notably the belief that immigrant families do not want external services. However, even when families prefer to keep their loved one at home, this does not mean they are refusing professional support (7).

Individuals whose immigration status does not qualify them for public health insurance are often excluded from public end-of-life home care. In these cases, caregivers must manage the continuity of care alone — often hiring private staff, purchasing equipment out-of-pocket, or even considering a return to their country of origin for the final stages of life. Others choose to remain in Canada to stay with their local family network, but must do so without the benefit of public health services (24).

Post-caregiving

The end of the caregiving role often marks the start of a new period of transition — a time when many caregivers must redefine their identity, long built around their role as a supporter. This process can be particularly difficult for those who have carried a heavy burden, as is frequently the case for immigrant caregivers (3). After years dedicated to supporting a loved one, reconnecting with oneself and rebuilding a daily routine can prove difficult. It is therefore both important and relevant to offer caregivers resources and support even after their role has ended.

ECONOMIC, SOCIAL AND CULTURAL INTEGRATION

For immigrant caregivers, integration into a new community and the caregiving trajectory are often mutually influential. This is especially true for newcomers, already juggling multiple responsibilities — finding employment, caring for family, navigating unfamiliar systems (political, educational, healthcare, etc.), seeking credential recognition, and learning the language. Taking on caregiving in this context can significantly hinder the integration process; at the same time, the pressures of integration can diminish a caregiver’s capacity to support their loved one (3).

Language learning

Language proficiency is a central issue in the journey of immigrant caregivers when the local language is neither their native tongue nor one they have mastered. Those still in the process of learning the language face difficulties with social integration and interactions within the host society.

A lack of time — often due to caregiving responsibilities — compounds the difficulty of language acquisition. This is particularly evident in Quebec, where a stipend is provided specifically for full-time participation in French language courses. For immigrant caregivers, committing to the required hours to secure this income creates a significant conflict with their caregiving duties, often stalling their linguistic integration (3).

Employment

Occupational downgrading can significantly affect the career paths of immigrant caregivers, who are more likely than Canadian workers to be employed in positions below their skill level or training (3). In many cases, this is primarily linked to the migration experience. Lack of recognition of foreign credentials or experience further limits access to the types of flexible employment that allow work to be balanced with caregiving (3). Moreover, being forced to reduce working hours to fulfill caregiving duties negatively impacts not only the financial situation of immigrant caregivers, but also their sense of belonging and integration into the host society (3).