That's certainly true for those who are waiting for permanent residency through the caregiver program, but even for those who do have permanent resident status, there's a very top-down decision-making structure within many health care institutions.
Those who are personal support workers or health care aides, certainly from the research I've done, do not feel they're in a place to speak out in terms of their thoughts about what could make the system work better. Certainly those in publicly funded and unionized work environments felt more free to speak up, but the overwhelming trend I saw was of workers who felt that, even as they saw institutional mismanagement, not enough PPE and very low staff-to-resident ratios, they had a limited voice to speak up.
I think that's a space where we need to include their voices in the decision-making processes going forward as we rethink our long-term care institutions in light of the COVID-19 pandemic.