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Ang KW, Koh YLE, Wang XF, Yusoff AM, Tan AM, Poh XYC, Zhang N, Tan NC. Pilot cross-sectional study of foreign domestic workers supporting the basic healthcare needs of older persons in the community. BMJ Open 2022; 12:e051877. [PMID: 35351699 PMCID: PMC8961118 DOI: 10.1136/bmjopen-2021-051877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This pilot study aimed to determine the proportions, level of knowledge, anxiety and confidence of foreign domestic workers (FDWs) who were involved in supporting the healthcare needs of older persons with long-term non-communicable diseases. DESIGN The pilot study used a cross-sectional and descriptive design.FDWs who accompanied the older adults attending a primary healthcare setting in Singapore. 100 eligible FDWs' demographic data, knowledge and confidence level of caregiving in food preparation, medication supervision, exercise, blood pressure (BP), blood glucose (BG) monitoring and anxiety level assessed by the Generalised Anxiety Disorder-7 scale were recorded. Descriptive statistics were performed and presented. Items on confidence were regrouped into two groups of 'very' versus 'no/a little/moderate'. Knowledge scores and caregiving tasks were assessed with items on confidence using Mann-Whitney U test and χ2 test, respectively. RESULTS The FDWs were from Indonesia (60%), Philippines (23%) and Myanmar (14%). Their mean age was 33 years with an average of 5.8 years working experience; 62% self-reported previous caregiver training for elderly. The mean age of care-recipients was 81 years. Knowledge of FDWs on BP and BG monitoring was low (<50% answered correctly). Among the 55 FDWs who were required to perform BP monitoring, 45.5% lack confidence. Similarly, 40% of the 30 FDWs were not confident in performing BG monitoring. Those with very high confidence levels had higher knowledge on BP and BG monitoring. Of those who were involved in medication supervision (n=86), 36% lacked confidence. The majority of the FDWs (96%) were not affected by anxiety in managing these healthcare tasks for older persons. CONCLUSION More than half of the FDWs supported healthcare needs of older persons but they had inadequate knowledge and lacked confidence in performing the healthcare-related tasks.
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Affiliation(s)
- Kim Wai Ang
- SingHealth Polyclinics, Singapore
- SingHealth-Duke NUS Family Academic Clinical Programme, Singapore
| | | | | | | | | | | | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore
- SingHealth-Duke NUS Family Academic Clinical Programme, Singapore
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Hoens S, Smetcoren AS. Hiring Live-in Migrant Care Workers: Motivations and Experiences of Older People and their Families. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09351-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Briones-Vozmediano E, Rivas-Quarneti N, Gea-Sánchez M, Bover-Bover A, Carbonero MA, Gastaldo D. The Health Consequences of Neocolonialism for Latin American Immigrant Women Working as Caregivers in Spain: A Multisite Qualitative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218278. [PMID: 33182437 PMCID: PMC7664865 DOI: 10.3390/ijerph17218278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/01/2020] [Accepted: 11/06/2020] [Indexed: 11/16/2022]
Abstract
In Spain, most jobs available for Latin American immigrant women are in intimate labour (caregiving and domestic work). This work is usually performed under informal employment conditions. The objective of this study was to explain how the colonial logic mediates the experiences of Latin American women working in intimate labour in Spain, and the effects of such occupation on their health and wellbeing, using a decolonial theoretical framework. A multi-site secondary data analysis of qualitative data from four previous studies was performed utilizing 101 interviews with Latin American immigrant women working as caregivers in Spain. Three interwoven categories show how the dominant colonial logic in Spain creates low social status and precarious jobs, and naturalizes intimate labour as their métier while producing detrimental physical and psychosocial health consequences for these immigrant caregivers. The caregivers displayed several strategies to resist and navigate intimate labour and manage its negative impact on health. Respect and integration into the family for whom they work had a buffering effect, mediating the effects of working conditions on health and wellbeing. Based on our analysis, we suggest that employment, social, and health protection laws and strategies are needed to promote a positive working environment, and to reduce the impact of caregiving work for Latin American caregivers.
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Affiliation(s)
- Erica Briones-Vozmediano
- GESEC Group, Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain;
- Grup de Recerca en Cures de la Salut, Institut de Recerca Biomèdica de Lleida, 25198 Lleida, Spain
- Global Migration and Health Initiative, Toronto, ON M5T 1P8, Canada; (N.R.-Q.); (D.G.)
| | - Natalia Rivas-Quarneti
- Global Migration and Health Initiative, Toronto, ON M5T 1P8, Canada; (N.R.-Q.); (D.G.)
- Health Sciences Department (Occupational Therapy), Faculty of Health Sciences, University of A Coruña, 15006 A Coruña, Spain
| | - Montserrat Gea-Sánchez
- GESEC Group, Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain;
- Grup de Recerca en Cures de la Salut, Institut de Recerca Biomèdica de Lleida, 25198 Lleida, Spain
- Global Migration and Health Initiative, Toronto, ON M5T 1P8, Canada; (N.R.-Q.); (D.G.)
- Correspondence:
| | - Andreu Bover-Bover
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), 28029 Madrid, Spain;
- Department of Nursing and Physiotherapy, University of Illes Balears, 07122 Mallorca, Spain
| | - Maria Antonia Carbonero
- Department of Philosophy and Social Work, University of Illes Balears, 07122 Mallorca, Spain;
| | - Denise Gastaldo
- Global Migration and Health Initiative, Toronto, ON M5T 1P8, Canada; (N.R.-Q.); (D.G.)
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
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Cohen-Mansfield J, Golander H. Predictors of Migrant Live-in Care Workers' Burden/Burnout and Job Satisfaction When Caring for Frail Older Persons in Israel. J Gerontol B Psychol Sci Soc Sci 2020; 76:1151-1160. [PMID: 33031515 DOI: 10.1093/geronb/gbaa171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To clarify how work characteristics affect migrant live-in care workers' burden/burnout as well as their job satisfaction. METHODS Data from 116 migrant live-in care workers were collected in 2013-2014 in Tel Aviv and Jerusalem through structured interviews about their job satisfaction and their degree of burden/burnout. Due to the conceptual and empirical similarity (zero-order correlation and joint internal reliability), of burden and burnout, the 2 were combined into one variable. These outcome measures were examined in connection with the older person's level of disability, care workers' relationship with the older person, and their employment conditions. RESULTS According to the regression models, work characteristics (care recipients' functional status and care workers' relationship with the care recipient) had a direct impact on burden/burnout. Employment-related variables (employment conditions and satisfaction with those conditions) had an indirect effect. A combination of work characteristics (relationship with the older person) together with the care worker's response to employment conditions (satisfaction with employment conditions) had a direct influence on the care workers' job satisfaction. Problematic employment conditions had an indirect effect. DISCUSSION The results suggest that fostering better relationships and improving employment conditions could help reduce care workers' burden/burnout as well as improve their degree of satisfaction.
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Affiliation(s)
- Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel.,Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Israel
| | - Hava Golander
- Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Israel.,Department of Nursing, The Stanley Seyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
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Ho KHM, Chiang VCL, Leung D, Cheung DSK. A feminist phenomenology on the emotional labor and morality of live-in migrant care workers caring for older people in the community. BMC Geriatr 2019; 19:314. [PMID: 31744456 PMCID: PMC6862863 DOI: 10.1186/s12877-019-1352-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022] Open
Abstract
Background Global societal changes, such as increasing longevity and a shortage of family caregivers, have given rise to a popular worldwide trend of employing live-in migrant care workers (MCWs) to provide homecare for older people. However, the emotional labor and morality inherent in their interactions with older people are largely unknown. The aim of the present study is to understand the corporeal experiences of live-in migrant care workers in the delivery of emotional labor as seen in their interactions with older people by: (1) describing the ways by which they manage emotional displays with older people; and (2) exploring their morality as enacted through emotional labor. Methods We performed a secondary analysis drawing on feminist phenomenology to thematically analyze data from interviews with 11 female MCWs. Follow-up interviews were conducted with 10 participants. The participants had two to 15 years of experience in caring for older people in their homes in Hong Kong. Results Performing emotional labor by suppressing and inducing emotions is morally demanding for live-in MCWs, who experience socio-culturally oppressive relationships. However, developing genuine emotions in their relationships with older people prompted the MCWs to protect the interests of older people. Through demonstrating both fake and genuine emotions, emotional labor was a tactic that live-in MCWs demonstrated to interact morally with older people. Conclusions Emotional labor allowed live-in MCWs to avoid conflict with older people, and to further protect their own welfare and that of others. This study highlights the significance of empowering live-in MCWs by training them in ways that will help them to adapt to working conditions where they will encounter diverse customs and older people who will develop an increasing dependence on them. Thus, there is a need to develop culturally appropriate interventions to empower live-in MCWs to deliver emotional labor in a moral manner.
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Affiliation(s)
- Ken H M Ho
- School of Nursing, Tung Wah College, 31 Wiley Road, Kowloon, Hong Kong SAR
| | - Vico C L Chiang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR.
| | - Doris Leung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | - Daphne S K Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
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Ho KHM, Chiang VCL, Leung D, Ku BHB. When Foreign Domestic Helpers Care for and About Older People in Their Homes: I Am a Maid or a Friend. Glob Qual Nurs Res 2018; 5:2333393617753906. [PMID: 29404382 PMCID: PMC5791470 DOI: 10.1177/2333393617753906] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/05/2017] [Accepted: 12/06/2017] [Indexed: 11/16/2022] Open
Abstract
We examine the lived experiences of foreign domestic helpers (FDH) working with community-dwelling older people in Hong Kong. Unstructured interviews were conducted with 11 female FDHs, and thematically analyzed. The theme inescapable functioning commodity represented the embodied commodification of FDHs to be functional for older people in home care. Another theme, destined reciprocity of companionship, highlighted the FDHs' capacity to commit to home care and be concerned about older people. The waxing and waning of the possibilities of commodified companionship indicated the intermittent capacity of FDHs to find meaning in their care, in which performative nature for functional purposes and emotional engagement took turns to be the foci in migrant home care. This study addresses the transition of FDHs from task-oriented relation to companions of older people through care work. Discussion draws on the development of a kin-like relationship between FDHs and older people with emotional reciprocity grounded in moral values.
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Affiliation(s)
| | | | - Doris Leung
- The Hong Kong Polytechnic University, Hong Kong
| | - Ben H B Ku
- The Hong Kong Polytechnic University, Hong Kong
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Rugolotto S, Larotonda A, van der Geest S. How migrants keep Italian families Italian: badanti and the private care of older people. INTERNATIONAL JOURNAL OF MIGRATION HEALTH AND SOCIAL CARE 2017; 13:185-197. [PMID: 29721036 PMCID: PMC5868556 DOI: 10.1108/ijmhsc-08-2015-0027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 02/02/2017] [Accepted: 02/21/2017] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this paper is to describe how migration affects the care of older people in Italy. Design/methodology/approach The paper is based on anthropological fieldwork by one of the authors. This consisted of in-depth interviews with 20 "badanti" (migrant caregivers), with relatives of older people and with social workers in the city of Verona, Italy. It further included extensive study of secondary materials on the topic of migrant care of older people. Findings Badanti, Italian families and older people find themselves locked in an uneasy contract: badanti because they are exploited and often unable to find better, formal employment; Italian families because they are aware that they fail to render their moral duty to their aged parents and grandparents; and older people because they feel neglected and maltreated by their children. Yet the three parties also rely on each other to make the best of a precarious situation. The relationship between badanti and Italian elderly highlights the contradictions within Italian politics on care and migration. This case study shows how migrants help Italian families to hold on to the tradition of family care for ageing parents. Research limitations/implications The small sample of badanti and families provides a detailed and profound insight of the complexity of elder care in Italy but does not allow generalisation for developments in the country as a whole. Practical implications Policy makers should take notice of the indispensability of informal migrant care in present day Italy. Originality/value The originality of the paper lies in the in-depth conversations with badanti and in the way in which elderly care is contextualised in the Italian tradition of care and present day politics.
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Affiliation(s)
| | - Alice Larotonda
- Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - Sjaak van der Geest
- Department of Medical Anthropology, University of Amsterdam, Amsterdam, The Netherlands
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Lessons for regulating informal markets and implications for quality assurance – the case of migrant care workers in Austria. AGEING & SOCIETY 2015. [DOI: 10.1017/s0144686x1500001x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTThe rising number of private care arrangements in which live-in migrant care workers are engaged as a functional equivalent to family care calls for special attention by policy makers and formal long-term care providers on their implications for quality assurance and professional standards in the long-term care sector. Austria is one of the first countries in Europe where tangible legal measures have been taken to regulate this area under the heading of ‘24-hour care’, typically provided by middle-aged women. Reform measures went beyond policing and control mechanisms, including also incentives and tangible subsidies for all stakeholders. This paper contributes to a better understanding of their impact on the transition from informal to formal economy, focusing on quality assurance and working conditions. Based on empirical data and findings from semi-structured interviews with relevant stakeholders, a framework for the analysis of ‘illegal markets', based on Beckert and Wehinger's theory, is used to discuss potential implications in terms of valuation, competition and co-operation for policy in Austria, and to draw lessons for other countries. Results indicate that even after efforts to ‘legalise’ migrant care, the sector remains a ‘grey’ area within modern labour market legislation and quality management. This is due to the very nature of personal care, low professional status associated with care work and the reluctance of political stakeholders to regulate private household activities.
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