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“I Can't Do This Alone”: a study on foreign domestic workers providing long-term care for frail seniors at home

Published online by Cambridge University Press:  20 November 2017

Wai Jia Tam ,
Gerald Choon-Huat Koh ,
Helena Legido-Quigley ,
Ngoc Huong Lien Ha  and
Philip Lin Kiat Yap
Wai Jia Tam*
Affiliation:
Department of Education, Geriatric Education and Research Institute, Singapore
Gerald Choon-Huat Koh
Affiliation:
School of Public Health, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
Helena Legido-Quigley
Affiliation:
School of Public Health, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
Ngoc Huong Lien Ha
Affiliation:
Department of Education, Geriatric Education and Research Institute, Singapore
Philip Lin Kiat Yap*
Affiliation:
Department of Education, Geriatric Education and Research Institute, Singapore Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
*
Dr Wai Jia Tam, Medical Officer, Education Research 2 Yishun Central 2, Geriatric Education and Research Institute, Singapore768024. Phone: +65-60878029. Email: tamwaijia@gmail.com.
Correspondence should be addressed to: A/Prof Philip Lin Kiat Yap, Senior Consultant Geriatrician, Department of Geriatric Medicine 90 Yishun Central, Khoo Teck Puat Hospital, Singapore768828. Phone: +65-66022154. Email: yap.philip.lk@alexandrahealth.com.sg
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Abstract

Background:

Foreign domestic workers (FDWs) play an important role in long-term caregiving of seniors at home. However, how FDWs cope with the caregiving demands, the dynamic interaction between familial and FDW caregivers and its impact on care recipients remain largely un-explored. Existing caregiver interventions mainly target familial caregivers; little assistance is available for FDW caregivers. This study explores FDWs’ challenges, coping strategies, and the support they need in caring for seniors.

Methods:

FDWs were recruited from a geriatric ward and outpatient clinic of a tertiary hospital in Singapore. Qualitative in-depth interviews were conducted with 25 FDWs caring for frail seniors and five healthcare staff. Interviews were transcribed and analyzed using thematic analysis.

Results:

FDWs were from Indonesia, Philippines, and Myanmar. Nineteen cared for seniors with dementia (SWDs). We derived six subthemes, clustered into three salient themes: two described social support to FDWs by the senior's family members, two described their coping strategies, and two described their job satisfaction. Those who cared for SWDs faced more difficulties. We derived two family models of care: FDW-centered family dynamics, where family members rely on FDWs to perform most duties, causing poor impact on seniors’ well-being and team-based family dynamics, where family members and FDWs share the caregiving burden, resulting in better impact on seniors’ well-being.

Conclusion:

FDWs face significant challenges in eldercare. Improving FDWs’ access to training courses in eldercare, providing them with more emotional support, engaging employers to create healthy caregiving spaces at home, and improving access to senior care services can be helpful.

Keywords

caregivingdementiaqualitativeforeign domestic workers caring for frail seniors
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 9: Issue Theme: Quality of Care for Frail Older Adults , September 2018 , pp. 1269 - 1277
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Alzheimer's Disease Association (2008). Profiling the Dementia Carer in Singapore. Singapore.Google Scholar
Alzheimer's Disease International (2014). Dementia in the Asia Pacific Region. United Kingdom.Google Scholar
Bai, X., Kwok, T. C. Y., Chan, N. Y. T. and Ho, F. K. Y. (2013). Determinants of job satisfaction in foreign domestic helpers caring for people with dementia in Hong Kong. Health and Social Care in the Community, 21, 472–479. doi: 10.1111/hsc.12029.Google Scholar
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37, 122–147. doi: 10.1037//0003-066X.37.2.122.Google Scholar
Basnyat, I. and Chang, L. (2016). Examining live-in foreign domestic helpers as a coping resource for family caregivers of people with dementia in Singapore. Health Communication, 32, 1–9. doi: 10.1080/10410236.2016.1220346.Google Scholar
Chan, A. H. (2005). Live-in foreign domestic workers and their impact on Hong Kong's middle class families. Journal of Family and Economic Issues, 26, 509–528. doi: 10.1007/s10834-005-7847-4.Google Scholar
Chang, H.-J. (2009). The correlation of home care with family caregiver burden and depressive mood: an examination of moderating functions. International Journal of Gerontology, 3, 170–180. doi: 10.1016/S1873-9598(09)70043-2.Google Scholar
Chang, H.-Y., Chiou, C.-J. and Chen, N.-S. (2010). Impact of mental health and caregiver burden on family caregivers’ physical health. Archives of Gerontology and Geriatrics, 50, 267–271. doi: 10.1016/j.archger.2009.04.006.Google Scholar
Chau, P. H., Woo, J., Kwok, T., Chan, F., Hui, E. and Chan, K. C. (2012). Usage of community services and domestic helpers predicted institutionalization of elders having functional or cognitive impairments: a 12-month longitudinal study in Hong Kong. Journal of the American Medical Directors Association, 13, 169–175. doi: 10.1016/j.jamda.2010.07.011.Google Scholar
Cheng, S. J. (1996). Migrant women domestic workers in Hong Kong, Singapore and Taiwan: a comparative analysis. Asian and Pacific Migration Journal, 5, 139–152.Google Scholar
Cheng, S.-J. A. (2003). Rethinking the globalization of domestic service: foreign domestics, state control, and the politics of identity in Taiwan. Gender and Society, 17, 166–186. doi: 10.1177/0891243202250717.Google Scholar
Chiou, C. J., Chang, H.-Y., Chen, I. P. and Wang, H. H. (2009). Social support and caregiving circumstances as predictors of caregiver burden in Taiwan. Archives of Gerontology and Geriatrics, 48, 419–424. doi: 10.1016/j.archger.2008.04.001.Google Scholar
Chong, A. M. L., Kwan, C. W., Chi, I., Lou, V. W. Q. and Leung, A. Y. M. (2014). Domestic helpers as moderators of spousal caregiver distress. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 69, 966–972. doi: 10.1093/geronb/gbu034.Google Scholar
de la Cuesta-Benjumea, C., Donet-Montagut, T. and Galiana-Gómez de Cádiz, M. J. (2012). “Turning to one's own world”: escape mechanisms employed by immigrant caregivers in Spain for relieving the burden of care. Journal of Transcultural Nursing, 23, 56.Google Scholar
Gallart, A., Cruz, F. and Zabalegui, A. (2013). Factors influencing burden among non-professional immigrant caregivers: a case-control study: caregiver burden in immigrants. Journal of Advanced Nursing, 69, 642–654. doi: 10.1111/j.1365-2648.2012.06049.x.Google Scholar
Huang, C.-Y. et al. (2009). Stressors, social support, depressive symptoms and general health status of Taiwanese caregivers of persons with stroke or Alzheimer's disease. Journal of Clinical Nursing, 18, 502–511. doi: 10.1111/j.1365-2702.2008.02443.x.Google Scholar
Humanitarian Organization for Migration Economics (2015). Home sweet home? Work, life and well-being of foreign domestic workers in Singapore. Available at: http://home.org.sg/homeosg/wp-content/uploads/2017/07/Home-sweet-home_work-life-and-well-being-of-foreign-domestic-workers-in-Singapore.pdf; last accessed October 30, 2017.Google Scholar
Iecovich, E. (2011). What makes migrant live-in home care workers in elder care be satisfied with their job? The Gerontologist, 51, 617–629. doi: 10.1093/geront/gnr048.Google Scholar
Institute, D. G. H. (2013). Study finds that family caregivers of Singapore elderly who rely on foreign domestic workers fare better. Singapore.Google Scholar
Ministry of Manpower (2016). Foreign workers numbers. Available at: http://www.mom.gov.sg/documents-and-publications/foreign-workforce-numbers; last accessed 12 September.Google Scholar
Mould-Quevedo, J. F. et al. (2013). The burden of caring for dementia patients: caregiver reports from a cross-sectional hospital-based study in China. Expert Review of Pharmacoeconomics and Outcomes Research, 13, 663–673. doi: 10.1586/14737167.2013.838029.Google Scholar
National Population Talent Division. (2010). Population White Paper.Google Scholar
Østbye, T., Malhotra, R., Malhotra, C., Arambepola, C. and Chan, A. (2013). Does support from foreign domestic workers decrease the negative impact of informal caregiving? Results from Singapore survey on informal caregiving. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 68, 609. doi: 10.1093/geronb/gbt042.Google Scholar
Rockwood, K. et al. (2005). A global clinical measure of fitness and frailty in elderly people. Canadian Medical Association Journal (Journal de l'Association Medicale Canadienne), 173, 489–495. doi: 10.1503/cmaj.050051.Google Scholar
Seow, J. (2015). Courts see more cases of maids being abused. The Straits Times.Google Scholar
Steffen, A. M., McKibbin, C., Zeiss, A. M., Gallagher-Thompson, D. and Bandura, A. (2002). The revised scale for caregiving self-efficacy: reliability and validity studies. The journals of gerontology. Series B, Psychological Sciences and Social Sciences, 57, P74–P86. doi: 10.1093/geronb/57.1.P74.Google Scholar
The Singapore Family Physician (2013). Distance Learning Course on “Dementia”, Vol. 39. Singapore.Google Scholar
Wee, S.-L., Hu, A. J., Yong, J., Chong, W. F., Raman, P. and Chan, A. (2015). Singaporeans’ perceptions of and attitudes toward long-term care services. Qualitative Health Research, 25, 218–227. doi: 10.1177/1049732314549812.Google Scholar
Yap, L. K. P., Seow, C. C. D., Henderson, L. M. and Goh, Y. N. J. (2005). Family caregivers and caregiving in dementia. Reviews in Clinical Gerontology, 15, 263–271. doi: 10.1017/S0959259806001900.Google Scholar
Yeoh, B. S. A. and Huang, S. (2009). Foreign domestic workers and home-based care for elders in Singapore. Journal of Aging and Social Policy, 22, 69–88. doi: 10.1080/08959420903385635.Google Scholar