Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-23T12:25:41.779Z Has data issue: false hasContentIssue false
  • English
  • Français

Insiders and outsiders: policy and care workers in Taiwan's long-term care system

Published online by Cambridge University Press:  12 November 2015

CHEN-FEN CHEN
CHEN-FEN CHEN*
Affiliation:
Department of Social Welfare, Chinese Culture University, Taiwan.
*
Address for correspondence: Chen-Fen Chen, Department of Social Welfare, Chinese Culture University, 55, Hwa Kang Road, Yang Ming Shan, Taipei 111, Taiwan, ROC E-mail: czf2@faculty.pccu.edu.tw
Get access Rights & Permissions [Opens in a new window]

Abstract

As in many developed countries, foreign care-givers have made up a short-term labour force to help shoulder the responsibilities of older adult care in Taiwan since 1992. This study uses the dual labour market and the occupational segregation theoretical frameworks and a mixed-method approach to examine whether foreign care-givers are supplementary or have replaced Taiwanese care-givers in Taiwan's long-term care (LTC) industry, and to understand better the status of care workers and their influx into the secondary labour market. As of 2012, 189,373 foreign workers joined the care services, compared to 7,079 Taiwanese, indicating they are no longer supplementary. The gap between the dual care system and workforce regulation has resulted in occupation segregation, and the secondary care labour market has been divided into ‘institutional’ and ‘home’ spheres, segregating care-givers into three levels: all Taiwanese care-givers, foreign institutional care-givers, and foreign home care-givers, the latter being the cheapest, most obedient and most adaptable LTC products. This case exhibits the ‘particularistic’ associations between nationality and care-givers’ workplace, which should be abolished. Only by squarely facing the changes and impacts caused by importing workers into the secondary labour market can one propose concrete, effective LTC labour plans and retention policies.

Keywords

foreign care-giverslong-term careolder adultshome careoccupational segregation
Type
Articles
Information
Ageing & Society , Volume 36 , Issue 10 , November 2016 , pp. 2090 - 2116
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, B. 2007. A very private business: exploring the demand for migrant domestic workers. European Journal of Women's Studies, 14, 3, 247–64.Google Scholar
Ayalon, L. 2009 a. Evaluating the working conditions and exposure to abuse of Filipino home caregivers in Israel: characteristics and clinical correlates. International Psychogeriatrics, 21, 1, 40–9.Google Scholar
Ayalon, L. 2009 b. Family and family-like interactions in households with round-the-clock paid foreign carers in Israel. Ageing & Society, 29, 5, 671–86.Google Scholar
Avalon, L. 2009 c. Fears come true: the experiences of older care recipients and their family members of live-in foreign home caregivers. International Psychogeriatrics, 21, 4, 779–86.Google Scholar
Ayalon, L. 2010. The perspectives of older recipients, their family members, and their round-the-clock foreign home caregivers regarding elder mistreatment. Aging & Mental Health, 14, 4, 411–5.Google Scholar
Ayalon, L. 2011. Abuse is in the eyes of beholder: using multiple perspectives to evaluate elder mistreatment under round-the-clock foreign home carers in Israel. Ageing & Society, 31, 3, 499–520.Google Scholar
Berdes, C. and Eckert, J. M. 2001. Race relations and caregiving relations: a qualitative examination of perspectives from residents and nurse's aides in three nursing homes. Research on Aging, 23, 1, 109–26.Google Scholar
Berdes, C. and Eckert, J. M. 2007. The language of caring: nurse's aides’ use of family metaphors conveys affective care. The Gerontologist, 47, 3, 340–9.Google Scholar
Brannon, D., Barry, T., Kemper, P., Schreiner, A. and Vasey, J. 2007. Job Perceptions and Intent to Leave among Direct Care Workers: Evidence from the Better Jobs Better Care Demonstrations. The Gerontologist, 47, 6, 820–9.Google Scholar
Browne, C. V. and Braun, K. L. 2008. Globalization, women's migration, and the long-term care workforce. The Gerontologist, 48, 1, 16–24.Google Scholar
Cangiano, A., Shutes, I., Spencer, S. and Leeson, G. 2009. Migrant Caregivers in Aging Societies: Research Findings in the United Kingdom. Centre on Migration, Policy and Society, University of Oxford, Oxford.Google Scholar
Chen, C. F. 2011 a. Dual long-term care system: the dilemma choice between ethnicity and service quality. Taiwan: A Radical Quarterly in Social Studies, 85, 381–6. (In Chinese)Google Scholar
Chen, C. F. 2011 b. Management or exploitation? The survival strategy of employers of family foreign caregivers. Taiwan: A Radical Quarterly in Social Studies, 85, 89–156. (In Chinese)Google Scholar
Chung, Y. E. 2010. The study on the utilization of dual care resources for the disabled elderly: combine institutional care with foreign caregivers. Master's thesis, Chinese Culture University, Taipei, Taiwan, ROC. (In Chinese)Google Scholar
Colombo, F., Llena-Nozal, A., Mercier, J. and Tjadens, F. 2011. Help Wanted? Providing and Paying for Long-term Care. Organisation for Economic Co-operation and Development, Paris.Google Scholar
Cuban, S. 2013. Deskilling Migrant Women in the Global Care Industry. Palgrave Macmillan, Basingstoke, UK.Google Scholar
Degiuli, F. 2007. A job with no boundaries: home eldercare work in Italy. European Journal of Women's Studies, 14, 3, 193–207.Google Scholar
Doeringer, P. B. and Piore, M. J. 1971. Internal Labor Markets and Manpower Analysis. Lexington, MA: Health.Google Scholar
Doyle, M. and Timonen, V. 2009. The different faces of care work: understanding the experiences of the multi-cultural care workforce. Ageing & Society, 29, 3, 337–50.Google Scholar
Duffy, M., Armenia, A. and Stacey, C. L. (eds.) 2015. Caring on the Clock: The Complexities and Contradictions of Paid Care Work. Rutgers University Press, New Brunswick, New Jersey.Google Scholar
Edwards, R. 1979. Contested Terrain: The Transformation of the Workplace in the Twentieth Century. Basic Books, New York.Google Scholar
England, P. and Folbres, N. 2003. Contracting for care. In Ferber, M. A. and Nelson, J. A. (eds), Feminist Economics Today. The University of Chicago Press, London, 61–79.Google Scholar
Fan, Y. K. 2005. Who is qualified as a migrant worker? Mapping the configuration of the migrant labour market in Taiwan. Master's thesis, National Taiwan University, Taipei, Taiwan, ROC. (In Chinese)Google Scholar
Guba, E. G. and Lincoln, Y. S. 1994. Competing paradigms in qualitative research. In Denzin, N. K. and Lincoln, Y. S. (eds), Handbook of Qualitative Research. Sage, Thousand Oaks, California, 105–17.Google Scholar
Hakim, C. 2000. Work-Lifestyle Choice in the 21st Century: Preference Theory. Oxford University Press, New York.Google Scholar
Harris-Kojetin, L., Lipson, D., Fielding, J., Kiefer, K. and Stone, R. I. 2004. Recent Findings on Frontline Long-term Caregivers: A Research Synthesis 1999–2003. Institute for the Future of Aging Services, Washington DC.Google Scholar
Holt, T. 2002. The Problem of Race in the 21st Century. Harvard University Press, Cambridge, Massachusetts.Google Scholar
Huang, W. C., Chau, T.-T., Hsiao, T. M., Huang, C. F., Wang, P. M., Tseng, S. C. and Chen, S. C. 2003. Prognostic factors related to stroke patients with home health care: a chart review of 202 cases. Taiwan Journal of Family Medicine, 16, 4, 251–9.Google Scholar
Huang, S., Yeoh, B. A. and Toyota, A. 2012. Caring for the elderly: the embodied labour of migrant care workers in Singapore. Global Networks, 12, 2, 195–215.Google Scholar
Kane, R. A., Kane, L. R. and Ladd, C. R. 1998. Nature and purpose of long-term care. In Kane, R. A., Kane, L. R. and Ladd, C. R. (eds), The Heart of Long Term Care. Oxford University, New York, 3–29.Google Scholar
Kemper, P., Heier, B., Barry, T., Brannon, D., Angelelli, J., Vasey, J. and Anderson-Knott, M. 2008. What do direct caregivers say would improve their job? Differences across settings. The Gerontologist, 48, special issue 1, 17–25.Google Scholar
Lan, P. C. 2005. Stratified otherizations: recruitment, training and racialization of migrant domestic workers. Taiwanese Journal of Sociology, 34, 1–57. (In Chinese)Google Scholar
Lan, P. C. 2006. Legal servitude and free illegality: control and exit of migrant workers. Taiwan: A Radical Quarterly in Social Studies, 64, 107–49. (In Chinese)Google Scholar
Lichtenberg, J. 1998. Racism in the head, racism in the world. In Zack, N., Shrage, L. and Sartwell, C. (eds), Race, Class, Gender and Sexuality: The Big Questions. Blackwell Publishers, Malden, Massachusetts, 43–47.Google Scholar
Liu, M. C. 2000. A critique from Marxist political economy on the ‘cheap foreign labour’ discourse. Taiwan: A Radical Quarterly in Social Studies, 38, 59–90. (In Chinese)Google Scholar
Lu, P. C. and Chen, C. F. 2009. Issues and options in vocational qualifications and training requirements for home caregivers in Taiwan: lessons learned from Britain and Japan. Social Policy & Social Work, 13, 1, 185–233. (In Chinese)Google Scholar
Ma, T. C. and Tu, P. Y. 2010. Labour rights in globalization: the import of foreign welfare workers in Taiwan. Hong-Kong Journal of Social Sciences, 38, Spring/Summer, 121–39. (In Chinese)Google Scholar
Massey, D. S., Arango, J., Hugo, G., Kouaouci, A., Pellegrino, A. and Taylor, E. J. 1993. Theories of international migration: review and appraisal. Population and Development Review, 19, 3, 431–66.Google Scholar
McFarlane, L. and McLean, J. 2003. Education and training for direct caregivers. Social Work Education, 22, 4, 385–99.Google Scholar
Miles, R. 2000. Apropos the idea of ‘race’ … again. In Back, L. and Solomos, J. (eds), Theories of Race and Racism: A Reader. Routledge, New York, 125–143.Google Scholar
Ministry of Labor 2015. Annual Report of Foreign Care Workers in Taiwan. Ministry of Labor, Republic of China (Taiwan), Taipei.Google Scholar
Organisation for Economic Co-operation and Development 2005. The OECD Health Project: Long-term Care for Older People. Organisation for Economic Co-operation and Development, Paris.Google Scholar
Pearson, V. I. 2000. Assessment of function in older adults. In Kane, R. L. and Kane, R. A. (eds), Assessing Older Persons. Oxford University Press, New York, 17–48.Google Scholar
Piore, M. J. 1975. Notes for a theory of labor market segregation. In Edwards, R., Reich, M. R. and Gordon, D. (eds), Labor Market Segregation. D. C. Heath and Company, Lexington, Massachusetts, 125–50.Google Scholar
Piore, M. J. 1980. Birds of Passage: Migrant Labour and Industrial Societies. Cambridge University Press, London.Google Scholar
Potter, S. J., Churilla, A. and Smith, K. 2006. An examination of full-time employment in the direct-care workforce. Journal of Applied Gerontology, 25, 5, 356–74.Google Scholar
Redfoot, D. L. and Houser, A. N. 2005. We Shall Travel On: Quality of Care, Economic Development, and the International Migration of Long-term Caregivers. American Association of Retired Persons Public Policy Institute, Washington DC.Google Scholar
Spencer, S., Martin, S., Bourgeault, I. I. and O'Shea, E. 2010. The Role of Migrant Care Workers in Ageing Societies: Report on Research Finding in the U.K., Ireland, the U.S. and Canada. International Organization for Migration, Geneva.Google Scholar
Stone, R. I. 2004. The direct care worker: the third rail of home care policy. Annual Review of Public Health, 25, 521–37.Google Scholar
Stone, R. I. and Dawson, S. L. 2008. The origins of better jobs better care. The Gerontologist, 48, special issue 1, 5–13.Google Scholar
Stone, R. I. and Harahan, M. F. 2010. Improving the long-term care workforce serving older adults. Health Affairs, 29, 1, 109–15.Google Scholar
Stone, R. I. and Wiener, J. M. 2001. Who Will Care for Us? Addressing the Long-term Care Workforce Crisis. The Urban Institute, American Association of Homes and Services for the Aging, Washington DC.Google Scholar
Timonen, V. and Doyle, M. 2010. Migrant caregivers’ relationships with care recipients, colleagues and employers. European Journal of Women's Studies, 17, 1, 25–41.Google Scholar
Tseng, Y. F. 2004. Expressing nationalist politics in a guest-worker program: Taiwan's recruitment of foreign labour. Taiwanese Journal of Sociology, 32, 1–58. (In Chinese)Google Scholar
Ungerson, C. 2004. Whose employment and independence? A cross-national perspective on ‘cash for care’ schemes. Ageing & Society, 24, 2, 189–212.Google Scholar
Walsh, K. and Shutes, I. 2013. Care relationships, quality of care and migrant workers caring for older people. Ageing & Society, 33, 3, 393–420.Google Scholar
Wang, C. Y. 2012. A study of language-teaching for foreign caregivers in the Taiwanese long-term care facilities. Journal of Long-term Care, 16, 2, 159–76. (In Chinese)Google Scholar
Wu, S. C. 2006. The trapped labourer: an analysis of the working conditions and employee–employer relations of foreign domestic workers and the examination of foreign labour policies in Taiwan. Social Policy & Social Work, 10, 2, 1–48. (In Chinese)Google Scholar
Yeoh, B. S. A. and Huang, S. 2010. Foreign domestic workers and home-based care for elders in Singapore. Journal of Aging & Social Policy, 22, 1, 69–88.Google Scholar
Yu, M.-K. 2014. Elucidating service program responses to domestic violence in Taiwan. NTU Social Work Review, 29, 53–96. (In Chinese)Google Scholar