Background In societies with ageing populations, foreign domestic workers are essential to provide care for older people in the community. Despite an increasing trend of employing foreign domestic workers as live-in caregivers to older people, limited research has been done to understand their caregiving experiences and coping strategies. Aims and objectives To explore the caregiving experiences and coping strategies of foreign domestic workers caring for older people in Singapore. Design Descriptive qualitative study. Methods This study was conducted in a large hospital in Singapore. Purposive sampling was used. Participants had to be able to converse in English and employed as foreign domestic workers to provide care to individuals aged 60 years and above, and needed assistance in at least one activity of daily living. Face-to-face in-depth interviews were conducted until data saturation was achieved. Interviews were audio-recorded and transcribed verbatim. Transcribed data were analysed using thematic analysis. Results We interviewed 11 participants. Their mean age was 35 years, and they provided caregiving for about 20 hours daily. Eleven subthemes were identified and were organised into four main themes. These themes were "Juggling with Caregiving and Additional Responsibilities," "Facing Challenges," "Coping strategies" and "Seeking support." Conclusions Findings showed that many foreign domestic workers lacked the needed physical rest and support for them to recharge, and they were stressed caring for older people with behavioural issues. The findings highlighted the need for more physical rest, social support and caregiver training on behavioural management for foreign domestic workers. Relevance to clinical practice The findings could aid the understanding of the challenges and needs of foreign domestic workers and thereafter assist in development of relevant community nursing, social support and training on disruptive behavioural management for foreign domestic workers for them to effectively care for older people in the community.

Caregiving experiences, coping strategies and needs of foreign domestic workers caring for older people.

Aim Using an integrated model of health literacy, we discuss the importance of health literacy among foreign domestic workers in the provision of informal caregiving during outbreaks of communicable diseases. COVID-19 pandemic is used as an example. Background Adequate health literacy in the population is known to be important for the prevention of communicable diseases. Foreign domestic workers, a group of marginalized caregivers in private households, are generally presumed to have limited health literacy because of numerous socio-cultural disadvantages. To date, there is limited evidence that these informal health care providers receive support from community-based nurses. Design A discursive paper. Conclusion Foreign domestic workers, with varying levels of health literacy, may be viewed either as a resource to break the chain of infection or as a potential reservoir of communicable diseases in the community. Meanwhile, restrictions imposed in response to diseases transmissions (e.g., stay-at-home measures for COVID-19) may directly exacerbate the social support received by these foreign domestic works and their ability to access health-related information. There are also concerns about their ability to appraise and evaluate information related to communicable diseases at a time when fake news and misinformation is being disseminated through social media. Language and cultural barriers are important issues that need to be addressed to ensure that foreign domestic workers are in a position to follow public health recommendations. Relevance to clinical practice Nurses hold an important position in empowering foreign domestic workers with adequate health literacy, by engaging groups of foreign domestic workers in the community and their consulates in planning educational programmes and effectively disseminating information. At a time of global pandemic, an assessment of the health literacy levels of foreign domestic workers in places like Hong Kong is urgently required.

A discursive paper on the importance of health literacy among foreign domestic workers during outbreaks of communicable diseases

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. 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. 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. 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.

/pdf/a-feminist-phenomenology-on-the-emotional-labor-and-morality-1psmr21b9o.pdf

A feminist phenomenology on the emotional labor and morality of live-in migrant care workers caring for older people in the community.

Background Indonesians constituted 79% of foreign care workers for long-term care in Taiwan in 2015. Therefore, it is crucial to explore the effect of work stress and quality of life (QoL) on this population.

Purpose This study aims to explore stress levels, social support requirements, and perceived QoL among Indonesian care workers (ICWs) who work in home care settings.

Methods A cross-sectional design was used. Data were collected between 2014 and 2016 from a convenience sample of ICWs working in eastern Taiwan using a self-administered questionnaire that comprised the Stress Perception Scale (SPS), Social Support Scale (SSS), and World Health Organization Quality of Life-Brief scale. One hundred fifty-seven valid questionnaires were collected. The response rate was 80.51%. Data were analyzed using descriptive statistics, one-way analysis of variance, Pearson's correlation coefficient, and multiple regression analysis.

Results The results found that the average SPS of the sample was 70.50, with low QoL scores and requirements for more social support. In addition, significant and positive correlations were found between QoL and SPS, SSS, duration of patient care, and hours of care per week. Stepwise regression analysis showed that the most predictive variables for QoL were time spent caring, preservice training, psychological stress, and emotional support, which together accounted for 60.9% of the total variance.

Conclusions/Implications for Practice This study facilitated understanding of the stress on ICWs and the impact of social support on their QoL. The findings suggest that new immigrants in Taiwan should be introduced to foreign care workers or nursing attendants. Moreover, long-term-care-related teachers should work with home care institutions or agencies to develop a teaching model for innovative care skills to relieve the perceived stress of ICWs.

/pdf/an-exploration-of-factors-related-to-quality-of-life-in-468ds4apn5.pdf

An exploration of factors related to quality of life in Indonesian care workers in home-based care settings

The effectiveness of peer support in improving mental health and well-being has been well documented for vulnerable populations. However, how peer support is delivered to migrant domestic workers (MDWs) to support their mental health is still unknown. This scoping review aimed to synthesize evidence on existing peer support services for improving mental health among MDWs. We systematically searched eight electronic databases, as well as grey literature. Two reviewers independently performed title/abstract and full-text screening, and data extraction. Twelve articles were finally included. Two types of peer support were identified from the included studies, i.e., mutual aid and para-professional trained peer support. MDWs mainly seek support from peers through mutual aid for emotional comfort. The study’s findings suggest that the para-professional peer support training program was highly feasible and culturally appropriate for MDWs. However, several barriers were identified to affect the successful implementation of peer support, such as concerns about emotion contagion among peers, worries about disclosure of personal information, and lack of support from health professionals. Culture-specific peer support programs should be developed in the future to overcome these barriers to promote more effective mental health practices.

/pdf/peer-support-and-mental-health-of-migrant-domestic-workers-a-kx8mgogz.pdf

Peer Support and Mental Health of Migrant Domestic Workers: A Scoping Review

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.

https://journals.sagepub.com/doi/pdf/10.1177/2333393617753906

Ben H B Ku

Papers

When Foreign Domestic Helpers Care for and About Older People in Their Homes: I Am a Maid or a Friend.