Examining Live-In Foreign Domestic Helpers as a Coping Resource for Family Caregivers of People With Dementia in Singapore

Iccha Basnyat,Leanne Chang

doi:10.1080/10410236.2016.1220346

Abstract

ABSTRACTIn Singapore, the responsibility of caring for persons with dementia falls on family members who cope with a long-term caregiver burden, depending on available support resources. Hiring foreign domestic workers to alleviate caregiver burden becomes a prevalent coping strategy that caregivers adopt. This strategy allows caregivers to provide home care as part of fulfilling family obligations while managing the caregiver burden. This study aimed to investigate primary caregivers’ relationship with hired support and its impact on coping with caregiver burden. Twenty in-depth interviews were conducted with primary caregivers who hired live-in domestic helpers to take care of their family members with dementia. The findings revealed that caregivers perceived the normative obligations to provide home care to family members with dementia. They sought support from domestic helpers to cope with physical and mental burnout, disruption of normal routines, and avoidance of financial strain. A mutual-support relationship was built between caregivers and domestic helpers through trust and interdependence. The presence of domestic helpers as a coping resource reveals the positive outcomes of problem-, emotional-, and diversion-focused coping. This study illustrates that coping strategies are employed in different ways depending on the needs of caregivers, access to infrastructure, cultural expectations, and available resources.

Highlights

According to Alzheimer’s Disease International (2015), over 46 million people live with dementia worldwide and it will become a trillion-dollar disease by 2018
In this study we focus on caregivers’ appraisals and decision making related to the use of hired support as a coping strategy to unveil the dynamic interplay of caregiver burden, filial expectations, and the availability of foreign domestic workers (FDWs) in the local cultural context
In the context of Singapore, there is a cultural emphasis on providing home care by family caregivers to fulfill family obligation

Summary

Introduction

According to Alzheimer’s Disease International (2015), over 46 million people live with dementia worldwide and it will become a trillion-dollar disease by 2018. In Singapore the family home is considered the ideal caregiving space for older parents while nursing homes become the less desirable institutional space (Huang, Yeoh, & Toyota, 2012) In this Confucian society, filial responsibility bounds children to care for their aged parents (Chan, 2011; Lai, 2010). The cultural and structural environments have led foreign domestic workers (FDWs) to become the de facto mode of providing care at home (Tew et al, 2011; Yeoh & Huang, 2009) Situated in this Confucian context that values filial care and downplays institutional assistance, this study seeks to explore how foreign domestic workers become a support resource for family caregivers of persons with dementia. Dementia Caregiving in Singapore In Singapore an estimated 40,000 older adults above the age of 65 (i.e., 10% of the older population) live with dementia and this number is expected to soar to 80,000 by 2030

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