Care Drain Research Articles

“Care Drain” from East to West: The Narrative of Romanian Women Migrant Working in the Italian Domestic Care Sector

This study employs a qualitative methodology to investigate the implications of Romanian women’s migration to Italy for employment in the domestic care sector. The research is based on in‐depth interviews conducted face to face with 20 Romanian women who have resided in Italy for over a decade, with the aim of capturing the details of their long‐term integration processes. These interviews, conducted in 2022, specifically focus on the participants’ lived experiences of migration and adaptation within the Italian context. Findings reveal that economic motivations are a primary driver intertwined with aspirations for personal and familial advancement. However, the research also highlights the challenges faced by these women, including precarious employment conditions, emotional strain due to family separation, and complexities of integration within the host society. Social networks and transnational ties emerge as crucial factors influencing both the decision to migrate and the subsequent adaptation process. The analysis underscores the duality inherent in care work migration: While it bolsters the Italian care economy and offers economic opportunities for the migrants, it simultaneously exposes them to vulnerabilities such as job insecurity and potential exploitation. By investigating this migration of care workers, the research contributes to the field of welfare economics by clarifying the economic ramifications of gendered occupational segregation and migration status. Furthermore, it advocates for implementing inclusive labour market practices and policies that prioritize the well‐being of migrant care workers and facilitate their successful integration into host societies.

TRAINING FOR CAREGIVER OF OLDER ADULTS IN ECUADOR: REPORT ON PRESENTIAL, DISTANCE, AND HYBRID MODALITIES

Abstract Caregiving for older adults in Ecuador is provided by family members, professional caregivers as well as untrained domestic workers. All three groups lack access to theoretical and technical training. The accelerating care drain towards Europe and North America, the fast-paced aging in the region as well as increasing trends of North American older adults migration to Ecuador, increase the need for large scale, quality and affordable caregiver training. We report the methods and outcomes of three modalities of training for caregivers of older adults combining over 100 individuals trained over the course of four years: a traditional presential training, which was offered prior to the COVID-19 pandemic; an online modality via Zoom during the pandemic; and the early outcomes of a novel hybrid modality, combining presential and asynchronous video-based learning. We found that social interaction, including the sharing of personal experiences, was an essential part of the training experience, which translated into long-term social bonds and early stages of solidarity networks between participants. Online synchronous training allowed a broader geographical coverage but failed to contribute to socialization as well as generated challenges related to the learning experience and efficacy. The novel modality offered the broad geographical coverage, lowered the cost and allowed socialization. It however created technical and quality control challenges. Training of caregivers is a key component to promote aging in place and age-friendliness. Our experience and conclusion aim to contribute to the future of training in the Global South as well as in the Global North.

Paradoxes in the Invisibility of Care Work

My paper focuses on the theme of visibility by teasing out some paradoxes of invisibility. In the ordinary social world, what is said to be invisible is generally what is here, right before our eyes, but to which we pay no attention. Care is invisible because it goes on without us seeing it. By suddenly making visible what is ordinarily invisible, the COVID pandemic has been a strange pedagogical moment, making visible the people who take care of “us”, and revealing our entire society’s ignorance of what allows it to live—whether in the context of everyday life or in the urgency of the risk of death. The grammar of care has thus imposed itself on everyone, because care is never so visible as in those situations where a form of life is shaken. Care work has been revealed as invisible work that keeps everyone going. “Invisible” does not refer to a difficulty in perceiving but rather a refusal to see. A refusal to see something that is not hidden, but which we do not see precisely because it is right before our eyes. Invisibility is thus denial, in both the social and the theoretical realms, especially when care work is envisioned in the terms of the further invisibilization of care work when it is done for the benefit of women as in the “care drain” from poor to rich countries. The asymmetry in the relations between North and South is part of the invisibility of what sustains societies. The invisible chains of care reveal the extent to which the question of service is the fundamental question of social invisibility.

Workshop: Care4Care: the migrant care workforce in Europe

Abstract Background Foreign trained health workers increasingly fill the care gaps caused by labour market shortage and governance failures. As doctors, nurses and carers they make a crucial contribution to health system performance and the health of the population. These contributions are likely to increase in future, especially in high-income countries, where demographic change and NCDs reinforce the gap between demand for care and labour market supply. However, health system demands for migrant carers do not sit easily with the new wave of nationalism and populist movements in Europe and globally; they may also reinforce the ‘care drain’ in less well-resourced sending countries. There is an urgent need for more inclusive health workforce governance in order to take ‘care’ for the migrant health workforce both nationally and globally and ensure ‘health for all’. Objectives This workshop addresses these questions and fosters critical debate. It has three major aims: to make the migrant carers visible as important part of the health workforce and health system performance, to unmask the threats of growing nationalism and populist movements to healthcare systems and universal healthcare coverage, and finally to critically discuss how to govern the migrant care workforce in ways that improve both integration in the host country and solidarity across Europe and globally. The workshop brings together knowledge and expertise from the areas of health workforce, health services, and health policies and systems. It is organised as round table discussion, facilitated by an overview of migrant care workforce patterns and policies in selected European Union (EU) high-income countries and two in-depth country cases, namely Italy and Austria, both known for growing populism and nationalism and strong anti-migrant policies in the EU. The three panelists will discuss the role of migrant care workers and explore, from different perspectives, how to build capacity for new forms of health workforce governance that move beyond narrowly defined national/regional interests of health systems. The workshop will foster a wider debate on migrant careers and health workforce needs, and how public health can contribute to better take ‘care’ for the human resources for health. Key messages Migrant carers form an important part of the health workforce in European countries. Health systems must take care of the migrant health workforce and counteract growing nationalism.

Care drain and substitute mothering in women’s documentary film: Towards a transnational family model?

This article reads Teodora Ana Mihai’s documentary Waiting for August in the light of recent documentaries focusing on migration, such as Maid in America (2004) and Children in No Man’s Land (2008) by Anayansi Prado, as an approach to a particular form of social violence whose victims are children or teenagers who grow up without immediate adult care across the contemporary global world. I analyse these documentaries by women filmmakers, focusing on the transfer of care from mothers to elder sisters as a result of women’s economic transnational migration. I argue that they promote a model of self-sustaining, responsible motherhood based on women’s strong claim to a life of dignity and self-determination, as opposed to compromising solutions that have long been tolerated and even encouraged by patriarchal societal and political structures.

‘More like a daughter than an employee’: the kinning process between migrant care workers, elderly care receivers and their extended families

ABSTRACTThis paper explores the intersections of formal and informal care in the relationships that develop between elderly care receivers and their families and migrant domestic care workers and their families. The domestic migrant care literature has tended to focus on two main ‘hidden costs’ of this ‘care-chain’: the ‘care exploitation’ of paid carers by their employers and the ‘care drain’ impact on the family members left behind by the migrant. In this paper, we employ a care circulation framework to examine the process of becoming kin-like – or ‘kinning’, which remains relatively under-explored and warrants further research. An analysis of this process of kinning helps to highlight how the domestic space of care receiver homes are transformed – through the negotiation of relationships with migrant care workers – into transnational social fields that bring the diaspora worlds of the migrants into the everyday worlds of the locals.

The Care Drain and its Effects on the Families Left Behind: A Case Study of Sri Lanka

As growing numbers of women from the global South leave behind their own families to take up domestic work in wealthier countries, this shift in care and emotional resources has created a “care drain” in many migrant-exporting nations. Drawing on in-depth interviews with the families of migrant domestic workers in Sri Lanka, this paper examines how the care deficit caused by low-skilled female migration affects family structures, household relations, and the psychosocial wellbeing of migrants’ families. Highlighting the tension between the economic benefits and social costs of migration, the overall findings of this study suggest that despite economic benefits, low-skilled female migration often works to the social and emotional detriment of the families left behind.

Perspectivas sobre género, migraciones transnacionales y trabajo: rearticulaciones del trabajo de reproducción social y de cuidados en la Europa del Sur

El presente trabajo trata de dar cuenta del “estado del arte” y de algunas de las principales cuestiones a debate en relación con la temática de las migraciones trasnacionales y el trabajo reproductivo en el sur de Europa. Se comienza realizando una genealogía del complejo desarrollo teórico que conduce a la consolidación del programa de investigación que vincula la consideración del género con las migraciones transnacionales y las transformaciones del trabajo y de las formas de supervivencia, tanto por lo que hace a los aspectos productivos como reproductivos, en un contexto de globalización. Se presenta el análisis del proceso de reconfiguración multiescalar de la reproducción social y los cuidados, con especial atención a su dimensión global actual, apuntando a que el turning point de esta línea de investigación habría tenido lugar con el inicio de este siglo, con el surgimiento de nociones como las de “cadenas globales de cuidados” (Hochschild, 2001), o “fuga de cuidados” (Ehrenreich y Hochschild, 2013). Asimismo, se reconoce el protagonismo de esta nueva agencia, compuesta ahora en muchos casos por mujeres, que migran a otros países o continentes, precisamente para ocuparse de estas actividades reproductivas. Por último, se alude a algunos de los nuevos desarrollos conceptuales y teóricos en esta materia.

Biała emigracja: variegated mobility of Polish care workers

ABSTRACTThis paper analyzes migration of Polish healthcare and eldercare workers since Poland's accession to the European Union. The research indicates that while many Polish doctors, nurses, and caregivers ‘left’ Poland, they did not necessarily ‘stay’ abroad. Contemporary Polish migration has become ‘liquid’ and has often taken on a form of ‘pendulum’ or ‘circular’ migration and, in some cases, transnational commuting, especially in the early years following Poland's accession to the EU. These patterns are particularly evident among healthcare and eldercare workers whose flexible working schedules or life stages allow for retaining employment positions and households in Poland while taking short-term or prolonged leave of absence to work abroad. The research also suggests that different migration patterns are related to the characteristics of the place of migrant origin and the geographic distance or proximity of the destination countries. Residents of border towns can easily commute to cities on the other side of the frontier, while those who want to work in geographically more distant countries and cities must, by necessity, consider longer-term or permanent arrangements. The analysis of the variegated mobility of elder care workers is situated in the context of policy discussions related to care drain and care supply as well as quality of migrant care.

International migrations and care provisions for elderly people left behind. The cases of the Republic of Moldova and Romania

International migrations are posing numerous challenges to care systems in both sending and receiving countries. Based on a multi-method research conducted between 2011 and 2013, this article looks at how the care provisions for elderly people are rearranged in two Eastern European countries affected by the care drain phenomenon (the Republic of Moldova and Romania). The author charts and compares how transnational families, but also the other facets of the care diamond, such as the public sector, the market and the not-for-profit sector, provide care to elderly people left to cope at home alone because their close relatives have migrated. The main findings of the article are that transnational families are the principal welfare provider for elderly people left behind, while there is a serious delay in the adoption of specific policies for the elderly.

Victims of Care Drain and Transnational Partnering?

ABSTRACTThe paper studies Slovak female elder care workers in Austria. It evaluates the relevance of the care drain metaphor using a representative survey of the carers. It asks two sets of questions: (1) How widespread is the care drain phenomenon? Does migration of elder care workers create care shortages in Slovakia? (2) How do care workers evaluate their employment setting? Is it influenced by experiencing care drain and/or transnational partnering? The higher average age of the care workers means that only a minority has small children in Slovakia. The potential for care drain is therefore limited. Moreover, very few have elderly family members in need of care. On the other hand, most live with partners in Slovakia, so transnational partnering problems could be expected. The average job evaluation of the care workers is highly positive and comparably more enthusiastic than job assessment of women employed in Slovakia. Care workers with small children or partners in Slovakia do not provide a less positive evaluation of the job or its impact on relationships within their families. However, higher earnings and relatively good health of the patient influence the evaluation positively. This focus on earnings and work conditions indicates that care work is probably more similar to other forms of labour migration than anticipated by the current approaches to female migration flows. Indices suggest that these findings could be valid beyond the studied case. A cautious application of the care drain metaphor in intra-EU migration where living standards between countries are not as divergent as between post industrial societies of the West and the Third world is advised.

Motherhood, Agency and Sacrifice in Narratives on Female Migration for Care Work

In this article, I address the stigma associated with female migration in many regions of large-scale female mobility. Showing the use of and the relationship between different narratives of female migration in Western Ukraine, I challenge some of the assumptions of the care drain perspective, and show how this perspective implies a risk of losing sight of female agency in descriptions of female migrants. In many communities of origin for female migrants there is widespread criticism in the media and popular discourse of mothers who leave behind children and enjoy the good life abroad, with claims that female migration happens at the cost of family and children. Due to the stigma produced by this discourse, female migrants who are also mothers often prefer to speak of their decision to migrate as an act of sacrifice. Studies that frame female migrants as mothers tend to reproduce these narratives of sacrifice at the cost of understanding female migration where women go abroad to improve their own lives. As a result, the focus is shifted from the women’s agency and reasons for leaving, to the consequences of their absence.

'We have to be satisfied with the scraps': South African nurses' experiences of care on adult psychiatric intellectual disability inpatient wards.

Migrating nursing labour inadvertently reinforces South Africa's care drain, contributes to a global care crisis and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge. An exploratory descriptive-interpretivist method investigated nurses' experiences of psychiatric intellectual disability work. Sixteen free association narrative interviews were collected in 2013. Thematic analysis allowed findings to emerge from the data. Findings reflect a number of themes: 'relational interaction', 'care burden', 'system fatigue', 'infantilising dynamic of care' and 'resources for coping'. System fatigue contributes more to negative experiences of providing care than direct patient work, and nurses experience more relational reciprocity from patients than from institutional management. Organizations should meet nurses' needs for burnout prevention, afford them impact in implementing institutional controls, and engage in a non-exploitative and non-exclusionary way.

From “brain drain” to “care drain” : Women's labor migration and methodological sexism

The metaphor of “care drain” has been created as a womanly parallel to the “brain drain” idea. Just as “brain drain” suggests that the skilled migrants are an economic loss for the sending country, “care drain” describes the migrant women hired as care workers as a loss of care for their children left behind. This paper criticizes the construction of migrant women as “care drain” for three reasons: 1) it is built on sexist stereotypes, 2) it misrepresents and devalues care work, and 3) it misses the opportunity for a theoretical change about how skills in migration contexts can be understood.

Migration and The Family Transformations It “Leaves Behind”: A Critical View From Ecuador

Increasing awareness has been raised, in a transnational perspective, on the significant effects of an extended separation on the relationships between family members “here” and “there”. Widely debated, in this perspective, is the nexus between parental emigration and the social reproduction of those left behind, with particular respect to dependent children. My article explores along these lines the evolution of “after-migration” intergenerational relationships in Ecuador. In this country a massive, mostly female-led emigration has made the conditions of children left behind increasingly salient, whether for their peculiar vulnerability or the stigmatization they are subject to. Building on my analysis of the Ecuadorian case, I first investigate the changing intra-family roles, relationships and expectations that emerge in Ecuadorian families after mothers’ emigration; second, the interaction between informal caregivers’ and emigrant parents’ initiatives in providing care to left-behind kids; third, the prospects for the lenses of care drain and transnational caregiving to be reconciled with each other as a requisite for more inclusive policies. Overall, this article argues for the need to appreciate the structure of opportunities of home societies as a major influence on transnational family living, and as an optic for advancing the relevant theoretical debate.

Migration and The Family Transformations It “Leaves Behind”: A Critical View From Ecuador

Increasing awareness has been raised, in a transnational perspective, on the significant effects of an extended separation on the relationships between family members “here” and “there”. Widely debated, in this perspective, is the nexus between parental emigration and the social reproduction of those left behind, with particular respect to dependent children. My article explores along these lines the evolution of “after-migration” intergenerational relationships in Ecuador. In this country a massive, mostly female-led emigration has made the conditions of children left behind increasingly salient, whether for their peculiar vulnerability or the stigmatization they are subject to. Building on my analysis of the Ecuadorian case, I first investigate the changing intra-family roles, relationships and expectations that emerge in Ecuadorian families after mothers' emigration; second, the interaction between informal caregivers' and emigrant parents' initiatives in providing care to left-behind kids; third, the prospects for the lenses of care drain and transnational caregiving to be reconciled with each other as a requisite for more inclusive policies. Overall, this article argues for the need to appreciate the structure of opportunities of home societies as a major influence on transnational family living, and as an optic for advancing the relevant theoretical debate.

Care drain: who should provide for the children left behind?

Care drain brings the traditional problem of carers' choice between paid work and family at a new level. Taking care drain from Romania as a case study, I analyse the consequences of parents' migration within a normative framework committed to meeting the needs of vulnerable individuals. The temporary migration of parents who cannot take their children with them involves moral harm, particularly the frustration of children's developmental and emotional needs. I use recent feminist work on justice and care in the economy to address the question whose responsibility it is to fill the void of care created by temporary migration. I argue that the moral issues raised by care drain are also issues of social justice and therefore call for rectification by the states involved.

Love Gain: The Transformation of Intimacy among Foreign Domestic Workers in Singapore

Previous scholarship on the transformation of intimacy among foreign domestic workers has focused mainly on the care/love drain on the children left behind in workers’ countries of origin. It has neglected the ways in which individual domestic workers struggle to gain love and care in destination countries. Among foreign domestic workers who have extended their stays partly because of their bonds with boyfriends, partners, or even “husbands” working in Singapore, the care drain widely observed among the families of foreign domestic workers in their home countries can be coupled not only with monetary gain but also in some instances with a gain in love and care for the foreign domestic workers themselves. A decade of participant observation and qualitative interviews, conducted mainly with domestic workers, also indicated that intimacies are also shaped by Singaporean policies on foreign domestic workers and by the strong economic demand from their families back home.

‘I have a child and a garden’: young people's experiences of care giving in transnational families

This article concerns young people's experiences with care giving when their parents migrate. Drawing on qualitative interviews with 21 young people from Transylvania (Romania), the article examines their accounts of living in transnational families: how the experience of care giving intersects their transitions to adulthood and the personalised meanings young people attach to their actions. This article argues that care giving relationships are more complex than the previous literature on ‘care drain’ and ‘transnational care giving’ has shown. The research demonstrates that young people do act as caregivers, despite traditionally being incorporated in the category of ‘children left behind’ and contribute, together with their migrant parents, to the global dynamics of care giving. This article argues that gendered approaches to care provision help to create an adultocratic vision of the position of young people in transnational families. Finally, this article calls for discourses on care giving to incorporate the generational dimension in ways that recognise young people's care giving roles.

The impact of migrant work in the elder care sector: recent trends and empirical evidence in Italy

Italy is characterized by a very high and increasing demand for elder care but, paradoxically, also by a surprisingly low level of public service provision in this sector. Due to current demographic, economic and socio-cultural trends, the potential availability of informal family care has been decreasing while, on the other hand, still strong familistic attitudes have so far limited the emergence of formal—both home and residential—care services. The ‘cash-for-care’ orientation of the Italian welfare system, with direct payments prevailing over in-kind services, has thus gradually developed into a care regime where monetary transfers to dependent (older) people are often used to privately employ migrant care workers. This phenomenon is analyzed in the context of two different studies (EUROFAMCARE and DIPO), in order to understand how migrant care work has been affecting both family care and professional care work in Italy. The main findings suggest that the widespread employment of migrant care workers—propelled by public care allowances—has certainly relieved many families from most burdensome care tasks, but at the same time partly ‘crowded out’ formal care services. Care quality issues remain. however, largely under-investigated, as do care drain effects in sending countries.