Live-in Caregivers Research Articles

AND THEN THERE WERE THREE: INCORPORATING A LIVE-IN CAREGIVER INTO THE HOME OF A COUPLE WHERE ONE SPOUSE HAS DEMENTIA

AND THEN THERE WERE THREE: INCORPORATING A LIVE-IN CAREGIVER INTO THE HOME OF A COUPLE WHERE ONE SPOUSE HAS DEMENTIA

Migrant workers and fissured workforces: CS Wind and the dilemmas of organizing intra-company transfers in Canada

Canadian temporary foreign worker programs have been proliferating in recent years. While much attention has deservedly focused on programs that target so-called low-skilled workers, such as seasonal agricultural workers and live-in caregivers, other programs have been expanding, and have recently been reorganized into the International Mobility Program (IMP). Streams within the IMP are quite diverse and there are few legal limits on their growth. One of these, intra-company transfers (ICTs), is not new, but it now extends beyond professional and managerial workers to more permeable and expansive categories. As a result, unions increasingly face the prospect of organizing workplaces where ICTs and other migrant workers are employed alongside permanent employees, raising difficult legal issues and strategic dilemmas. This article presents a detailed case study of one union’s response to this situation.

A Traveling Script: Labor Migration, Precarity, and Performance

Originally performed in Vancouver, the testimonial play Nanay was developed to address the politics and hard ethical dilemmas of caregivers and migrant labor in Canada. When moved from Vancouver to the Philippines, the play was considerably revised with input from the community to consider the problems facing Filipino live-in caregivers from within the context of their home country.

Caught between a rock and a hard place: mental health of migrant live-in caregivers in Canada

BackgroundCanada depends on Temporary Foreign Workers (TFWs), also known as migrant workers, to fill labour shortage in agriculture, hospitality, construction, child/senior care, and other low-skilled occupations. Evidence shows that TFWs, especially women live-in caregivers (LC), constitute a vulnerable population. Their health is compromised by the precarious and harsh working and living conditions they encounter. There is a paucity of research on the mental health of LCs, their support systems and access to mental health services.MethodIn this community-based exploratory study, we used mixed methods of survey and focus groups to explore the work related experiences and mental health of migrant live-in caregivers in the Greater Toronto Area in Ontario, Canada. Convenience and snowball sampling were used to recruit participants. The inclusion criteria were: being 18 years or older, initially migrated to Canada as TFWs under LC program, resided in the Greater Toronto Area, and able to understand and converse in English based on self-report. This paper reports on the focus group results derived from inductive thematic analysis.ResultsA total of 30 women LCs participated in the study. Most of them were from the Philippines. A number of key themes emerged from the participants’ narratives: (1) precarious migration-employment status (re)produces exploitation; (2) deskilling and downward social mobility reinforce alienation; (3) endurance of hardship for family back home; (4) double lives of public cheerfulness and private anguish; and (4) unrecognized mental health needs. The study results reflected gross injustices experienced by these women.ConclusionA multi-faceted approach is required to improve the working and living conditions of this vulnerable group and ultimately their health outcomes. We recommend the following: government inspection to ensure employer compliance with the labour standards and provision of safe working and living conditions; change immigration policy to allow migrant caregivers to apply for permanent residence upon arrival; the TFWs Program to establish fair wages and subsidized housing so that caregivers can truly access the live-out option; and local ethno-specific, settlement and faith organizations be leveraged to provide TFWs with social support as well as information about their rights and how to access health and social care.

A Statistical Approach for Analyzing Residential Isolation and its Determinants for Immigrant Communities: an Application to the Montr\xe9al Metropolitan Region

The aim of this paper is to measure the net propensity to live in isolation for Montréal’s main immigrant communities and to identify specific profiles that are particularly isolated. For that purpose, a statistical approach is used based on individual determinants to compute standardized isolation indexes that take into account the socioeconomic composition of the different groups. The models we developed also reveal how individuals’ characteristics, such as generational status, date of migration, education, language abilities or income, affect their residential isolation. Results reveal that many individual characteristics have strong impacts on residential isolation, and that those impacts are not always the same among immigrant communities. Also, the low propensity to live in isolation observed for all immigrant communities suggests that the place stratification model is probably not relevant to explain the residential dynamics of immigrant communities in Montréal. However, some vulnerable groups are much more likely to live in isolation: Haitian and South Asian with low education, low-income Maghrebis, and Filipinos who arrived via the Live-in Caregivers program. Some wealthy groups are also more isolated, such as Italians arrived before 1981. Therefore, considering this wide heterogeneity among immigrant communities, studies on their residential dynamic should not consider them as a whole.

Strangers No More: Immigration and the Challenges of Integration in North America and Western Europe. By Richard Alba and Nancy Foner. Princeton, NJ: Princeton University Press, 2015. Pp. 336. $35.00 (cloth); $24.95 (paper).

Strangers No More: Immigration and the Challenges of Integration in North America and Western Europe. By Richard Alba and Nancy Foner. Princeton, NJ: Princeton University Press, 2015. Pp. 336. $35.00 (cloth); $24.95 (paper).

Gendered Citizenship: A Case Study of Paid Filipino Male Live-In Caregivers in Toronto

Gendered Citizenship: A Case Study of Paid Filipino Male Live-In Caregivers in Toronto

Differences in Living Arrangements Among Older Adults Transitioning Into the Community: Examining the Impact of Race and Choice.

The federal Money Follows the Person Rebalancing Demonstration program allows nursing home residents to use Medicaid funds for home and community-based services rather than institutional care. Race, choice in housing, and challenges faced prior to transitioning may impact living arrangements following a discharge into the community. This study examines the influence of these factors on living arrangements for 659 program participants age 65 or older. Unmarried Blacks and people with financial or legal challenges are less likely to live with a live-in caregiver or in supervised housing compared with unmarried Whites. Race did not determine living arrangements among married participants, but housing transition challenges did. Findings inform policies targeting nursing home rebalancing efforts by highlighting racial diversity in living arrangements and emphasizing the need for affordable, accessible housing options for older adults of any race seeking to live in the community rather than remain in an institutional setting.

How Do English-speaking Caribbean Immigrants in Toronto Find Jobs?: Exploring the Relevance of Social Networks

INTRODUCTION This paper draws from a doctoral dissertation that examined factors beyond human capital that influenced labour market outcomes for immigrants to Toronto from Jamaica, Guyana, and Trinidad and Tobago. The majority of Canada's immigrants from these three countries live in Toronto. In addition, these immigrants are primarily racialized individuals who possess strong English language skills and high levels of education, training and work experience, but have experienced higher unemployment rates and lower incomes than the Canadian-born population (Colin 2007; James 2009; Preston et al. 2010). The key argument is that for English-speaking Caribbean immigrants, social networks are as important, if not more so, as human capital, for securing meaningful employment in Toronto. Canada's immigration policy seeks to attract immigrants on the basis of their human capital, but largely ignores the demand side factors that relate to how immigrants actually find jobs and does not adequately address factors that allow high-skilled immigrants to find work. The study is based on critical policy research, an inter-disciplinary approach to research that has many dimensions, but this paper is primarily focused on critical race. Critical race theorists investigate notions of race, blackness, and whiteness in the production of societal biases. Traditional critical race theory is focused on an analysis of the social construction of race and racism, and the manner in which people of colour are ordered and constrained in society (Trevino, Harris and Wallace 2008). In the Canadian context, emphasis is placed on examining the manner in which structural and institutional arrangements operate at a disadvantage to racialized groups. Critical race theory, therefore, offers useful insights in how discrimination comes to be structured into Canada's labour market (Galabuzi 2006; James 2009; James, Plaza and Jansen 1999). A number of researchers have expressed concern that Canada's employers may be discriminating against immigrants on the basis of race (Aylward 1999; Block and Galabuzi 2011; Teelucksingh and Galabuzi 2007; Warner 2006). Others have documented that Canada's visible minority immigrants earn lower incomes and have higher unemployment rates than other immigrants and the native-born (Block and Galabuzi 2011; Cardozo and Pendakur 2008; Gilmore 2008; Pendakur and Pendakur 2011; Reitz 2001, 2007). Quantitative studies have also established that poor labour market outcomes for racialized immigrants are linked to racial and gender discrimination (Pendakur and Pendakur 1998; Pendakur and Pendakur 2011). Though not the focus of this study, there are also lessons to be learned from the labour market experiences of Canada's seasonal agricultural workers, live-in caregivers and other temporary foreign workers who have experienced wage discrimination and abusive recruitment practices (Faraday 2014; Satzewich 1991; Tilson 2009). Experimental studies have also found evidence of discrimination, in that resumes from applicants with non-English sounding last names are often excluded at early stages of the job application process (Henry and Ginzberg 1985; Oreopoulos 2011). Qualitative studies of the experiences of nurses in Ontario also found that African-Canadian nurses experienced racism, sexism and classism (Das Gupta 1996; Hagey et al. 2001). Many of Canada's Caribbean immigrants have reported experiences of discrimination in the labour market, which they believe have affected their labour market outcomes (Colin 2007; James 2009; Preston et al. 2010). In each census period from 1996 to 2006, immigrants from the Caribbean experienced higher unemployment rates and lower incomes than the Canadian-born population (Colin 2007). This is the context from which the study examined the lived-experience of English-speaking Caribbean immigrants in Toronto, focusing in part on the obstacles they faced and highlighting the relevance of social networks to their job search. …

Does Canada "Care" about Migrant Caregivers?: Implications under the Reformed Caregiver Program

Domestic and caregiving work have been part of the Canadian fabric since our colonial founding and have long represented one of the most easily accessible routes for migration open to women. Until very recently the Live-In Caregiver Program (LCP) operated as the primary program in Canada facilitating this labour migration. While the LCP has been replaced by the Caregiver Program (CP), it has yet to be determined how these changes will impact migrant caregivers. We suggest that many lessons can be drawn from our knowledge of migrant caregivers' experiences under the LCP that can help us understand the dynamics of new immigration policies. Using the global care chain framework, we consider here whether Canada's caregiver migration policy demonstrates a concern for the wellbeing of migrant caregivers as workers, as family members and as citizens. Our analysis suggests that the CP does not adequately address the concerns raised through the global care chain critique. Rather, the CP continues and deepens the trend of using immigration policy to hold people in substandard employment, with very little care for migrant caregivers whether in terms of their labour rights, their family relationships or their sense of belonging and citizenship.

Places of difference: narratives of heart-felt warmth, ethnicisation, and female care-migrants in Swiss live-in care

Care for the elderly is a contemporary issue of multi-level, feminist concern. In Switzerland, private agencies offer so-called 24-h care services, for which they place or employ mobile women as live-in caregivers in private households. The larger discourse has debated care workers’ movements to Switzerland with much controversy. The article explores this interest in issues of mobility and place in an analysis of three central narratives within the larger discourse: care agencies’ ‘warmth’ discourse, scholarship’s uses of ‘ethnicisation’, and public discussions of ‘female care migrants’. Analysis of the narratives shows how care agencies ascribe care workers a particular ‘heart-felt warmth’ based on their so-called countries of origin. Scholarship’s reference to processes of ‘ethnicisation’ in live-in care illustrates a similar focus on care workers’ characteristics, nation-states, and nationalities. While the public discussion of care workers as ‘female care migrants’ frames care workers’ movements as a migration between discreet and distant places. The article argues that the ways in which the three narratives emphasise the places associated with care workers position these places in terms of difference. From a feminist perspective, this focus on difference is of underlying significance for the perpetuation of fundamental inequities in live-in care. In particular, the discursive differentiation between nation states serves to continually justify lower pay for workers associated with ‘other’ places. As such, the article’s analysis suggests that the discursive invocation of places of difference underlies the marked inequities in Swiss live-in care.

Networks beyond nationalities? Relationships amongst Eastern European women workers in Italy facing the economic crisis

ABSTRACTThis article explores the intricate relationship between Georgian, Ukrainian and Polish women working as live-in elderly caregivers in the province of Reggio Emilia, Italy. Their case shows how both elements of competition and of support can articulate the relationship between national groups that, on the one side, have in common some cultural, linguistic and historical legacies, but, on the other, have a different legal status in the European Union and positions in the Italian labour market for elderly care. In so doing, this article contributes to the debate on migrants’ social networks by pointing to the necessity of further exploring the boundaries that define people’s participation to the same circle of contacts and relationships that constitute their network of reference. From the analysis of 36 in-depth interviews with women of these nationalities, the article shows how the three groups have overlapped through time in the same Italian areas and how they have emulated each other in their migratory trajectories as well as in their employment strategies in the elderly care sector, but it will also underline how in some cases they have competed and been divided, especially beginning in 2008 as a consequence of the economic crisis.

24-hour care: Work and sleep conditions of migrant Filipino live-in caregivers in Los Angeles.

Live-in formal caregivers spend consecutive days in patients' homes, raising questions about their ability to secure adequate sleep while on duty. Few studies have examined sleeping conditions and outcomes for this growing workforce. We collected weeklong sleep logs and interview data from 32 Filipino caregivers in Los Angeles who provide live-in services at least 3 consecutive days per week. Respondents recorded a total average of 6.4 sleep hours during workdays divided over 2.4 sleep periods. Caregivers rated sleep quality as lower while at work; over 40% indicated excessive daytime sleepiness. Female caregivers reported worse sleep outcomes than their male counterparts. Some variations in sleep outcomes were found by employment arrangements. Live-in caregivers experience frequent sleep interruptions at all hours of the day and night to attend to patients' needs. The resulting impacts on sleep quality pose risks for both work-related injury and errors in patient care. Am. J. Ind. Med. 59:1120-1129, 2016. © 2016 Wiley Periodicals, Inc.

Educational attainment of childhood immigrants: how does immigration type matter?

ABSTRACTThis study examines the extent to which the way immigrant parents are selected and admitted matters in the educational attainment of childhood immigrants above and beyond the effects of conventional factors of immigrant vulnerability and resources. Using Canada’s 2011 National Household Survey linked with immigrant landing records, this study finds large differences by admission class in university completion rates for childhood immigrants. Children of skilled workers and business immigrants had much higher university completion rates than children of refugees who, in turn, had higher rates than children of live-in caregivers and in the family class. Advantages or disadvantages associated with the admission class of immigrant parents are passed on to their children, resulting partly from group differences in the education and language ability of parents, and partly from the unique pre- and post-migration circumstances experienced by each immigrant class.

Migrant Nurses and Federal Caregiver Programs in Canada: Migration and Health Human Resources Paradox.

Despite the links between health human resources policy, immigration policy, and education policy, silos persist in the policy-making process that complicate the professional integration of internationally educated nurses in Canada. Drawing on the literature on nurse migration to Canada through the Live-in Caregiver Program, this paper sheds light on the contradictions between immigration and health human resources policy and their effect on the integration of internationally educated nurses in Canada. The analysis reveals a series of paradoxes within and across immigration and health human resources policy that affect the process of professional integration of this group of health professionals into the nursing workforce in Canada. I will further link the discussion to the recently implemented Caregiver Program, which provides a unique pathway for healthcare workers, including nurses, to migrate to Canada. Given recent introduction of the Canadian Caregiver Program, major policy implications include the need to bridge the gap between health human resources policy and immigration policy to ensure the maximum integration of migrant nurses in Canada.

Experiences of Informal Caregivers of Older Adults Transitioned From Nursing Homes to the Community Through the Money Follows the Person Demonstration

ABSTRACTThis study examined experiences of 156 informal caregivers of older adults who transitioned to the community through the Connecticut Money Follows the Person (MFP) Rebalancing Demonstration after prolonged nursing home stays. Caregiver burden, positive aspects of caregiving, depressive symptoms, anxiety, and comparative subjective stress were examined in relation to caregiver demographics and care receiver characteristics with a cross-sectional survey. Caregivers reported low burden, depressive symptoms, and anxiety, and fairly high levels of positive aspects of caregiving and satisfaction with community services. Most caregivers were less stressed compared to the time the care recipient was in, or before they entered, a nursing home. Live-in caregivers experienced more positive aspects of caregiving, but adult children reported higher burden than other caregivers. Unmet service needs also increased caregiver burden. Programs like MFP are a viable option with broadly positive outcomes from a caregiver’s perspective. Enthusiasm for increasing access to community care is growing for older adults who otherwise would reside in nursing homes for extended periods. Identifying unmet service needs and needs for targeted functional support could further enhance caregiver experiences and contribute to the successful transition of older adults to the community.

Long-Term Care of Older Adults in Malta: Influencing Factors and Their Social Impacts Amid The International Financial Crisis

ABSTRACTThis article explores recent changes in long-term care (LTC) for older persons in Malta, resulting from restructuring or other contextual factors related to the international financial crisis. The ageing population continues to grow, while traditional ways of providing care for the ageing population are progressively dwindling. Waiting lists for residential care have grown longer, although public-private partnerships have served to shorten these lists to some degree. Community care services are not keeping pace with need, and the frail elderly wishing to remain in their own homes often cannot do so without significant assistance from other sources.Service recipients fall into four groups: those affording private residential care; those granted a government-subsidized residential bed; those cared for at home by relatives; and those similarly cared for by nonfamily live-in caregivers with (or without) input from family members. Existent data are reviewed and analyzed along with a focus group of 30 stakeholders to explore this topic further. Future recommendations are made and consequences are explored as caregiving options move away from the responsibility of the traditional family system toward greater pressure on state-provided care, use of expensive private care, and waiting lists to secure services.

The perspective of employers/families and care recipients of migrant live-in caregivers: a scoping review.

In high-income countries, migrant live-in caregivers are increasingly in demand to provide health and social care in the home. While there is a wide range of research on the perspectives of live-in caregivers (including domestic workers) in destination countries, few studies address the perspective of families who hire them. The aim of this study was to explore the extent, range and nature of international literature on the needs and experiences of employers/families and care recipients of live-in caregivers. We undertook a scoping review of the literature on this topic using Arksey and O'Malley's five stages. With the assistance of a health science librarian, a comprehensive search of nine databases was undertaken from April to July 2014. Two research assistants independently reviewed 2493 articles. The data were analysed through data charting, numerical summary and thematic analysis. Thirteen articles met the inclusion criteria for the scoping review. Many of these studies (n=7) were conducted in Israel, and the majority (n=8) focus on elderly care recipients. The findings reveal the diverse roles live-in caregivers perform, including emotional and physical care; changes in family dynamics and roles upon hiring a live-in caregiver; the negative experiences, including abuse, of live-in caregivers and elderly care recipients; the positive outcomes for families with a live-in caregiver; and families' common perception that live-in caregivers are like kin, a part of the family. Furthermore, evidence points to some degree of bi-directional emotional support between caregivers and employers/families, which adds complexity to their relations and the negotiation of power.

Filipino migrant stories and trauma in the transnational field

We put to work recent efforts to decolonise trauma theory in the context of our experience of writing and performing in the Philippines our testimonial theatre play about Canada's Live-In Caregiver Program (LCP). The play, a collection of monologues based on verbatim scholarly research transcripts, was performed in Manila in November 2013 and October 2014, first as professional and then community theatre. We think through what it means to move a trauma narrative about family separation from Vancouver to Manila, both in terms of the reception of Canadian-based trauma and how it works in relation to traumas based in the Philippines. As a contribution to the geographies of trauma, we consider efforts to think what it would mean to decolonise trauma studies, and examine how trauma narratives gather other narratives as they travel, the politics of scholars from the Global North soliciting and circulating trauma narratives in the Global South, and the possibilities of building collective politics through individual stories of trauma.

Networked Mobility in the ‘Migration Industry’: Transnational Migration of Filipino Caregivers to Israel

This article examines how labor migration is facilitated and shaped within the neoliberal economy system, focusing on the case of Filipino migration to Israel. For Filipino women who seek to find economic opportunities abroad but lack skills, Israel has emerged as one of the most popular destinations since the mid-1990s, since it is a destination in which they are allowed to work as paid caregivers. In Israel, the caregiver sector occupies the greatest part of the overseas labor market, while providing local senior citizens with live-in caregivers at a cheap cost. In investigating the migration flow of Filipino caregivers to Israel, I draw a special attention to the informal operations of intermediary networks and their roles in initiating and sustaining Filipino migrant flow to Israel. In this article, the intermediary networks involve all those who engage in the migration process such as agents/sub-agents, family, friends, and the friends of their friends. In the context of Israel, where a relatively higher wage is assured for foreign caregivers yet where entry conditions require an exorbitant placement fee, the migration is operated through the complementary roles of a wide range of formal and informal intermediaries. Significantly, such privatization of overseas labor recruitment, characterized by a binding system and an overseas recruitment scheme, contributes to producing power to private agencies, enabling them to impose excessive placement fees on the migrants and control the employment. It is within this context that Filipino women are channeled into the Israel labor market, shaping the current migration flow.