Migrant Caregivers Research Articles

Care and wellbeing across Europe – a research frame for studying migrant families

ABSTRACT All over Europe, the question of sustainable care for the older people gains attention. Although the number of older migrants is increasing significantly, to date only little empirical research deals with migrant family care. In this paper, we thus give an overview of theoretical models on care and wellbeing and adjust them to (different groups of) migrants across Europe. We then present (rare) empirical studies on (in-) formal care and wellbeing, asking: do migrants give/use care more likely than natives and if so, why? Are migrant caregivers more or less burdened compared to non-migrant caregivers? How did the pandemic affect migrant caregivers? Based on our assessments of the state of quantitative research we highlight limitations and propose paths for future research on care in migrant families.

Emotional labor, conflicting caregiving responsibilities and resilience among foreign female caregivers in Japan: A photovoice study

AbstractPrompted by Japan's aging population and the growing demand for migrant female caregivers, this study employs a participatory action research method—photovoice (N = 11) and interviews (N = 9) to investigate the emotional labor, conflicting caregiving responsibilities, and resilience among foreign female caregivers in Japan. A total of 47 photographs and nine interviews were gathered, revealing three main themes with several sub‐themes, such as discrimination, loneliness, ergonomic challenges, and emotional burden. The findings shed light on the stigmatization faced by foreign female caregivers in Japan, who are often perceived as inadequately qualified for their roles. It particularly emphasizes the difficulties they face in balancing their caregiving duties in Japan with the inability to care for their own families back home. Additionally, Japan's stringent immigration policies, patriarchal social structure and the experiences of discrimination further complicate their situation. We recommend that policies and programs focus on improving working conditions (such as reducing workload and increasing wages), supporting family unity, and providing greater flexibility for social integration among migrant caregivers.

Live-in or locked-out: housing of migrant workers before and during COVID-19

This article presents a comparative policy analysis of housing arrangements for migrant caregivers and farmworkers before and during COVID-19. By Juxtaposing structural conditions and industrial sectors, we explore the link between housing and labour migration regime, analysing its implications on migrant workers’ living conditions. Despite substantial differences in housing arrangements, prioritising employers’ needs and ethnonational values over migrant workers’ well-being and rights places migrant workers in both sectors at risk of exploitation. Crisis conditions, such as COVID-19, exacerbate the vulnerability of migrant workers to exploitation. By unpacking the repercussions of disparities between official rights-based housing policy and their implementation, this article seeks to contribute to the literature on the intersection between labour migration and housing policies. Rooted in a structural perspective on labour exploitation, we argue that bridging these disparities and preventing exploitation, while improving migrant workers’ living conditions, requires policymakers to address power imbalances between employers and migrant workers.

Exploring the association between sleep and health performance of migrant home care workers and elderly care recipients in Taiwan

ABSTRACT This study, conducted in June and July 2022 through purposive sampling, aimed to explore the relationship between sleep and health performance in 33 pairs of elderly individuals and their migrant caregivers in southern Taiwan. Participants completed a structured questionnaire and wore an Actiwatch for seven days. Pearson correlation and independent t-test were used for analysis. Nearly 50% of foreign home care workers suffered from insomnia, and 80% of elderly care recipients with disabilities experienced sleep disorders. The number of chronic illnesses and/or dementia among the elderly and insomnia among care workers were associated with poor self-perceived health (r = –0.667, p < .001) and sleep disorders among the elderly (r = 0.368, p = .035). The problem of caregiving should be addressed. Future studies should increase the sample size and extend the duration of the study to enhance the generalizability of the findings.

Family ideology: uneasy entanglements of eldercare in Germany

AbstractMaterial pressures on privatized households are commonly absorbed through a family ideology, according to which members must pool resources and care for each other, while the family relations they thereby nurture are inherently valuable and constitute their own reward. Drawing on my fieldwork on family‐based eldercare in Germany, I explore the implications of this ideology. Specifically, I argue that it mollifies family caregivers’ unease about the injustices of Germany's eldercare system. Family members are entangled in this system as employers of mostly low‐paid, migrant caregivers; as performers of unremunerated care work at high personal costs; and, if they are women, as reproducers of a gendered division of care labour they object to and resent. Because this entanglement is filtered through the lens of family ideology, the focus of family caregivers shifts away from these broader injustices and towards co‐caregiver conflicts as well as expectations from and commitments towards other family members.

Predictors of live-in migrant caregiver employment for people with dementia in Taiwan.

With the increasing number of individuals with dementia, families have hired an increasing number of live-in migrant caregivers (LIMCs). Currently, limited evidence is available regarding the influence of long-term care resource utilization on the hiring of LIMCs for caring for individuals with dementia in Taiwan. We recruited individuals with dementia who did not hire LIMCs and their primary family caregivers from nine hospitals in Taiwan as baseline. Multivariable logistic regression was used to evaluate the utilization of long-term care resources for individuals with dementia and other factors that may affect the decision to hire LIMCs. The users of non-long-term care resources had the highest likelihood of hiring LIMCs (odds ratio [OR] = 4.24, 95% CI, 2.30-7.84). Compared with spouses, nonimmediate family caregivers (OR = 3.40, 95% CI, 1.16-9.90) were significantly more likely to hire LIMCs. A higher likelihood of hiring LIMCs was observed for those with Lewy body dementia compared with other individuals (OR = 2.31, 95% CI, 1.03-5.14). Compared with individuals who did not hire LIMCs, those who hired LIMCs exhibited higher scores on the Neuropsychiatric Inventory (NPI) and higher severity of individual NPI items. Hiring LIMCs is strongly correlated with the utilization of non-long-term care resources and is influenced by the dynamics between individuals with dementia and their primary family caregivers. A higher likelihood of hiring LIMCs was observed for individuals with Lewy body dementia and individuals with elevated NPI scores compared with their counterparts. Given these observations, various support strategies and interventions should be tailored to the specific requirements of individuals with dementia and their families.

Nursing shortage and migration: Insights into the current situation in the Federal State of Saxony, Germany

This paper summarises two qualitative studies that examined the issue of recruiting migrant workers for the healthcare sector in the Federal State of Saxony, Germany. Given the shortage of skilled nursing staff, investigations were conducted to understand the situations and conditions that migrant caregivers are likely to encounter when working in the nursing and care work sectors in Dresden and in the district of Görlitz. These regions were characterised by sparse migrant populations and limited intercultural collaboration at the workplace until 2014/2015, when they witnessed an influx of refugees. To gather relevant data on the issue, problem-focused interviews were conducted with a number of white, German actors engaged in older people's care and in hospitals. A grounded theory-based approach and content analysis were used to analyse the responses. Findings highlighted the presence of racism in exchanges with migrant caregivers. Further, in a field of labour governed by economic constraints, racist practices fostered exclusions, especially when time and human resources were not invested in promoting teamwork. Thus, the working conditions of migrant caregivers can be potentially regarded as precarious, problematic and in need of anti-racist and employee-friendly practices. This work addresses a research gap by examining an issue that is relevant to labour sociology and nursing science in Germany from an anti-racist perspective while analysing specific working conditions. It also offers recommendations for a more promising collaboration that are based on the findings.

The enactment of rhetorical citizenship in a cultural journalism podcast: empowering low-skilled women migrants

ABSTRACT The article examines the enactment of rhetorical citizenship in a cultural journalism podcast that seeks (1) to raise awareness of the exploitation and abuses against intra-EU migrant caregivers (predominantly women) and (2) to reinvest with credibility and agency a woman activist with a contested personal history. The analytical framework draws upon semio-pragmatics, multimodal discourse studies and rhetorical criticism in order to show how rhetorical agency is jointly performed by the producer of the podcast (a woman journalist) and the migrant caregiver within the interaction frame of the podcast dispositive. We show that rhetorical agency is enabled through a balanced articulation of news-style documentary, reportage-specific personal narrative and voice-over commentary, cast in immersive podcast features. The producer combines traditional and alternative journalistic styles, genres and digital technologies to engage listeners, while connecting them to the low-skilled women migrants’ transnational everyday lives and problems, and to their voices and rhetorical acts.

“Honour thy father and thy mother”: the meaning of integrating migrant live-in caregivers for elderly in the Haredi society - challenges and barriers to culturally-sensitive interventions

ABSTRACT Background and Purpose This study seeks to examine the complexities of integrating migrant live-in caregivers for elderly in the Haredi society from the lens of elderly’s family members. The main research questions were – what is the meaning of integrating migrant live-in caregivers for elderly in the Haredi society, and what are the implications of these meanings for developing policies and interventions? Materials and Methods This phenomenological study included 15 adult family members of elderly people from the Haredi society who receive around-the-clock homecare from migrant caregivers. Data was collected through in-depth, semi-structured interviews. Results Three themes emerged from the interviews: The motives of family members to become the prime caregivers for their parents; The encounter between the values of the Haredi family and migrant live-in caregivers; The commandment to honour one’s parents, and whether the integration of a migrant caregiver is implementing this commandment. Conclusions and Implications Results shed light on family members’ attitudes, perceptions and interactions in a phenomenon not yet explored. The importance of these results is highlighted considering the potential conflict between the Haredi society as a faith-based community and migrant live-in caregivers. The results could help develop a culturally-sensitive social policy for faith-based societies.

Caregiving + Migrant Background = Double Jeopardy? Associations between Caregiving and Physical and Psychological Health According to Migrant Backgrounds in Norway.

Informal caregiving can have detrimental consequences for physical and psychological health, but the impacts are highly heterogenous. A largely ignored question is whether these impacts differ with migrant backgrounds, and whether caregiving and a migrant background combine to create double jeopardy. We explored these questions using large-scale data that allows stratification by sex, regional background, and types (inside vs. outside of household) of caregivers. We used cross-sectional 2021 data collected from two Norwegian counties as part of the Norwegian Counties Public Health Survey (N = 133,705, RR = 43%, age 18+). The outcomes include subjective health, mental health, and subjective well-being. The findings show that both caregiving, especially in-household caregiving, and a migrant background relate to lower physical-psychological health. In bivariate analysis, non-Western caregivers, women particularly, reported poorer mental health and subjective well-being (but not physical health) than other caregiver groups. After controlling for background characteristics, however, no interaction exists between caregiver status and migrant background status. Although the evidence does not suggest double jeopardy for migrant caregivers, caution is warranted due to the likely underrepresentation of the most vulnerable caregivers of migrant backgrounds. Continued surveillance of caregiver burden and distress among people of migrant backgrounds is critical to develop successful preventive and supportive intervention strategies for this group, yet this aim hinges on a more inclusive representation of minorities in future surveys.

The epidemiology of paediatric burn injuries in Johannesburg, South Africa

BackgroundChildren remain the most common victim of burns in Sub-Saharan Africa. This study describes the epidemiology of paediatric burn injury among patients admitted to Chris Hani Baragwanath Academic Hospital. MethodsHospital based cross-sectional, prospective study. Results509 patients were admitted to the unit over a 12-month period, with 482 patients included for baseline analysis. 50% of admitted patients were between 15 and 47 months with a median age of 25 months. 58% of participants were male. The predominant mechanism of injury was scalding (84%), in the winter season (32%). The most common site of burn was upper limb (75%). 63% of all admissions received first aid. Among those who received first aid, a described first aid method was provided in 74% of the cases. 226 out of 482 participants (47%) provided sociodemographic information. Access to basic amenities was high, with most admissions coming from households with access to electricity (91%). 90% of caregivers held at least a high school leaving certificate. Migrant caregivers made 19% of the caregivers, which was four times the proportion of foreign nationals counted in the national census. Most admissions (79%) were referrals from other centres as opposed to walk-ins. Severe burns were associated with thermal mechanism of injury, multiple burn sites, and receiving first aid prior to admission. ConclusionChildren under two years of age and children of minority groups are at greatest risk for burn injury and should therefore be targeted for injury prevention strategies and education on appropriate first aid. Level of evidenceAccording to the Journal of pediatric Surgery, this research corresponds to Level II evidence as a prospective study with less than 80% follow-up.

Migrant informal caregiver perceptions and experiences of caring for a family member with dementia: A systematic review and thematic synthesis.

To describe migrant family caregivers' experiences and perceptions of caring for a family member with dementia. There are demographic trends of aging populations and increased migration between countries. Age-associated diseases, such as dementia, are expected to increase, with migrants being at significantly increased risk. Knowledge of how dementia care is provided within migrant families is scarce. Systematic review and thematic synthesis of qualitative research were performed to inform the development of interventions that can acknowledge and respond to the needs, concerns and preferences of migrant family caregivers. Searches were performed in PubMed, PsycINFO and CINAHL and reference lists in published articles were reviewed for the period 2000-October 2020. The CASP checklist for qualitative research was used to assess evidence quality, and the ENTREQ framework was used as a guide for study reporting. Twenty-six articles from 10 Western countries, including 360 informal migrant caregivers from more than 30 countries of origin, were eligible. Within four areas of construct-perceptions of dementia and initial help-seeking; barriers to accessing and using formal dementia care; caregiver burden and coping and resilience-12 descriptive themes were identified. Several concepts cut across the themes, such as language difficulties; the role of the family in relation to care and support; cultural perceptions of dementia and care; stigma, pride and shame; the importance of religion and the importance of trust. The review revealed commonalities among migrant family caregivers that resulted in reduced understanding of dementia and the importance of diagnosis and treatment. To prevent a negative trajectory in caregiving, with perceived demands causing high levels of stress and strain, several barriers to migrants accessing and using formal care need to be assessed and addressed.

Dilemmas around temporariness and transnational recruitment agencies: the case of migrant caregivers in Taiwan and Germany

ABSTRACT The precarious nature of caregivers’ migration is one of the fundamental characteristics of the growing marketisation of home-based care at the transnational level. Against this background, scholars have dedicated increasing attention to the role of private actors involved in the transnational recruitment/employment of migrant caregivers, such as the for-profit agencies, asking whether these intermediaries are a good or a bad thing. In order to understand the dilemmas facing this complex scenario, we interviewed trade unionists, activists, and academic experts in Taiwan and Germany, both of which are countries where the growing care needs of the ageing population are addressed by employing caregivers from abroad. In these interviews, research participants in both countries strongly criticised the emergence of transnational agencies as influential actors in the field and accused them of reproducing an exploitative temporariness of work for migrant caregivers and of the care services they provide, grounded in the temporary dimension of their mobility patterns. The research participants also evaluated the current situation as they tried to imagine alternative arrangements. Advocates for migrant caregivers’ rights expressed intense frustration at the widespread acceptance of today’s situation but they also suggested that other forms of intermediaries and of temporariness might be developed.

Contested skills and constrained mobilities: migrant carework skill regimes in Taiwan and Japan

This article compares the paradoxical conditions of migrant care workers in two major receiving countries in Asia: Taiwan’s policy regime has positioned live-in care workers as “unskilled” foreigners, who nevertheless have gained increasing desirability and mobility in the labor market. By contrast, Japan has maintained the regime of skilled migration but the recent expansion of the trainee program reinforces paternalistic control over migrant caregivers, who are considered culturally inadequate. Contesting the assumption that skills indicate desirability and mobility in the labor market, I argue that we must examine the context-dependent constitution of skills at the intersection of migration, care, and skill regimes. I propose a multifaced framework to examine how the state and intermediary agencies co-produce the skill regime of care migration, including the following dimensions: migrant skills as a political language and structure of governance, care work skills as social and cultural constructions, the infrastructure of recruitment and training, and the consequence of labor market mobility.

The impact of the caregiver mobility on child HIV care in the Manhiça District, Southern Mozambique: A clinical based study.

Manhiça District, in Southern Mozambique harbors high HIV prevalence and a long history of migration. To optimize HIV care, we sought to assess how caregiver's mobility impacts children living with HIV (CLHIV)´s continuation in HIV care and to explore the strategies used by caregivers to maintain their CLHIV on antiretroviral treatment (ART). A clinic-based cross-sectional survey conducted at the Manhiça District Hospital between December-2017 and February-2018. We enrolled CLHIV with a self-identified migrant caregiver (moved outside of Manhiça District ≤12 months prior to survey) and non-migrant caregiver, matched by the child age and sex. Survey data were linked to CLHIV clinical records from the HIV care and treatment program. Among the 975 CLHIV screened, 285 (29.2%) were excluded due to absence of an adult at the appointment. A total of 232 CLHIV-caregiver pairs were included. Of the 41 (35%) CLHIV migrating with their caregivers, 38 (92.6%) had access to ART at the destination because either the caregivers travelled with it 24 (63%) or it was sent by a family member 14 (36%). Among the 76 (65%) CLHIV who did not migrate with their caregivers, for the purpose of pharmacy visits, 39% were cared by their grandfather/grandmother, 28% by an aunt/uncle and 16% by an adult brother/sister. CLHIV of migrant caregivers had a non-statistically significant increase in the number of previous reported sickness episodes (OR = 1.38, 95%CI: 0.79-2.42; p = 0.257), ART interruptions (OR = 1.73; 95%CI: 0.82-3.63; p = 0.142) and lost-to-follow-up episodes (OR = 1.53; 95%CI: 0.80-2.94; p = 0.193). Nearly one third of the children attend their HIV care appointments unaccompanied by an adult. The caregiver mobility was not found to significantly affect child's retention on ART. Migrant caregivers adopted strategies such as the transportation of ART to the mobility destination to avoid impact of mobility on the child's HIV care. However this may have implications on ART stability and effectiveness that should be investigated in rural areas.

Everyday Ethical Challenges and Informal Ethics Support Structures of Migrant Caregivers in Older Adult Care in England

"This paper builds on anthropological fieldwork I conducted in 2019 while living for over two months with migrant caregivers of older adults in Epsom, England. Caregivers’ experiences resonated with existing literature on everyday ethical challenges in caregiving: navigating divergent perspectives on good care, negotiating professional disagreements on treatments, dealing with older adults’ verbal and physical abuse appropriately, and telling older adults ‘white lies’ to avoid mental distress. Caregivers also faced unique ethical challenges because of their migrant identities: dealing with racism, conscientious objecting of certain requests made by older adults, struggling with language when following training and defending themselves against exploitative managers, and carrying the burden of being a translator to fellow migrant colleagues. Based on insight into ethical challenges unique to migrant caregivers, this paper focuses on informal ethics support systems on which migrants relied ‒ an unexplored area in the literature on ethics support within social care ‒ and explores formal ethics support systems that could support migrant caregivers in the future. Existing literature shows that the UK in general lacks ethics support systems to help caregivers recognize and appropriately address ethical challenges. The literature goes on to explore kinds of formal ethics support systems that could address ethical challenges. However, the literature completely overlooks needs and challenges unique to migrant caregivers who increasingly constitute the older adult care workforce in the UK. Understanding everyday ethical challenges and informal support systems of migrant caregivers are important steps in ensuring wellbeing of caregivers, and thus, quality of care. "

(Un)folding places with care: Migrant caregivers ‘dwelling‐in‐folds’

AbstractThis paper is based on longitudinal ethnographic work among Bulgarian migrant women who work as live‐in caregivers and domestic workers in Italian households and explores the analytical potential of place and place making for transmigration literature by conceptualizing the co‐production of place with subjectivities. Such approach sensitizes to mundane practices of care and belonging, which actively create migratory lives of meaning. Drawing on Deleuze's concept of the fold as subjectivity and Clifford's notion of dwelling‐in‐travelling, I propose the term ‘dwelling‐in‐folds’ – and its mechanism ‘folding place’ – in order to make sense of temporary migrants’ experience of place(s) that foregrounds their ability to connect and reconcile fractures and discontinuities, particularly when doing transnational motherhood. In doing so, the paper folds place empirically – showing how ‘dwelling‐in‐folds’ is achieved and unfolds place analytically – demonstrating the potential of this concept for sociology and transmigration studies.

Anti-Immigration Propaganda in the Northern League and the Freedom Party of Austria

&#x0D; &#x0D; &#x0D; Over the past two decades, populist-radical parties of Western Europe arguably re- vised their propaganda towards the rejection of Muslim migrants with gender-sen- sitive arguments. Among these parties, the Northern League (LN) and the Freedom Party of Austria (FPÖ) achieved their electoral breakthrough thanks to their anti-mi- gration campaigns, which, inter alia, aligned peculiar gender perspectives with long- term attitudes towards ethnicity, welfare and Islam. Drawing on the LN’s and FPÖ’s election programmes, visuals and leader statements from the early 2000s, the present article discusses the common assumptions regarding the populist radical right’s dis- cursive changes towards anti-Islamism. The paper argues that the two parties in the mentioned period forged their propaganda against the rejection of Muslim migrants in religious and gender-sensitive terms, but their ethnic and class-oriented exclusions equally remained. The documents in question also revealed that these parties recent- ly softened their attitudes towards migrant caregivers to preserve traditional gender images in Austria and Italy. The LN’s and FPÖ’s long-term preoccupations with Ital- ian and Austrian women’s roles in worklife, family and reproduction are likely to bring about changes in the conceptions of female migrants in the care sector. The question still remains whether the parties began to tolerate Muslim female workers, since their propaganda, in contrast to the literature, did not suggest the acknowledgement of Muslims in any of the labour fields.&#x0D; &#x0D; &#x0D;

COVID-19 Pandemic and Resilience of the Transnational Home-Based Elder Care System between Poland and Germany

ABSTRACT As COVID-19 puts older people in long-term institutional care at the highest risk of infection and death, the need for home-based care has increased. Germany relies largely on migrant caregivers from Poland. Yet the pandemic-related mobility restrictions reveal the deficiencies of this transnational elder care system. This article asks if this system is resilient. In order to answer this question, the research team conducted interviews with 10 experts and randomly selected representatives of brokering and sending agencies in Germany and Poland. We interviewed 13 agencies in Germany and 15 in Poland on the agencies’ characteristics, recruitment strategies, challenges of the pandemic, and impact of legal regulations in the sector. The analysis shows that the system could mobilize adaptive capacities and continue to deliver services, but its absorptive capacity is limited. To enhance resilience, policies working toward formalization and legalization of care services across national borders are required.

Invisible diaspora: A scoping review of migrant caregivers’ social integration trajectory

Background: The Canadian Caregiver program, initiated in 1992, functions to conceal the inadequate public policy and programs on child and elder care in Canada. Consequently, migrant caregivers have become an invisible diaspora filling a domestic labour gap with few protections.&#x0D; Aim and Methods: This scoping review aims to identify the systemic barriers that undermine social integration of migrant caregivers. We searched ten publication index databases from 2001-2020. We retrieved 1,624 articles, after accounting for exclusion criteria, 22 peer-reviewed articles were selected for this review representing migrant women across Canada who are and/or were part of the program.&#x0D; Results: Four key barriers were identified: economic exploitation, deskilling and downward occupational mobility, asymmetrical accountability, and social isolation.&#x0D; Conclusion: Discriminatory policies and hidden exploitative employment practices of the Canadian Caregiver program perpetuate a cycle of marginalization. This review also found that community support groups and alliances function to promote resilience among migrant caregivers through community advocacy.