Erfahrungen von älteren Menschen und deren Familien mit einer Rund-um-die-Uhr Betreuung durch Care MigrantInnen

Abstract

Background: Live-in arrangements with migrant care workers have considerably increased over the last years since they allow older frail persons to age-in-place despite functional limitations. However, little is known about the ramifications live-in care arrangements for families. Aim: The aim of the study was to investigate families’ experience with live-in migrant care workers and indicators of quality from their perspective. Method: Constructivist grounded theory study with 22 families who were recruited via care agencies in the German-speaking part of Switzerland and participated in 29 individual or dyadic interviews. Results: Live-in care by migrant care workers has potentially positive ramifications for older persons and their families, but only so if families, first, reach a consensus about the need for the employment of migrant care workers; second, experience them as competent; and third, mutually forge relationships and negotiate daily life. A successful care arrangement occurs when there is a relational fit among those involved, which leaves families feeling cared for, safe and relieved. They experience a renewed stability in their family system, enriching relationships, and assuredness about the quality present in the care situation. Conclusions: A successful care arrangement is the result of relationships that have been actively created and a negotiated shared existence in a family-like network. It has a positive effect on the well-being of those receiving care and their family members. The family-like network needs competent support.

Ethical harms for migrant 24h caregivers in home care arrangements

“…10 p. 208, own translation) This is aggravated by the fact that, in the eyes of the relatives, the perception and evaluation of competence is particularly characterised by the caring behaviour and compassion of the 'live-in'. 6 She is expected to identify needs and respond to requests with flexibility. 6 External care providers cannot meet this need to the same extent.…”

“…It is, instead, a global market trend (see e.g. Italy, 5 Switzerland 6 and Israel 7 ) that has developed at the interface of changing circumstances (inter alia, changed family structures and labour mobility with decreasing family caregiving potential and an increase in the need for long-term care) and the differing political approaches to safeguarding long-term care. It is estimated that approximately 600,000 Central and East European care migrants are employed in German home care arrangements.…”

“…27 This results in an extraordinary moral pressure because “a live-in often has to realise that she is the only one who feels responsible for the well-being of the person in need of care.” 10 p. 208, own translation) This is aggravated by the fact that, in the eyes of the relatives, the perception and evaluation of competence is particularly characterised by the caring behaviour and compassion of the ‘live-in’. 6 She is expected to identify needs and respond to requests with flexibility. 6 External care providers cannot meet this need to the same extent.…”

“… 6 She is expected to identify needs and respond to requests with flexibility. 6 External care providers cannot meet this need to the same extent. Professional/occupational and private aspects and, thus, professional/job-related and personal duties can become increasingly intermingled over time.…”

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“…However, little is known about family caregivers' motives, understandings, and experiences with regard to live-in care arrangements (exceptions to this are Chiatti et al 2013;Petry et al 2016). This is an important research gap because family caregivers in Switzerland, as well as worldwide, are the backbone of long-term home care.…”