The impact of having foreign domestic workers on informal caregivers of persons with dementia – findings from a multi-method research in Singapore

Abstract

Background Informal caregivers of persons with dementia (PWDs) sometimes engage foreign domestic workers (FDWs) to support their caregiving journey. However, there has not been much research to establish if this is really beneficial. The current study aims to investigate whether engaging FDWs specifically for caregiving of PWDs truly moderates caregiver stress and to explore caregivers’ experiences of engaging FDWs. Methods A multi-method study design with a quantitative and qualitative sub-study was adopted. For the quantitative sub-study, 282 informal caregivers of PWDs were recruited. Propensity score matching analysis was used. For the qualitative sub-study, 15 informal caregivers with FDWs were interviewed. Inductive thematic analysis was conducted. Results The quantitative sub-study confirmed that engaging FDWs did moderate the depressive symptoms of informal dementia caregivers (marginal effect = -3.35, p = 0.0497). However, such support did not affect their caregiving burden, self-efficacy, and perceived positive aspects of caregiving. The qualitative sub-study suggested that engaging FDWs is an ambivalent experience, which entails both support and challenges. Conclusions The current study confirmed previous research findings, that engaging FDWs moderated depressive symptoms among caregivers of PWDs, and it could be through their physical support such as in daily caregiving activities. Policy-makers may consider providing more subsidies to caregivers caring for PWDs with mobility issues to hire FDWs. They may also consider providing training to FDWs on dementia caregiving skills and improving the intake of such training as this might be helpful for both FDWs and caregivers during this journey.

Care Needs Profiles and Their Association with Caregiver Strain among Community-Dwelling Older Adults with Cognitive Impairment

“…Among the controls, financial adequacy and PCI cognitive function were negatively associated with caregiver strain, whereas caregiver education and spousal caregiver were positively associated with caregiver strain. Hiring FDWs was unrelated to caregiver strain, as the recent study reported [28].…”

Exploring a career pathway for home support workers in Ireland: a systematic scoping review of the international evidence

“…Careers of migrant workers: Migrant workers play an indispensable role in providing home support work, especially in high-income countries ( 271 , 272 ). Female migrant domestic workers globally lack opportunities to develop their career and there is a need for tailored employer responses to support fairness and equality ( 273 – 276 ).…”

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

“…37 LIMCs presumably play a collaborative caregiving role within the families of individuals with dementia, effectively mitigating depression symptoms and alleviating caregiver stress. 7,12 Families of individuals with Lewy body dementia are more likely to hire LIMCs than families of individuals with other types of dementia. This observation is consistent with previous research findings suggesting that individuals with Lewy body dementia experience difficulties from their substantial behavioral and psychological symptoms, thus resulting in the higher loss of independence and greater functional impairment.…”

“…These LIMCs provide valuable assistance, which may have positive effects on both the emotional and physical aspects of caregiving. 11–13…”

“…These LIMCs provide valuable assistance, which may have positive effects on both the emotional and physical aspects of caregiving. [11][12][13] In response to the aforementioned shifting dynamics and in accordance to the 1992 Employment Service Act, the Taiwanese government has introduced LIMCs as a vital resource for enhancing home-based care and postponing the institutionalization of older individuals, including those with dementia. This phenomenon is not exclusive to Western societies and is notably observed in multiple Asian countries such as Singapore and Hong Kong.…”