Intensive Caregiving Experience
The demands from family members and the care recipients exerted significant negative impact on the physical and psychological wellbeing of the FDW, primarily manifested through strained relationships. The continual requests from the care recipient's family members, pulling the FDW away from her care recipient, caused initial confusion, physical discomfort and sense of helplessness due to overwhelming demands. Additionally, violent tendencies from both the care recipients and their family members strained the relationship, causing distress for the FDW. Overall, these demands had an adverse effect on the FDW's physical and psychological health.
" She (recipient’s wife) would hit me... Of course, my feelings was hurt.. When I’m doing something, she would bug me to do something else.... I got stressed. I considered jumping down... (C024)
"I was stressed because I had to be wary of him (care recipient)... When I was around him, I would start sweating... He was someone else’s father so when he hit me, I didn’t dare to be angry." (C024)
In order to cope with the distress, the FDW sought normalization of her experiences through her social support system and exerted a locus of control to moderate her Quality of Life (QoL). Seeking advice from friends who had similar caregiving experiences helped her address specific issues related to care. Over time, the FDW gained confidence to stand firm on her beliefs about appropriate care, even in the face of conflicting opinions from the care recipient's family.
" Sometimes, when I have something I want to know, I asked my friends (for their experience). That other time, when there was a lot of phlegm, I asked if they had the same experience. When he shouts, I also asked my friend if her patient shout. She said “People with dementia are like this too. They shout too. " (C024)
Relationship Caregiving Experience Profile
FDWs' experiences were characterized by trusting and family-like relationships with both the care recipient and employer. Generally, they maintained open communication and had a sense of agency in their caregiving role. Viewing care recipients as family, FDWs expressed sympathy, leading to minimal perceived burden. They valued dedicated rest time/days. Despite facing significant demands and cultivating family-like relationships, FDWs remained unaffected personally. This was attributed to their skill in establishing a clear personal boundary, which acted as a buffer against emotional and demanding aspects. This boundary also facilitated their adaptation to caregiving situations, with challenges seen as inherent to their job and not affecting them personally.
"The difficult part was at nighttime. If he screamed, couldn’t sleep, or when he was in pain… that one was the most difficult for me. Difficult because I pitied him… But it’s part of the job, what to do." (C035)
"I mean, just consider it as common thing... This is the risk of looking after an elderly... Because I’m a carefree person. I think that it is normal for my boss to scold me, I don’t care. That’s why if someone is not mentally prepared, more than being “crazy”, (I suggest not to) work overseas... I enjoy working here very much, if not I would have been gone back." (C035)
"Since I was in Singapore, I’ve changed a few employers, and this one is the nicest one... A lot of relaxing time. (…) (It is) law from MOM... since last January, helpers from any country have to be given off-day at least once or more in a month, the main thing is that there’s off-day given. Previously, don’t expect any of that. It was like crazy, really… (I) didn’t get any off-day." (C035)
The ability to adapt increased FDWs' sense of control and self-efficacy, allowing them to optimize caregiving tasks and handle emergencies calmly. Healthcare professional-provided education and training further improved FDWs' self-efficacy, instilling confidence in employers who trusted them with caregiving responsibilities.
"(He’s) very heavy... But I already have the trick, so now I don’t need to lift him. (…) I had an idea to push upwards his legs. Well, just like that. Because when he lies down, he often slips down, so his legs must be lifted. The bed is the same as the one in the hospital, it can be positioned vertical and horizontal. So, I put it in horizontal position then I pushed upwards his legs. Well, only like that. So, it’s easy, I don’t need help (anymore). (C035)
Balanced Profile
FDWs with a balanced experience reported moderate caregiving burden and high benefits. Compared to those with intensive or relationship-based experiences, they faced fewer intensive demands from other family members. Despite managing household chores alongside caregiving, their ability to prioritize and manage time proved beneficial. Autonomy granted by employers empowered them to control their priorities. These FDWs utilized a range of resources, including social support and family-like relationships, both within and outside the workplace. Training and consistent support from healthcare professionals facilitated their assimilation into caregiving duties, contributing to adaptability and resilience.
“Maybe sometimes at 4pm when it’s time to rest, then I rest. If it’s not 4pm yet and the work is not done, even if I’m tired, I will continue to work. I manage my own schedule" (C036)
"Usually, I share with my friends. We share about work, or anything, like if we have family or friend problems, we share and discuss them”. (C038)
" I talk to my employer. Since we don’t have other people around us, so she chose to trust to me, I chose to trust her. I can share to her. She’s open to me, I’m open to her. That’s our relationship as an employer and a worker." (C021)
"... I learned from the nurse and practiced it. Then now to me... taking care of (name of care receipient) is like normal already because I am used to it..." (C032)
Positive appraisal and adaptability were notable in handling stress. FDWs viewed caregiving challenges as manageable, adapting to their duties with a positive mindset. Despite exhaustion, they remained emotionally composed and continued to perform well. Positive beliefs about themselves and their employers boosted confidence in difficult situations. As they came into terms that that every job has its stressors and challenges, FDWs learnt to enjoy the caregiving process despite difficulties faced
" Many things change when taking care of the grandmother, but despite this, I feel that it’s manageable. Whatever happens to the grandmother, I no longer get emotional and I just try my best." (C021)
"Well, having a job (of course) sometimes I feel tired… (I’m a) human. But I’m used to it… My job is just like this." (C022)
"No, we can’t feel stressed. Must learn to enjoy it. Working comes with some level of stress, not always comfortable but just have to go through it. Can’t say it is heavy. " (C018)
" You need to be brave if you are not doing anything wrong. You don’t need to be scared. You need to be confident. If you make mistakes you have to admit your mistakes and apologize for them. Now whatever they are going to say, I will respond as best I can. If they like me, they will keep me, if not they will dismiss me. That’s all on my mind." (C027)
Empathy was a distinct theme for those with a balanced experience, stemming from close relationships. Interestingly, Relationship profile individuals showed sympathy but not empathy, possibly due to a clear personal boundary. FDWs expressed empathy for care recipients and understanding for employers facing challenges. Despite perceiving caregiving as manageable, FDWs acknowledged the risks and uncertainties associated with caring for the elderly. Many were unsure about continuing as caregivers after their contracts ended.
"I love (X) so much. I care for her for so long already... Every time I see her, I cry because of her bed sores. I know it’s painful... every time I clean ah... Then I tell her, “So sorry Ma(ma), I know, I know it’s painful. I know how you feel.” (C032)
"… My boss is kind-hearted… He knows what I have to deal with…because Ah Gong is quite difficult to handle. (My employer) does not demand me to do other chores (…) (He has) never gone out, poor him… He really (cares) about Ah Gong, his father. (…) If Sir seemed stress out, I would just keep quiet, " (C034)
"After my contract ends, maybe 50:50, I would probably prefer to do domestic chores... There is a higher risk taking care of elderly, we never know when he/she will fall, we don’t know what is ahead. There is a definitely a higher risk." (C018)
Satisfied Profile
FDWs exhibiting satisfied profile showed similarities with those in Balanced profile concerning demands, resources, and coping strategies. Those with satisfied profile exhibited notable adaptability, a positive outlook, a well-defined personal boundary and self-efficacy, all of which prove advantageous in managing stressors in the caregiving environment and positively impacting the QoL of FDWs. Similar to other profiles, caregiving demands arising from conditions and characteristics of care recipients are present, often causing distress. Nevertheless, positive mindset and attitude of FDWs seemed to assist them in establishing a clear personal boundary, which, in turn, proves beneficial in mitigating experienced stress.
Despite facing caregiving challenges, FDWs expressed contentment in being able to support their families back home. On the flip side, an excessively positive mindset sometimes leads to a reluctance to share personal feelings with others, even when social support is available. Some FDWs believed that stress would naturally dissipate without discussing it with others. Enhancing the self-efficacy of FDWs with the Satisfied profile was cited as achievable through caregiver training, education, employer instructions, and guidance from healthcare professionals. Additionally, FDWs proactively seek help from professionals when needed.
" I don’t feel stressed because I choose to live happily… Since the grandmother is having dementia and bedridden. There are moments when she pinches and stuff like that. But I can’t do anything about it. I have to be understanding." (C030)
"I don’t feel upset… There’s nothing to feel upset about. (…) I send my salary back to my family. My parents don’t cause me any stress either. Since there’s no reason to. We’re not rich but there’s nothing (to feel stressed about)." (C030)
" When I’m stressed, I don’t talk. I don’t want to talk. (…) I have people I can call, (but) I don’t want to talk... [I: If you don’t talk, does it go away? The stress.] Bit by bit." (C026)
“ I have less stress because of nurses’ instructions and I have more confidence. I really like them. I don’t have to be afraid of them and I can tell them everything and they are really friendly." (C031)
Moreover, the motivation to provide care also plays a role in the adaptability of FDWs with the Satisfied profile, a factor not observed in other profiles. For instance, one FDW shared that her enthusiasm for caring for the elderly stems not from passion but from her religious beliefs.
" I’m used to looking after them. In Taunggyi, we believe that we can receive blessing from taking care of elderly… from Christian religion belief.." (C030)