A recently concluded research by the Mission For Migrant Workers (MFMW), revealed that elderly care work is widespread among Migrant Domestic Workers (MDWs) on top of their other household chores. The research findings showed that support for MDWs caring for the elderly is seriously inadequate, thus adversely affecting their well-being. This makes the situation worrisome.
The research entitled
“Migrants and Elderly Care: Investigating the conditions, concerns, and needs of migrant domestic workers who are involved in elderly care and assistance”
was conducted through a survey of more than 1500 MDWs to provide information on the working and living conditions, difficulties encountered, impact on rights and well-being, and needs of migrant domestic workers who are involved in elderly care.
The current situation raises important questions on the ambiguity of domestic work, the rights of domestic workers as workers, family relations, and elderly care work as a social or public responsibility vis-à-vis household responsibility or individual responsibility.
Elderly care provided by MDWs
The research found that as high as 40% of MDWs are engaged in elderly care work with three-quarters (74%) of them taking care of a single elderly person. Two-thirds (61%) of 616 respondents in elderly care have wards who require additional assistance as either they “walk with assistance/assistive device” (31%), are “wheelchair bound” (19%), or “bedridden” (11%).
MDWs in elderly care work provide a wide range of care and assistance to their elderly wards, which include ensuring their food and nutrition, providing various medical-related services, assisting in their personal hygiene, and accompanying the elderly to physical and social activities. Only 10% of the 616 respondents said that they are only responsible for taking care of the elderly. An overwhelming majority (90%) of respondents in elderly care work do not exclusively perform the said task.
On difficulties encountered
It is found that less than half (43%) of the 616 respondents who are currently or used to take care of the elderly received training and most of the training is informal, without accreditation, and not necessarily responsive to the needs of their ward. While formal training is not readily available and expensive, difficulties that MDWs experienced range from communication problems to ill-preparedness to the given task.
One of the difficulties the respondents faced taking care of the elderly is the lack of information on the elderly persons’ condition. “Sometimes, the employers do not tell us the illness, the situation, and the needs of the elderly. I do not know what care she needs and the situation to be aware of. For example, some elderly persons like to throw things or lock the door, and it is hard for us to handle that if the employer did not inform us about it and what to do when the problem arises.” Some employers tend to hide the problems or conditions of the elderly when they interview workers such as suicidal behavior and illnesses such as Parkinson’s disease and dementia. Without sufficient information and knowledge given, MDWs face dangerous situations taking care of the elderly.
On well-being and rights
Performing elderly care work affects the working and living conditions of MDWs mainly in relation to length and regularity of rest days, and sleeping period and arrangements.
The most widespread impact on the wellbeing of MDWs when it comes to elderly care is on rest days and sleeping arrangement. It is found that 2 out 5 of MDWs who take care of the elderly experience problems on rest days and 1 in every 10 of them do not have a day off.
Meanwhile, 28% (171) of the respondents have experienced impact on their sleeping arrangement and hours, with more than half of them saying that they lack sleep and 19% reported not sleeping at all at times for 24 hours. It can be said that 1 out of 3 MDWs in elderly care have issues with sleeping arrangement and hours. In absolute value based on actual population, there are an estimated 7,661 MDWs who at times do not sleep at all while they are taking care of the elderly. At any given day, there are 20 MDWs who takes care of elderly continuously for 24 hours.
Some (19%) or 115 respondents reported their meal breaks being affected. There are MDWs who could only get one or two meals per day (34%) or do not eat at all for the whole day (4%). Which means that 1,094 MDWs who are taking care of elderly experience not eating while doing their task.
Moreover, 39% of the 616 reported physical and mental health issues.
Such a condition can greatly affect the work performance of MDWs. Lack of rest and especially insufficient sleep may have effects on the physical condition and mental alertness of MDWs. These are important to the conduct of their work but more especially with caring for the elderly.
Improve support and protection of MDWs in elderly care
The study concluded that elderly care work is widespread among migrant domestic workers. There is a need to expand and deepen knowledge based on the situation and address concerns to ensure both the elderly and the MDWs are well-assisted and supported.
The findings suggested that MDWs in elderly care experience a wide range of difficulties in relation to the work given to them. Many encounter difficulties resulting from deprivation of information and education, and appropriate training.
It was also pointed out that the well-being of MDWs is sometimes adversely affected by the task they are required to perform. Rest and sleep deprivation is a top concern. The situation needs to be remedied, as such an impact does not only affect their overall well-being but also affects their work in caring for the elderly.
The group recommended the Hong Kong government to take the following steps:
1. Recognize the longstanding participation and contribution of MDWs to elderly services in Hong Kong. Acknowledge the issues and challenges that MDWs face in delivering these services and ensure representation of MDWs in policy-making decisions on elderly care and services;
2. Analyze and align Hong Kong’s policies with international standards as well as other best practices around the world to protect the rights and well-being of both MDWs and elderly people. Review and investigate possible modification to be made on the “Standard Employment Contract” to ensure that MDWs especially those who take care of the elderly get enough rest, sleeping hours, and meal breaks. Enforcement of contract provision on rest days should be enhanced;
3. Educate and raise awareness of employers and household members regarding the potential difficulties that can be encountered while doing elderly care work, the need for effective communication, and the importance of disclosure on the condition of the elderly;
4. Review the effectiveness of the “Pilot Scheme on Training for Foreign Domestic Helpers on Elderly Care” and make prior elderly care training accessible and free for MDWs;
5. Review and revise elderly care framework that shifts this public and social responsibility to private, household-level care where MDWs are mobilized instead.
About the Research
The aging population of Hong Kong has currently necessitated public discussions about elderly care work in the city. While there have been studies on condition of the elderly and trajectory of services needed, studies and conversations on the topic largely ignore the fact that migrant domestic workers also play a role in elderly care work.
Conducted through a survey of more than 1500 MDWs and several focus group discussions among Filipino, Indonesian, Thai, Sri Lankan, and Nepali migrants, the study “ Migrants and Elderly Care: Investigating the conditions, concerns, and needs of migrant domestic workers who are involved in elderly care and assistance” was conducted to expand and deepen knowledge on the situation and hopes to initiate dialogues on MDWs in elderly care as a policy framework and as a social practice.
The research was made possible through the support of the St John’s Cathedral Endowment Fund.
About the MFMW
The Mission For Migrant Workers (MFMW Limited) of St John’s Cathedral is a leading and trusted service provider and partner of Asian migrants and a committed advocate in building a caring and inclusive Hong Kong society.
Established in 1981, the MFMW believes that migrant workers as integral to but marginalized in Hong Kong, deserve care, respect and protection of their rights. MFMW provides crisis assistance services to MDWs in distress, empowers their communities, promotes harmony in households and works for a more multicultural and inclusive Hong Kong.