Experiences of Formal and Informal Caregivers of Older Persons in Singapore

Transiting Back Home: Caregivers' Lived Experiences in Caring for Loved Ones on the Nasogastric Tube in the Home-Setting in Singapore

INTRODUCTION

Little is understood about caregivers' lived experiences when first caring for patients on the nasogastric tube at home in an Asian setting. To enhance understanding, our study aimed to chart these caregivers' psycho-emotional evolutions felt during such caregiving experiences in Singapore.

METHOD

Utilizing purposive sampling, a descriptive phenomenological study was performed, with semi-structured interviews of 10 caregivers of persons on nasogastric tube feeding conducted. Thematic analysis was utilized.

RESULTS

Our findings chart four psycho-emotional transitions of a caregiver's journey in nasogastric tube feeding and the cultural dynamics involved-(a) Disruption of Caregivers' Normality: Attempting to Grasp Reality, (b) Encountering Road-Blocks: Despondency Arises and Frustrations Abound, (c) Adjusting to the New Normal: Reclaiming Confidence and Positivity, (d) Thriving and Integrating into the New Normal, and (e) Cultural Dynamics At Play.

DISCUSSION

Our findings illuminate the understanding of caregivers' varying needs, guiding delivery of culturally-congruent caregiver support targeted at each psycho-emotional evolution.

Working Conditions Affecting Home Care Workers' Stress and Turnover Intention

This study explored how working conditions influence the psychological outcomes of paid family and non-family home care workers, focusing on the interaction between institutional and recipient effects. Using data from the 2019 Korean Long-Term Care Survey (N = 998), we performed regression analyses on home care workers' stress and turnover intention. For both types of home care-workers, inadequate working conditions and high occupational hazards influenced stress, while good working conditions and low occupational hazards influenced turnover intention. Overall, the findings suggest that wages, working hours, and work intensity must be reformed in a home care-worker-friendly manner; the wages for home care workers must be raised to a level appropriate to their care work; the services provided by home care workers should be explicitly stipulated; and, to eliminate occupational hazards, environments for fostering cordial relationships between recipients and home care workers must be developed.

Local knowledge and unliveable narratives: How insights from family caregiving narratives can inform locally relevant ageing policy

BACKGROUND AND OBJECTIVES

Accommodating local knowledge in national ageing policy demonstrates a country's intention to preserve local values, including cultural values of older adults' care. However, including local knowledge must provide space for nuanced and adaptive responses to it so that ageing policies can support families in adapting to changes and challenges around caregiving.

RESEARCH DESIGN AND METHODS

This study interviewed members of 11 multigenerational households in Bali to understand the ways family carers use and resist local knowledge about multigenerational caregiving for older adults.

RESULTS

Using qualitative analysis of the interplay between personal and public narratives, we found that narratives of local knowledge provide moral imperatives related to care, which shape expectations and a standard for evaluating the younger generations' behaviour. While most of the participants' accounts fit comfortably with these local narratives, some described challenges in which their life circumstances prevented them from identifying themselves as a virtuous carer.

DISCUSSION AND IMPLICATIONS

Findings provide insight into the role of local knowledge in constructing caregiving function, carers' identities, family relationships, families' adaptation, and the influence of social structure (e.g., poverty and gender) on caregiving issues in Bali. These local narratives both confirm and dispute findings from other locations.

Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study

BACKGROUND

Hospital at Home (HaH) programs have been shown to improve clinical outcomes, quality of care, and patient satisfaction. However, how Asian patients experience HaH remained underexplored.

OBJECTIVE

To explore the perceptions and experiences of patients and caregivers admitted to a hospital-at-home program in Singapore.

DESIGN

Descriptive qualitative study design.

PARTICIPANTS

Purposive sampling was used to conduct 36 interviews with 13 patients, nine Legally Acceptable Representatives (LARs), and 14 caregivers until data saturation was achieved.

INTERVENTIONS

NUHS@Home is a HaH program providing care through a multi-disciplinary team, enabled by remote vital signs monitoring through a tablet and wireless blood pressure and oxygen meters.

APPROACH

This study used in-depth semi-structured individual interviews. Interviews were transcribed and thematically analyzed using Braun and Clark's six-step inductive approach.

KEY RESULTS

The overarching theme identified was "Enablers, difficulties, and improvements to the HaH experiences" which was supported by three key themes: (1) Perceived better care at home, (2) Importance of social support, and (3) Organizational structures required to support HaH. Participants described overall HaH experiences around factors contributing to their impeding engagement, overall satisfaction, and quality of care.

CONCLUSIONS

Although HaH is unfamiliar to the Singapore population, most of the participants in this study had an overall positive experience. The key challenges found in this paper were the stress and inconvenience caused to caregivers. The enablers for positive HaH experiences were (1) consideration of patient's family members as key participants in the patients' therapeutic alliance; (2) the HaH care team must be accessible, approachable, and reassuring, and communicate frequently and timely with patients and their families; and (3) financing strategies to ensure HaH out-of-pockets costs remain affordable which are critical to keeping HaH as an option for patients and families.

A Descriptive Qualitative Study of Foreign Caregivers of Older Adult Stroke Survivors

BACKGROUND AND OBJECTIVES

With a growing aging stroke population and the changing structure of the society, the demand for foreign caregivers has rapidly increased in Taiwan and many other developed countries. However, little is known regarding the perception, values, and abilities of foreign caregivers and how those may influence their quality of care. This study aimed to explore and describe the experiences of Indonesian foreign caregivers, the largest migrant working population in Taiwan, who reside with and provide support to older adults with stroke and their families.

RESEARCH DESIGN AND METHODS

By adopting a descriptive qualitative approach, we conducted semistructured interviews with 22 Indonesian caregivers (mean age: 36 years) who were providing care to community-dwelling older stroke survivors (age ≥ 65 years) in Taiwan. Data were analyzed through thematic analysis.

RESULTS

Six themes were constructed from the interviews: (a) foreign caregiver's background, (b) foreign caregiver's perception of the health and functional status of stroke survivors, (c) foreign caregiver's values and preferences, (d) consequences of caring for stroke survivors, (e) skills/abilities/knowledge of foreign caregivers to provide stroke survivors with required care, and (f) potential resources that foreign caregivers can use.

DISCUSSION AND IMPLICATIONS

Foreign caregivers described the positive and negative aspects of caring for stroke survivors. Differences in language, religion, culture, values, and expectations between foreign caregivers and stroke survivors influence the caregiving experience. These findings can help Taiwan and other developed countries to better support foreign caregivers providing critical care to older adults with stroke and their families.

Greek Caregivers of Chronically Ill Patients Struggling in Everyday Life

BACKGROUND

Caregivers of chronically ill geriatric patients face several problems throughout the disease progression of the patients under their care. This is a prospective crosssectional study conducted from September 2017 to September 2018, including 130 caregivers of geriatric patients from Attica, Greece.

OBJECTIVES

This study investigates caregivers' anxiety, perception of changes in their lives, and quality of life.

METHODS

The questionnaires administered were the revised Bakas Caregiving Outcomes Scale (rBCOS), the State-Trait Anxiety Inventory (STAI), and the Linear Analogue Scale Assessment (LASA).

RESULTS

Influencing factors associated with rBCOS, STAI and LASA were care timespan and energy levels. Only the State Anxiety Scale and the Patient-caregiver Relationship rBCOS questionnaire seemed to be affected by a cancer diagnosis.

CONCLUSION

Our findings revealed that anxiety, low quality of life, and perception of changes in the lives of caregivers are the underlying factors. Significant factors were time spent caring for the patient, the status of their relationship, the diagnosis, especially in life-threatening and life-limiting diseases, and the caregivers' energy levels. These results are important in order to comprehend the lives of caregivers and assess by what means could the healthcare system and society further assist them.

Technology Acceptance of a Mobile Application to Support Family Caregivers in a Long-Term Care Facility

BACKGROUND

Family caregivers are unpaid individuals who provide care to people with chronic conditions or disabilities. Family caregivers generally do not have formal care-related training. However, they are an essential source of care. Mobile technologies can benefit family caregivers by strengthening communication with care staff and supporting the monitoring of care recipients.

OBJECTIVE

We conducted a mixed-method study to evaluate the acceptance and usability of a mobile technology called the Smart Care System.

METHODS

Using convenience sampling, we recruited 27 family caregivers to evaluate the mobile Smart Care System (mSCS). In the quantitative phase, we administered initial and exit questionnaires based on the Unified Theory of Acceptance and Use of Technology. In the qualitative phase, we conducted focus groups to explore family caregivers' perspectives and opinions on the usability of the mSCS. With the quantitative data, we employed univariate, bivariate, and partial least squares analyses, and we used content analysis with the qualitative data.

RESULTS

We observed a high level of comfort using digital technologies among participants. On average, participants were caregivers for an average of 6.08 years (standard deviation [SD] = 6.63), and their mean age was 56.65 years (SD = 11.62). We observed a high level of technology acceptance among family caregivers (7.69, SD = 2.11). Behavioral intention (β = 0.509, p-value = 0.004) and facilitating conditions (β = 0.310, p-value = 0.049) were statistically significant and related to usage behavior. In terms of qualitative results, participants reported that the mobile application supported care coordination and communication with staff and provided peace of mind to family caregivers.

CONCLUSION

The technology showed high technology acceptance and intention to use among family caregivers in a long-term care setting. Facilitating conditions influenced acceptance. Therefore, it would be important to identify and optimize these conditions to ensure technology uptake.

Applying the RE-AIM framework to evaluate a holistic caregiver-centric hospital-to-home programme: a feasibility study on Carer Matters

Background

Prolonged caregiving of an older adult can cause family caregivers to be overwhelmed, potentially affecting the well-being of both the caregivers and their care-recipients. Carer Matters is a holistic hospital-to-home programme, centred on caregivers’ needs as their care-recipients transit from hospital to home. The programme was piloted to support caregivers through caregivers needs assessment, tailored resources, tele-support, training courses, and community support network. This study aimed to examine the feasibility of Carer Matters in a tertiary hospital in Singapore.

Methods

This feasibility study was conducted on the pilot implementation from January to December 2021, during the Covid-19 pandemic. It adopted the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. The study highlighted quantitative data collected from key process indicators, such as number of caregivers screened, assessed on their needs and provided with assistance. Additionally, qualitative data was collected from in-depth interviews with 51 stakeholders involved in the implementation to examine their perspectives and experiences. These included family caregivers, clinician caregiver support nurses, hospital leaders and community partners.

Results

During the pilot, 550 caregivers were enrolled. All caregivers received educational resources when they completed the needs assessment, while 69 of them who reported high burden were given tele-support and 252 attended our caregiver training courses. Despite initial recruitment challenges and obstacles to adoption, stakeholders interviewed found Carer Matters to be effective in providing caregivers with emotional support, knowledge and skills that improved their caregiving abilities, and reduced their sense of isolation and caregiving stress. Among caregivers, the training courses were effective with majority of caregivers agreeing that the courses addressed their needs (99%) and improved their knowledge of the relevant disease conditions (97%). Programme maintenance considered among stakeholders included strategies such as multipronged approach in recruiting caregivers and inviting caregiver advocates to share their experiences.

Conclusion

This feasibility study highlights that Carer Matters is a valuable component to the ecosystem of support for family caregivers and their care recipients. Carer Matters extends the current patient-centric care model to a more holistic post-discharge continuity of care for both caregivers and their care-recipients, improving and maintaining their overall well-being to better allow transition from hospital-to home.

Trial registration

Feasibility Study of Project Carer Matters for Family Caregivers of Persons with Dementia (NCT number: NCT05205135).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08317-3.

Governance of Assisted Living in Singapore: Lessons for Aging Countries

A global trend toward aging populations means that the challenge of providing adequate long-term care to older people looms large in many countries. In Singapore, a public discourse revolving around the expansion of assisted living to create age-friendly environments in long-term care has emerged. This study examines Singapore's experience in developing regulations for assisted living by documenting the different levels of regulation in place and by identifying the regulatory gaps remaining to govern assisted living. Anchoring in a conceptual framework on the governance of assisted living, different regulatory components of assisted living at the micro-, meso-, and macro-levels are analyzed. Using a case study method, primary and secondary data examining the experiences of governing and implementing assisted living in Singapore were collected. Analysis was conducted using a thematic analysis approach. Micro- and some macro-level regulations, which include admission assessment, staffing, and infrastructural requirements for assisted living, are maturing and evolving, while meso-level regulations, such as operational management, the monitoring framework, and stipulations for training requirements for staff, remain a work-in-progress in Singapore. The regulations for assisted living are currently primarily guided by soft laws, such as practice guidelines; the government has committed toward enacting permanent regulations for all long-term care facilities with the phased implementation of the Health Care Services Act from 2021 to 2023. We conclude that assisted living, despite the early stage of its development in Singapore, is a viable care model that should be expanded to meet the rising demand for care on the part of a majority of older people, who fall in the middle of the care continuum (that is, they can neither live independently nor need complete institutionalization). We also propose five policy recommendations for all aging countries to strengthen the governance of assisted living in long-term care. These include establishing (i) clear provisions on care quality assessment and the redress of grievance, (ii) minimum standards of care, (iii) differential regulations for assisted living, (iv) routine care assessment, and, (v) applying technology in assisted living facilities to address a shortage of care workers.

Work-family balance among caregivers of elderly people: a systematic review

Abstract Introduction Active workers may experience role conflict when trying to reconcile work and caregiving activities with elderly family members. Objective To carry out a systematic review of empirical research on work-family balance among caregivers of the elderly. Method Scopus, PubMed, Scielo, BVS, Web of Science and PsycInfo databases were consulted to identify research published from 2015 to 2020. Results 20 articles were identified and categorized as follows: 1. Caregivers of elderly people with dementia and cancer; 2. Gender; 3. Sandwich Generation and Baby Boomers; and 4. Individual and collective coping strategies. It was highlighted that there are specificities in the work-family balance that can favor both positive and negative spillovers; therefore, they must be considered in the planning of individual and collective strategies. Conclusion In order to favor work-family balance, the choices between work and family responsibilities should be studied, as well as expanding this narrow framework through the analysis of aspects involving gender, biography, cultural norms, social values, economic aspects and political solutions available to these workers.

Equilíbrio trabalho-família entre cuidadores de idosos: uma revisão sistemática

Resumo Introdução Trabalhadores podem vivenciar um conflito de papéis ao tentarem conciliar trabalho e atividades de cuidado com familiares idosos. Objetivo Realizar uma revisão sistemática das pesquisas empíricas sobre equilíbrio trabalho-família entre cuidadores de idosos. Método Foram consultadas as bases de dados Scopus, PubMed, Scielo, BVS, Web of Science e PsycInfo para identificar as pesquisas publicadas no período de 2015 a 2020. Resultados Identificaram-se 20 artigos que foram categorizados da seguinte forma: 1. Cuidadores de idosos com demência e câncer; 2. Gênero; 3. Geração Sanduíche e baby boomers; e 4. Estratégias de enfrentamento individuais e coletivas. Destacou-se que existem especificidades no equilíbrio trabalho-família que podem favorecer tanto o spillover positivo quanto o negativo; por isso devem ser consideradas no planejamento das estratégias individuais e coletivas. Conclusão Para favorecer o equilíbrio trabalho-família, deve-se estudar as escolhas entre os trabalhos e responsabilidades familiares, bem como ampliar esse quadro estreito por meio da análise de aspectos que envolvam gênero, biografia, normas culturais, valores sociais, aspectos econômicos e soluções políticas disponíveis a esses trabalhadores.

Types of Caregiving Experience and Their Association With Caregiver Depressive Symptoms and Quality of Life

ObjectiveThis study examines distinct types of caregiving experience, each formed by varied combinations of caregiving burden and benefits, and their association with caregiver depressive symptoms and quality of life. Methods: We apply latent profile analysis and multivariable regression to data on 278 caregivers participating in the Caregiving Transitions among Family Caregivers of Elderly Singaporeans (TraCE) study in 2019-2020. Results: We identify four caregiving experience types: (1) balanced (low burden and moderate benefits, 40% of caregivers), (2) satisfied (low burden and high benefits, 33%), (3) intensive (high burden and high benefits, 17%), and (4) dissatisfied (moderate burden and low benefits, 10%). Caregivers with dissatisfied and intensive caregiving experience tend to report higher depressive symptoms and lower quality of life compared to those with satisfied caregiving experience. Discussion: A person-centered approach helps capture the heterogeneity in caregiving experience. Policymakers should develop tailored interventions by caregiving experience types for promoting caregiver well-being.

Caregiving and Care Receiving Experiences Among Older Chinese Immigrants and Their Home Health Aide

INTRODUCTION

There is limited information about how racial and cultural similarities or differences between patient and caregiver may affect quality care. The purpose of this study was to explore caregiving and receiving experiences among older Chinese immigrants and their home health aides by using in-depth interviews in culturally concordant dyads in a community setting.

METHODOLOGY

A purposive sample of 10 dyads of older Chinese immigrants and their home health aides were recruited using a snowball sampling method (N = 20). All interviews were audio recorded, transcribed, and coded for qualitative content analysis.

RESULTS

The majority of older adults were female (n = 8) and their average age was 76.8 years. The following themes emerged: companionship and rapport, reconciling the need for care services with the expectations of family, the value of matched gender, language, and ethnic foodculture, assisting with daily routines, and experiencing caregiving burden due to a dual role.

DISCUSSION

This study elucidated the dynamics between care recipients and their caregivers with shared cultural backgrounds.

Exploring the Experience and Determinants of the Food Choices and Eating Practices of Elderly Thai People: A Qualitative Study

Over the past decade, Thailand has experienced a rapid increase in its elderly population. Many unfavorable health outcomes among elderly people are associated with nutrition. Nutrition in elderly people is affected by physical, mental, and social factors. This study explored the food choices and dietary practices among community-dwelling elderly people in Thailand from the perspective of both caregivers and the elderly people themselves. Six focus group discussions and six semistructured interviews were conducted in the Samut Sakhon Province of Thailand. Deductive thematic analyses were conducted based on the “food choice process model framework.” The results show that physical and mental factors and societal factors are important determinants of food choices. Moreover, a changing food environment and economic factors were found to affect food choices. Issues of trust in food safety and food markets were highlighted as growing issues. Therefore, fostering healthy food choice interventions that consider both environmental and societal aspects is necessary.

Supporting the mobilization of health assets among older community dwellers residing in senior-only households in Singapore: a qualitative study

BACKGROUND

Care activities provided by community health practitioners for older adults primarily focused on disease prevention and management. However, healthy longevity can go beyond disease prevention and management and promote greater well-being by tapping into the accrual of resources that older adults possess using the salutogenic approach. This study explored how health resources are used among older adults who are residing in senior-only households to promote and maintain health, with the intent of providing insights into how community health practitioners can support these older adults via asset-based strategies.

METHODS

We adopted a descriptive qualitative study design using focus group discussions. Twenty-seven older adults who either lived alone or with their spouses were purposively sampled from an elderly populated residential estate in Singapore. Six focus group discussions, conducted from December 2016 to May 2017, were audio-recorded, transcribed, and analyzed using thematic analysis.

RESULTS

The themes that emerged were 'tapping on internal self-care repository', 'maintaining and preserving informal social support', and 'enabling self by using environmental aids', and an eco-map of aging assets was used to capture an overview of internal and external resources. With the repository of personal strengths, knowledge, and experiences, these older adults were generally resourceful in navigating around their resource-rich environments to cope with everyday life stressors and promote health. However, they were occasionally limited by individual factors that affected their comprehension, access, maintenance, and utilization of resources.

CONCLUSION

The eco-map of aging assets can be used as an assessment framework by community health practitioners to recognize, consider, and build a repertoire of resources among these older adults. It serves as a gentle reminder to adopt an ecological approach in considering and tapping into older adults' wide-ranging personal, social, and environmental resources. Community health practitioners can support resource integration as resource facilitators via cognitive, behavioral, and motivational salutogenic pathways to overcome resource mobilization barriers faced by older adults. Such an approach helps older adults to find their internal capabilities and abilities to know who, where, what, and how to seek external resources to identify solutions, creating the intrinsic value to sustain their actions on resource utility.

Burden of informal caregivers of dependent elderlies in the community in small cities

AIM

To analyze sociodemographic factors and aspects of care related to the burden of informal caregivers of dependent elderlies in the community.

METHODS

A cross-sectional study with 125 caregivers. Data collection was carried out in municipalities of the Northwest of Rio Grande do Sul through a structured interview in 2017 and 2018. The Caregiver Burden Inventory was used. The Pearson or Spearman correlation coefficients and t-student test or Analysis of Variance (ANOVA) were done. For the multivariate analysis, Linear Regression was used.

RESULTS

Most caregivers were female (73.6%), married (55.2%) and daughters (68.0%). The variables that showed a statistically significant relationship with burden were: caregiver age (p = 0.039), education (p = 0.001), time devoted to care (p = <0.001), kinship degree (p = 0.001), living with the elder (p <0.001), using their income (p = 0.001) and female gender (p = 0.017).

CONCLUSION

Women caregivers, with less education, who spend more time in weekly care and lived with the elder presented higher burden.

Migrant Caregivers of Older People in Spain: Qualitative Insights into Relatives' Experiences

The traditional structure of families is undergoing profound changes, causing the so-called “crisis of family care.” This study describes the experiences and emotions of the family member who hires migrant caregivers for the older people. This is a qualitative study using a phenomenological design with nine women participants between 53 and 72 years of age. The data collection was carried out through two in-depth interviews and a focus group. There were three major topics: (1) the women in this study recognized that they were not able to take care of the family member directly, due to their responsibilities as female workers and mothers. The fact that migrant caregivers were chosen was conjunctural, where economic reasons were more important. (2) The family members supported the caregivers by teaching them about care and also resolving conflicts produced by culture shock. (3) Trusting the caregiver was a gradual process; the family members felt a complex set of emotions (insecurity, gratitude for the help, moral obligation). In conclusion, they wanted a caregiver who would provide the elder dependent with the love and compassion that they, as daughters, would provide if they had time to do so. The family became the caregiver’s managers and assumed the responsibility of training and helping them.

Responsabilidade filial no cuidado aos pais idosos: estudo misto

Resumo Objetivo: Examinar a relação entre atitudes de responsabilidade filial e comportamentos de cuidado dos filhos cuidadores. Métodos: Estudo de métodos misto com triangulação concomitante de dados com 100 filhos cuidadores de idosos vinculados a serviços de atenção primária. Na etapa quantitativa, para avaliação das atitudes de responsabilidade filial, foram aplicadas as Escalas de Expectativa Filial e Dever Filial. Os comportamentos de cuidado foram avaliados por meio do apoio instrumental, emocional e financeiro, companhia e visita. Na etapa qualitativa utilizou-se questões abertas sobre atitudes e comportamentos de cuidado. Foram feitas análises inferencial e temática e triangulação dos dados. Resultados: Apoio financeiro e emocional apresentaram associação com Dever Filial (p=0,050; p=0,001) e Expectativa Filial (p=0,013; p=0,023), respectivamente. Na etapa qualitativa estes comportamentos filiais emergiram como sobrecarga financeira e ensinamentos para seus próprios filhos também os cuidarem na velhice. Companhia e visita foram associadas apenas com Dever Filial (p=0,015), de forma semelhante ao encontrado nos depoimentos relativos a ser um dever natural e satisfação de estar presente na vida dos pais. Não houve associação entre atitudes de responsabilidade filial e ajuda nas atividades de vida diária, divergente dos achados da categoria “Dificuldades em ser filho cuidador”. Conclusão: Compreender atitudes e comportamentos de cuidado contribui para melhoria da qualidade da atenção dos profissionais que assistem essa população.

[Psychosocial Stressors and Resources of Live-in Caregivers in German Households - a Qualitative Study]

Ziel der Studie 24-Stunden-Betreuungskräfte, die in deutschen Privathaushalten haushalts- und personennahe Dienstleistungen für ältere pflegebedürftige Menschen erbringen, stammen meist aus dem Ausland. Diese Arbeitsverhältnisse liegen in der Regel außerhalb tariflich oder arbeitsrechtlich verbindlicher Vereinbarungen. Betreuungskräfte erfahren soziale Isolation sowie eine Vermischung von Arbeit und Privatsphäre. Die Studienlage ist aufgrund der schwierigen Erreichbarkeit der Zielgruppe sehr lückenhaft. Die vorliegende Studie ist eine qualitative explorative Analyse der Arbeits- und Gesundheitssituation von 24-Stunden-Betreuungskräften mit dem Fokus auf arbeitsplatzbezogene Belastungen und Ressourcen.

Methodik Die Rekrutierung erfolgte über Vermittlungsagenturen, Onlineportale, soziale Netzwerke und Vereine. Es wurden 9 semistrukturierte Interviews mit ausländischen 24-Stunden-Betreuungskräften in Privathaushalten geführt. Die Auswertung orientierte sich an der zusammenfassenden Inhaltsanalyse nach Mayring mit einer induktiven Kategorienbildung.

Ergebnisse und Schlussfolgerung Ständige Verfügbarkeit, Verständigungsschwierigkeiten und interpersonelle Konflikte sind alltägliche Belastungen für ausländische 24-Stunden-Betreuungskräfte. Diese Belastungen gehen mit Beeinträchtigungen der psychischen und physischen Gesundheit in Form von Erschöpfung, Schlaflosigkeit, erhöhter Reizbarkeit und Depressionssymptomen einher. Die Probandinnen erfahren aber auch Unterstützung durch Dritte und können sich emotional und räumlich von der direkten Betreuungssituation distanzieren. Das Erleben von Dankbarkeit, die Erfahrung akzeptiert zu werden aber auch eine finanzielle Absicherung werden als weitere relevante Ressourcen genannt. Die Sichtbarmachung der Zielgruppe ist forschungsbezogen durch einen ressourcenintensiven Rekrutierungsaufwand und politisch durch die Einführung einer gemeinsamen Berufsdefinition zu gewährleisten.