Lived Caregiving Experience of Foreign Domestic Workers (FDWs) for those with Terminal Illness in Singapore: A Secondary Qualitative Data Analysis

Abstract

Background Due to societal changes associated with evolving family structures in Singapore, the reliance on foreign domestic workers (FDWs) for elderly caregiving is increasing. While involving FDWs in caregiving has proven effective in moderating family caregivers' burden and benefiting patients' health outcomes, their caregiving experiences of FDWs are not always ideal. Existing studies on FDWs' caregiving experiences have mainly focused on elder care. However, palliative care, being more specialised and intense, poses unique challenges. Given high caregiver burden experienced in caring for non-cancer patients with terminal illnesses, this study aims to explore FDWs' experiences in caring for non-cancer patients at their end of lives in Singapore. Method A qualitative secondary analysis was conducted on 15 transcripts from a study related to a non-cancer palliative care program. The analysis used an adapted model combining the Informal Caregiving Integrative Model (ICIM), Inherent Tension of Caregiving Model, and Risk and Resistance Model (RRM) of Adjustment model. FDWs' experiences were categorized into five caregiving profiles based on perceived burden and benefits characterised by Pristavec. Results Based on caregiver experience profiling characteristics by Pristavec, one was classified under “intensive domestic helper”, while two others were classified as “relationship”. Nine had a “balanced” profile and three others were classified as “satisfied” FDWs. Common caregiver outcomes like psychological stress and physical fatigue were observed across different profiles. Each profile highlighted unique caregiving experiences, emphasizing the significance of individual coping strategies, clear personal boundaries, and positive mindsets in mitigating the impact of caregiving demands on FDWs' wellbeing. Conclusion This study provides valuable insights into FDWs' caregiving experiences of non-cancer patients with terminal illnesses. The findings suggest the need for tailored services or interventions to enhance FDWs' coping abilities. Future research could focus on developing caregiver support programs specifically designed for FDWs caring for individuals with terminal illnesses.