Till death do us Part: experiences of migrant live-in care workers facing the death of their care recipients - a study from Israel.

Résumé

BACKGROUND: As ageing in place becomes more widespread, the burdens on relatives of older people at advanced stages of illness, particularly those reaching life's end, become greater, requiring a level of support and responsibility that often exceeds the families' abilities. A common solution is employing live-in care workers, frequently migrant workers.OBJECTIVES: This study explores how live-in migrant care workers experience and cope with their care recipients' end-of-life and death phases.METHODS: This study is based on an ethnographic study that included 37 interviews with live-in migrant care workers employed in the homes of older adults in Israel.RESULTS: We identified four themes: (1) Loneliness and fear due to the need to make decisions; (2) Devotion; (3) Trauma, loss and disenfranchised grief; and (4) The impact of the national immigration policy. The first two themes related to the care workers' pre-death experiences, the third their post-death experiences and the last extraneous factors affecting end-of-life care.DISCUSSION: Live-in care workers, often the last to accompany their care recipients in their final moments, develop a sense of devotion and responsibility, often leading to feelings of fear and loneliness. Their lower occupational status and sociocultural foreignness affect them in the pre-death and post-death phases. The local immigration policy also influences their motivation to work with palliative patients.CONCLUSION: Applying a feminist critical social care perspective, we recommend policy and social attitude changes regarding live-in migrant care workers' role in end-of-life care.