Social workers' perspectives on care arrangements between vulnerable elders and foreign home care workers: Lessons from Israeli/Filipino caregiving arrangements

Objectives: This pilot study addresses a universal social phenomenon of foreign workers of lower socioeconomic status who provide care to more affluent, but frail older adults. In Israel, foreign workers from the Philippines provide the majority of paid 24-hour home care services to older adults. To date, the views of social workers, who are highly involved in this arrangement of care, have never been evaluated. Hence, this study evaluates the advantages and challenges associated with such an arrangement of care from the perspective of social workers. Methods: We conducted four focus groups with 31 social workers who work closely with Filipino home care workers, older adults, and their family members. Results: Using grounded theory methodology, we identified motivating factors that contribute to the popularity of this caregiving arrangement among both Filipinos and Israelis. We also identified four major areas of challenge; these include the intimate nature of this caregiving arrangement as well as cultural, legal, and financial disparities. Social workers also discussed strategies they use to assure the safety and satisfaction of the involved parties. Discussion: Despite the high need for this caregiving arrangement, many difficulties and challenges exist; these are partially due to very prominent cultural differences between the host culture, Israel, and the culture of the Filipino home care worker, and they are also due to legal, social, and economic differences ingrained in such a care arrangement.