Immigrant Home Health Workers' Experiences With the Elderly: A Qualitative Description Study
Elder care is increasingly filled by immigrant home health workers who are primarily female (88%), racial minorities (85%), and from developing countries including Mexico, Philippines, and countries in the Caribbean and Africa. Poverty, political unrest, and family reunification have increasingly lead migrant workers to find jobs in the American home health industry. Though there are substantial barriers to care work, home health aides find the relational part of the work to be the most meaningful to them. Little is known about what the migrant home health workers experience as they build relationships with their clients and the rewards and stressors that might simultaneously occur. This study is designed to address this need and explored the migration factors that led these workers to the U.S. and also investigate the personal experiences and viewpoints of the immigrant worker.
The qualitative description method (Sandelowski, 2000, 2010) is a systematic investigation of the everyday experiences of participants and the meanings of these experiences with less inference than other forms of qualitative methods. Purposive sampling method was used to ensure description rich cases. Qualitative description and symbolic interaction provided the organizing structure of the data analysis plan. Inductively created codes were systematically drawn from the data as well as guided conceptually by previous theories. Thirty female participants Massachusetts participated in two rounds of semi-structured interviews, resulting in forty-five interviews. Data collection and data analysis were conducted simultaneously to allow for iterative process between the findings and investigative process.
Home health work in Massachusetts is dominated by workers from the Caribbean and Africa. Relevant themes that emerged from the data showed that home health work for immigrant workers serves as a viable career option. Workers enter this field as it is an easily accessible job for newly arrived immigrants and considered to have more benefit than other low wage jobs including career advancement opportunities in nursing. In addition, other themes spoke to the relational aspect of the job serves as a unique purpose for immigrant workers. Their extended kinship experience provides them a valuable skill set when providing caregiving. Not only was the relationship rewarding for the worker but also served as a buffer for the substantial loss they may have experienced from political unrest or natural disasters in their home country and also the continued separation from loved ones while in the U.S.
Immigrant workers value caregiving as an important part of their heritage and often extend their notions of kinship to the clients. Though workers are mainly expected to provide personal care or homemaking services, workers exercise a special skill set to build trust, persuade clients, and practice patience in the face of discrimination, abuse, and non-compliant behaviors. Implications for social work research and practice include expanding cultural awareness and sensitivity of care managers at home health agencies and creating new partnerships between nursing schools and the home health industry to encourage increased access for immigrant caregivers.