Unlike in most high-income countries, in Israel personal (social) care of elderly patients in hospitals is provided either by relatives or friends, or, for those patients with live-in assistance at home, by their home care workers. Our aim was to understand the explicit and implicit roles of live-in carers and whether any difficulties occurred.
Methods
Interviews in the internal medicine unit of Hadassah Hospital with 17 patients, 16 relatives, 20 home care workers and 20 nurses. Data were subjected to categorical content analysis.
Results
Three major themes emerged: the development of teamwork with relatives and nurses; the varied roles of home care workers including nursing care, emotional care, and monitoring and supervision of the patient; and the conflicts and challenges associated with having a care worker related to their physical presence and the care worker’s own social needs.
Conclusions
Israel partially addresses its nursing shortage by allowing paid home care workers to take an active role in the care of hospitalized older adults. This can have both a positive and a negative impact on the role and perception of nursing.
Organization for Economic Cooperation and Development (OECD). Health at a glance 2011: OECD indicators. OECD Publishing. http://www.oecd.org/els/health-systems/49105858.pdf (2011, accessed 19 March 2015).
Heller E. The treatment of older adults in Israel. The topic of foreign homecare workers in Israel and Israeli nursing care workers–needs and available solutions [in Hebrew]. Jerusalem, Israel: Haknesset: Research and Information Center, 2003.
4.
National Insurance Institute of Israel. Annual review: long term care community law [in Hebrew]. Jerusalem: National Insurance Institute of Israel, 2011.
5.
AyalonL. Evaluating the working conditions and exposure to abuse of Filipino home care workers in Israel: characteristics and clinical correlates. Int Psychoger2009; 21: 40–49.
6.
WalshKO’SheaE. Marginalised care: migrant workers caring for older people in Ireland. J Popul Ageing2010; 3: 17–37.
7.
HuangSYeohBSAToyotaM. Caring for the elderly: the embodied labour of migrant care workers in Singapore. Global Networks2012; 12: 195–215.
8.
AuslanderGK. Family caregivers of hospitalized adults in Israel: a point-prevalence survey and exploration of tasks and motives. Res Nurs Health2011; 34: 204–217.
9.
ChoS-HKimH-R. Family and paid caregivers of hospitalized patients in Korea. J Clin Nurs2006; 15: 946–953.
10.
LiH. Hospitalized elders and family caregivers: a typology of family worry. J Clin Nurs2005; 14: 3–8.
11.
LevineCZuckermanC. Hands on/hands off: why health care professionals depend on families but keep them at arm’s length. J Law Med Ethics2000; 28: 5–18.
12.
AyalonLHalevy-LevinSBen-YizhakZ. Family caregiving at the intersection of private care by migrant home care workers and public care by nursing staff. Int Psychoger2013; 25: 1463–1473.
13.
IecovichERabinBPenchakM. Tasks performed by migrant live-in care workers during hospitalization of their older care recipients. Home Health Care Serv Q2013; 32: 178–196.
14.
McCluskeyA. Paid attendant carers hold important and unexpected roles which contribute to the lives of people with brain injury. Brain Inj2000; 14: 943–957.
15.
AyalonL. Family and family-like interactions in households with round-the-clock paid foreign carers in Israel. Ageing & Society2009; 29: 671–686.
16.
Fouka G, Plakas S, Papageorgiou D, et al. The increase in illegal private duty nurses in public Greek hospitals. J Nurs Manag 2012; 21(4): 633–637.
17.
PattonM. Purposeful sampling. Qualitative evaluation and research methods, Newbury Park, CA: Sage Publications, Inc., 1990.
18.
StraussACorbinJ. Basics of qualitative research techniques and procedures for developing grounded theory, 2nd ed. London, UK: Sage Publication, 1998.
19.
CreswellJW. Qualitative inquiry and research design: choosing among five traditions, Thousand Oaks, CA: Sage, 1998.
20.
LorenzoFMEGalvez-TanJIcaminaK. Nurse migration from a source country perspective: Philippine country case study. Health Serv Res2007; 42: 1406–1418.
21.
GroutsisD. Recruiting migrant nurses to fill the gaps: the contribution of migrant women in the nursing care sector in Greece. J Int Migrat Integrat/Revue de l'integration et de la migration internationale2009; 10: 49–65.
22.
KlineDS. Push and pull factors in international nurse migration. J Nurs Scholar2003; 35: 107–111.
23.
MitchellKMarstonSAKatzC. Introduction: life’s work: an introduction, review and critique. Antipode2003; 35: 415–442.
24.
AyalonL. Family and family-like interactions in households with round-the-clock paid foreign carers in Israel. Ageing Soc2009; 29: 671–686.
25.
EhrenreichBHochschildAR. Global woman: nannies, maids, and sex workers in the new economy, New York, NY: Metropolitan Books, 2000.
26.
AyalonLKanielMRosenbergL. Social workers’ perspectives on care arrangements between vulnerable elders and foreign home care workers: lessons from Israeli/Filipino caregiving arrangements. Home Health Care Serv Q2008; 27: 121–142.
27.
Green O and Ayalon L. Violations of workers’ rights and exposure to work-related abuse of migrant live-in and Israeli live-out home care workers: a preliminary report. Under review.
28.
Borjas GJ. The labour demand curve is downward sloping: reexamining the impact of immigration on the labour market. National Bureau of Economic Research. http://www.nber.org/papers/w9755.pdf (2003, accessed 19 March 2015).
