Care migration – the perspective of Spitex
Spitex employees are concerned about the quality of care in private homes and the working conditions of care migrants.
Care arrangements are increasingly moving away from the inpatient to the domestic domain. This is a consequence of the “outpatient over inpatient” health policy premise and the options afforded by medical and technical progress. This brings demanding and time-consuming care situations into private homes. Spitex services in this regard are insufficiently developed with regard to both staff and structure. For this reason, a care market is opening up in which care migrants live and work in private homes for people needing care.
The aim of the “Care migrants in domestic care” research project is to explore the opportunities and challenges of care migration from the perspective of Spitex. The investigation was undertaken using a combination of qualitative and quantitative research methods: as part of a standardised survey, the project team asked all 13 centres of Spitex Sihl and Limmat about the number of homes with care migrants, of which they were aware. At the time of the survey, Spitex was only aware of 13 households. This particularly showed a need for best practice information for Spitex organisations.
To assess care arrangements, 17 guided expert interviews were conducted with Spitex employees in the city of Zurich and neighbouring municipalities and cantons. The analysis identified the following four areas of conflict:
- linguistic and cultural understanding
- qualifications and demanding day-to-day work
- cooperation and responsibilities
- confrontation and cultural understanding
The interviews with experts and family members point to the difficulties regarding the long-term financing of support and care at home. Family practice is also shown to play a relevant part in the acceptance and support of care arrangements. In principle, care migrants are not in direct competition with Spitex, since they cover other service areas. Spitex perceives cooperation with care migrants largely as being interlinked. However, the findings also show that communicative, coordination, structural and ethical uncertainties and weaknesses exist, which may jeopardise the well-being of the sick people as well as the care migrants. Fair working conditions in the 24-hour care scenario are crucial for the quality of care, as working conditions are the foundation for the well-being of the care migrants and for the quality of life of the people for whom they are caring.
Jähnke, A., van Holten, K., & Bischofberger, I. (2012). Schlussbericht zur Befragung der Spitex zur Situation in Privathaushalten mit Care-Migrantinnen. Zürich: Careum Stiftung. PDF
The Department for Equality in the city of Zurich has put together an information dossier (german) on the subject of care migrants as new domestic workers.
December 2011–April 2012
Cooperation with the City of Zurich, Department for Equality
Jähnke, A., Truong, J., & Martin, M. (2012). Workshop Care-Migrantinnen in der häuslichen Versorgung. Moderation: Karin van Holten. Swiss Congress for Health Professions. Winterthur, 31. Mai 2012. PDF
van Holten, K., & Soom Ammann, E. (2015). Negotiating the potato: The challenge of dealing with multiple diversities in elderly care. In V. Horn & C. Schweppe (Hrsg.), Transnational Aging. Current insights and future challenges (S. 200–217). London: Routledge. Verlag
Beiträge der Abendveranstaltung «Sollen wir eine Care-Migrantin anstellen?» vom 14. Mai 2013 in Aarau.
Radio SRF 4 News: Care Migrantinnen in der Schweiz, 24.07.2013, www.srf.ch
van Holten, K. (2014). Pflegetrends in Privathaushalten – Neu verteilen oder auslagern? Vortrag. Fachstelle für die Gleichstellung von Frauen und Männern Kanton Bern. Thun, 29. April 2014. PDF
Walser, B. (01. Mai 2014). Eine Arbeit mit viel Präsenzzeit und wenig Privatsphäre. Berner Zeitung, 12-13. PDF
Schwerpunktausgabe des Online-Fachmagazins «FMC impulse» zu Angehörigen, Freiwilligen und Care Migrantinnen in der Pflege, Ausgabe 2015/2.