Understanding Family Caregivers' Experiences With Live-in Migrant Care Workers in Dementia Care: Challenges and Perspectives From a Qualitative Study in Taiwan

Live-in migrant care workers constitute a vital labor force in home-based eldercare in Taiwan; where demographic changes have heightened the demand for such assistant. Despite this, qualitative research exploring the experiences of family caregivers who employ these workers for relatives with dementia remains scarce in the Taiwanese context. This qualitative study aimed to investigate the motivations behind families' decisions to hire migrant workers for home-based dementia care within Taiwan, as well as to assess the associated benefits and challenges they encounter. In-depth interviews were conducted with 4 family caregivers, aged between 52 and 63 years, who had hired live-in migrant care workers between April and August 2022. The transcripts from these interviews were analyzed thematically to derive insights from the findings. The results revealed that family caregivers in Taiwan opted to hire migrant workers for dementia care following a thorough evaluation of their personal circumstances and available resources. Live-in migrant care workers acted as surrogate caregivers, enabling family members to alleviate their daily caregiving burden, improve their emotional well-being, and sustain their personal lives. However, family caregivers faced several challenges, including resistance from dementia-affected relatives toward migrant workers, difficulties in recruiting care workers amidst fluctuating external conditions, and instances of migrant care workers displaying irresponsibility or lacking essential knowledge and skills related to dementia care. Notably, as family caregivers' understanding of dementia evolved, they recognized the critical need to utilize public long-term care services to bolster the dementia-related knowledge and skills of their migrant employees. The study suggests implementing additional dementia-specific training programs tailored for both family caregivers and live-in migrant care workers in Taiwan. Such initiatives would enhance caregiving knowledge and competencies, ultimately improving the quality of life for both caregivers and care recipients.