Author: Ho, Hok Man
Title: The lived experience of foreign domestic helpers in caring for older people in the community : a hermeneutic phenomenological study
Advisors: Chiang, Vico (SN)
Degree: Ph.D.
Year: 2017
Award: FHSS Faculty Distinguished Thesis Award (2016/17)
Subject: Hong Kong Polytechnic University -- Dissertations
Household employees -- China -- Hong Kong
Foreign workers -- China -- Hong Kong
Older people -- Care -- China -- Hong Kong
Department: School of Nursing
Pages: xiv, 421 pages : illustrations
Language: English
Abstract: Background:In response to a shortage of family caregivers, importing workers to provide domestic care is growing in popularity worldwide. In Hong Kong, foreign domestic helpers (FDHs) are increasingly being employed to provide informal care for older people. While most current studies have focused on controlling the quality of the care provided by such caregivers by identifying factors and characteristics of their informal care, the assumption in such studies was that FDHs are to be manipulated for producing care work. Little is known about other interpretations of the experience of FDHs within this sphere of informal care, which is intrinsically different from that of traditional informal caregivers, such as family members, close relatives, or neighbours. Objectives:1. To describe and interpret the meaning of the lived experience of FDHs who are caring or who have cared for older people in the community; 2. To identify the insights obtained from exploring the meaning of the lived experience of FDHs for community health and social care research, education, and policies development. Methods:Heideggerian hermeneutic phenomenology is the philosophy and methodology that underpins this study. Ethical approval for this study was sought from the Human Subjects Ethics Sub-committee of the Hong Kong Polytechnic University. Data were collected using van Manen's methods, including phenomenological interviews and hermeneutic interviews. Unstructured interviews were conducted with eleven FDHs with a minimum of two years of experience in caring for older people in Hong Kong. Transcripts of the interviews with eleven FDHs have been included in this report. The researcher conducted a thematic analysis using the reflective methods of van Manen by (a) gathering lived experience descriptions (LEDs); (b) converting LEDs into anecdotes; (c) subjecting the anecdotes to the wholistic, selective, and line-by-line process of thematization; and (d) writing a phenomenological reflective account. The trustworthiness of the analysis was ensured by employing the framework proposed by de Witt and Ploeg of (1) balanced integration, (2) openness, (3) concreteness, (4) resonance, and (5) actualization..
Findings:Five themes that disclosed the structure of the meaning of the lived experience of FDHs in caring for older people were discovered, namely: (1) inescapable functioning commodity; (2) from dignity to indignity; (3) from being a commodity to being a dweller; (4) destined reciprocity of the companionship; and (5) memory without possession. The essence of the meaning of their experience was disclosed when their Being was revealed as that of the "waxing and waning of the possibilities of commodified companionship". Discussion:This revealed the danger in family care of regarding FDHs and caring per se as merely objects to be manipulated, while the possibility of authentic care was always present in the caring. Authentic care was manifested through the presence of the being as an authentic companion. This study examines the thoughts that we take for granted when hiring FDHs to care for older people in the modern age. With the insights obtained on the technological ordering of FDHs in the process of caring, the nature of the caregiver burden of the FDHs was disclosed as the thought of being unable to escape from everyday manipulation in the process of providing care. This study sheds light on the fundamental tenet to keep in mind when providing health and social care interventions and devising social policies to alleviate the caregiver burdens of FDHs. This study also provides insights on the ever-changing family structure of older people with the introduction of FDHs in a family. Conclusions:This study disclosed the instrumentality of the self of FDHs. Veiled behind such rational forces as the economics of supply and demand, and psychological motivations, the self of FDHs was kept astray as a functioning commodity. With this being as the functioning commodity, both we (as employers) and FDHs continued to utilize FDHs as merely resources for an end, which was the caring. This caring was empty when the being of the functioning commodity was taken as a whole, because other ontological possibilities of the being of the FDHs were eradicated. With this insight, the study reminded us about the forgotten call for family care, which is the caring per se. This caring is already the open region that enables the manifestation of being as an authentic companion. The tenets of every intervention supporting FDHs as informal caregivers also have to be considered in connection with preserving the ontological possibilities of authentic companionship. This preservation, in turn, requires nurses and healthcare professionals to develop an authentic understanding of the multiple realities of FDHs and to respect them. This authentic understanding is the art of the practice of health and social care which enables the FDHs to fill their life with meanings.
Rights: All rights reserved
Access: open access

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