IRELAND’S SENIOR citizens are being cared for in large numbers by one of the most marginalised groups in the labour force, a study by NUI Galway’s Irish Centre for Social Gerontology has found.
One in three care workers employed in this sector are registered nurses and care assistants from abroad, which is twice the proportion of foreign carers in the general health sector, according to the report.
The research and its recommendations are due to be presented today to Minister of State for Older People and Health Promotion Áine Brady by its authors Dr Kieran Walsh and Prof Eamon O’Shea.
The highest proportion of migrant carers is based in the eastern region around Dublin, with most nurses coming from India, followed by the Philippines and Poland, and most care assistants coming from Poland, followed by the Philippines and Nigeria. They work in home and long-stay residential care settings, run publicly and privately.
Even with the economic downturn the proportion of migrant carers will remain high as the sector is unregulated and poorly paid, the authors believe.
They interviewed a number of staff working in the sector who found difficulties with language, communication and cultural understanding on arrival, experienced discrimination, received low levels of pay and suffered due to inadequate regulation.
“These issues are intensified by the lack of funding and priority given to older adult care and, in particular, by the absence of support for migrant carers, employers and older people to cope with the cultural shift in the care workforce,” Dr Walsh says.
The authors believe that if greater priority is given to supporting the rights of both groups – migrant care workers and the elderly – both groups will benefit.
Among the eight recommendations are the provision of pathways for greater person-centred care for older people which acknowledge the role of migrant carers.
This should be formulated and implemented as part of the National Strategy for Older People, the authors state.
They recommend greater respect for racial and cultural differences of care providers and recipients, and increased resources and support structures for education, training, orientation and integration of migrant and Irish staff to cope with multi-cultural care environments.
They also recommend provision of appropriate structures for reporting racial abuse and labour exploitation at organisation, regional and national levels.
“It is impossible to separate the fate of migrant care workers from that of older people,” Prof O’Shea notes. “There is an irony here that not only are migrant workers marginalised, but they care for older adults in Ireland who are themselves often marginalised in terms of resource allocation.
“What we need, sooner rather than later, is a prioritisation of the older adult health and social care sector. Our older population requires greater person-centred care that acknowledges the role and potential of migrant carers to deliver such,” Prof O’Shea says.
Failure to integrate migrant workers appropriately into the sector and to address the key issues of resource allocation and funding could ultimately impact on the quality of care available to older people in this country, Prof O’Shea and Dr Walsh note.
The issue is also being investigated in Britain, North America and Canada by researchers at the University of Oxford, Georgetown University and the University of Ottawa. An international comparative report detailing some of the differences and common areas across the four countries, including Ireland, will be published this year.
Migrant workers: what they think
MIGRANT NURSES and care workers interviewed on a confidential basis for the NUI Galway report spoke of the rewarding aspect of their work with older people, but also acknowledged that there were serious challenges and difficulties.
Many spoke of the severe physical and emotional stresses which the work involved, their struggle to cope with the high cost of living in Ireland while also sending money home to dependants, and the positive feedback they received from clients and families.
Some spoke of their enjoyment of the work overall, stating that it was "natural" in their own societies to care for older people in the home.
A number spoke of experiencing workplace discrimination, and of a "stigma" associated with employing Africans. One Filipina nurse said the shift roster appeared to be engineered for the Irish employees, who also had more tenure.
"I do participate on staff nights out," she said, "but usually I am the one left to work . . . so that's how it goes. Like Christmas party, I will be the one who will be on night duty."
"There is no chance to go out," said one interviewee. "I am working here for all the days around, seven days in two weeks." Another said she was so exhausted when she wasn't working that all she wanted to do was to stay at home and "relax my brain".