Ms Xavia Yu Jie Ng1, Mr Feng An Jerome Chua1, Mr Zhi Zheng Yeo1
1HCA Hospice Limited, Singapore, Singapore
Biography:
Xavia is a Palliative Care Nurse at HCA Hospice Limited, Singapore’s largest home hospice organisation. Among the youngest in her company, she holds a Bachelor of Science (Nursing) with First Class Honours from the National University of Singapore and an Advanced Diploma in Palliative Nursing from Nanyang Polytechnic, where she received the St. Andrew’s Community Hospital Award for Outstanding Academic Performance. Xavia works closely with migrant live-in caregivers, supporting them in caring for patients at the end of life. She is passionate about empowering this vulnerable yet vital group who play a crucial role in delivering end-of-life care in Singapore.
Abstract:
Background:
Singapore responds to a super-ageing population by promoting ageing- and dying-in-place. Many families without available members to care for terminally ill relatives often hire migrant live-in carers to undertake caregiving responsibilities, usually for years until death. Little is known about how an individual worker experiences the full care trajectory from prolonged care, active dying and into bereavement.
Aims:
To explore the lived experience, including challenges encountered by and personal impact on a migrant live-in carer during end-of-life caregiving
Methods:
This case study reports a 41-year-old Indonesian worker’s lived experience caring for a 97-year-old woman for about 3 years until her death. One in-depth interview was audio-recorded, transcribed verbatim, independently coded by two authors and analysed using thematic analysis.
Results:
Challenges identified were (1) Religious differences as a barrier to attending to patients’ spiritual and religious needs, (2) Moral tension between obeying family requests and protecting patient safety and, (3) Difficulties in managing complex end-of-life conditions due to insufficient preparation, lack of confidence and difficulties in determining prognosis with certainty. Areas of personal impact were (1) Greater awareness of personal mortality encouraged empathetic caregiving, reinforced existing values, surfaced the importance of self-care and prompted the need to strengthen familial bonds, (2) Deep emotional bonds developed beyond a “worker” role triggered intense grief and loss when faced with the patient’s suffering and death, and (3) Process of caregiving allowed for derivation of pride and satisfaction, acquisition of new knowledge, cultivation of patience and emotional regulation, and functioned as a way to make up for past regrets.
Conclusion:
This rare longitudinal view of a migrant live-in carer’s lived experience highlighted areas currently under-described: moral conflict between employer and family, cross-belief spiritual labour by the worker, and finally, grief, identity change, and insufficient post-death support. These spotlight service needs in community palliative care.