Older persons' and their families' experience with live-in foreign home care workers: a grounded theory study

Background: Live-in arrangements with migrant care workers have considerably increased over the last years since they allow older frail persons to age-in-place despite functional limitations. However, little is known about the ramifications live-in care arrangements for families. Aim: The aim of the study was to investigate families' experience with live-in migrant care workers and indicators of quality from their perspective. Method: Constructivist grounded theory study with 22 families who were recruited via care agencies in the German-speaking part of Switzerland and participated in 29 individual or dyadic interviews. Results: Live-in care by migrant care workers has potentially positive ramifications for older persons and their families, but only so if families, first, reach a consensus about the need for the employment of migrant care workers; second, experience them as competent; and third, mutually forge relationships and negotiate daily life. A successful care arrangement occurs when there is a relational fit among those involved, which leaves families feeling cared for, safe and relieved. They experience a renewed stability in their family system, enriching relationships, and assuredness about the quality present in the care situation. Conclusions: A successful care arrangement is the result of relationships that have been actively created and a negotiated shared existence in a family-like network. It has a positive effect on the well-being of those receiving care and their family members. The family-like network needs competent support.