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ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Aging Psychiatry
Volume 16 - 2025 |
doi: 10.3389/fpsyt.2025.1485270
This article is part of the Research Topic Ethical Conflicts Regarding the Care of Older Adults with Dementia View all 9 articles
Vulnerabilities in migrant live-in care arrangements for people with dementia: A Comparative analysis of experts' insights from Germany and Israel
Provisionally accepted- 1 Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Tel Aviv District, Israel
- 2 Division for Ethics in Medicine, Department for Health Services Research, School VI-Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- 3 Division for Prevention and Rehabilitation Research, Department for Health Services Research, School VI-Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
Background: The global rise in dementia among older adults has led to an increased reliance on migrant live-in caregivers, particularly in countries like Germany and Israel. This triadic care arrangement, involving persons with dementia, their families, and migrant live-in caregivers, presents unique challenges and vulnerabilities. These vulnerabilities, deeply intertwined with ethical concerns, are shaped by the socio-cultural and legal contexts of each country. This study aims to explore these vulnerabilities through a comparative analysis of expert experiences in Germany and Israel. Method: A qualitative study was conducted using semi-structured interviews with 24 experts—14 from Israel and 10 from Germany—who have extensive experience in dementia care or migrant caregiving. The interviews were analyzed through qualitative content analysis, focusing on six dimensions of vulnerability: physical, psychological, relational/interpersonal, moral, socio-cultural-political-economic, and existential/spiritual. Results: The analysis revealed that all parties in the care triad—persons with dementia, migrant live-in caregivers, and family members—experience distinct yet interconnected vulnerabilities. These vulnerabilities are deeply entangled, manifesting in complex, interrelated ways both within each party and between the different parties in this triadic arrangement. The study also highlighted both similarities and differences in expert experiences between Germany and Israel, reflecting the unique socio-cultural and legal contexts of each country. Conclusions: The study underscores the multifaceted and interdependent nature of vulnerabilities in migrant live-in care arrangements for people with dementia. By comparing expert insights from Israel and Germany, the research highlights the critical role of national policies and cultural contexts in shaping these vulnerabilities, leading to distinct experiences and challenges in each country. Addressing these vulnerabilities is essential for improving the quality of care and the well-being of all parties involved in the triadic care arrangement.
Keywords: Vulnerability, dementia care, migrant caregivers, Experts, triadic care arrangement
Received: 23 Aug 2024; Accepted: 03 Feb 2025.
Copyright: © 2025 Ulitsa, Nebowsky, Ayalon, von Kutzleben and Schweda. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Natalie Ulitsa, Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, 5290002, Tel Aviv District, Israel
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