Fragile familiarity in transnational home care arrangements for older people

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Karin van Holten
Heidi Kaspar
Eva Soom-Ammann


This paper examines the notion of familiarity in live-in elder care settings and how it is challenged, changed, and reestablished. Live-in care is a strategy to prevent disruptions and preserve familiarity in enabling older persons in need of extensive care to stay at home – and thus, to enable ageing in place. This paper problematizes this strategy based on interviews with family caregivers who engaged a migrant live-in care worker in Switzerland. The key argument is that live-in care arrangements constitute an all-embracing form of inserting formal, paid-for care service delivery into the informal, private, intimate space of home. The live-in care arrangement not only challenges the familiarity of the home space, but also seems to ask for strategies of adaptation to familiarize the unfamiliar. Therefore, the introduction of live-in care is consequential for all involved parties and requires largely underestimated efforts to adapt to the new home space.


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Allan, G. & Crow, G. (2001). Families, Households, and Society. Sociology for a Changing World. Basingstoke, NY: Palgrave.

Anderson, A. (2012). Europe’s care regimes and the role of migrant care workers within them. Population Ageing 5(2): 135–146. doi:10.1007/ s12062-012-9063-y

Angus, J., Kontos, P., Dyck, I., McKeever, P. & Poland, B. (2005). The personal significance of home: Habitus and the experience of receiv¬ing long-term home care. Sociology of Health & Illness 27(2): 161–187. doi:10.1111/j.1467-9566.2005.00438.x

Baldassar, L., Ferrero, L. & Portis, L. (2017). More like a daughter than an employee: The kinning process between migrant care workers, elderly care receivers and their extended families. Identities, Global Studies in Culture and Power 24(5): 524–541. doi:10.1080/1070289X.2017.1345544

Bettio, F. & Verashchagina, A. (2010). Long-Term Care for the Elderly. Provisions and Providers in 33 European Countries. Synthesis Report for the Use of the European Commission [Internet]. Directorate- General Justice, Unit D1 “Gender Equality.” Available on 10.2838/87307 (Accessed: September 1, 2019).
Bischofberger, I. (2011). Angehörige als wandelnde Patientenakte: Ausgewählte Ergebnisse aus einem Projekt zur Klärung der Rolle der Angehörigen. [Family caregivers as walking patient-records: Selected results from a project to clarify the role of family caregivers]. Care Management 4(5): 27–29.

Bowlby, S. (2012). Recognising the time – Space dimensions of care: Caringscapes and carescapes. Environment and Planning A 44(9): 2101–2118.

Bowlby, S., Gregory, S. & McKie, L. (1997). Doing home: Patriarchy, caring, and space. Women’s Studies International Forum 20(3): 343–350.

Chambers, P., Allan, G. & Phillipson, C. (2009). Family Practices in Later Life. Ageing and the Lifecourse Series: 2009: 1. Bristol: Policy.

Chiatti, C., Di Rosa, M., Melchiorre, M. G., Manzoli, L., Rimland, J. & Lamura, G. (2013) Migrant care workers as protective factor against caregiver burden: Results from a longitudinal analysis of the EUROFAMCARE study in Italy. Aging & Mental Health 17(5): 609–614.

Cieraad, I. (1999). At Home: An Anthropology of Domestic Space. Syracuse: Syracuse University Press.
Colombo, F., Llena-Nozal, A., Mercier, J. & Tjadens, F. (2011). Help Wanted?: Providing and Paying for Long-Term Care. Paris: OECD.

Davies, S. & Nolan, M. (2003). “Making the best of things”: Relatives’ experiences of decisions about care-home entry. Ageing and Society 23(04): 429–450. doi:10.1017/S0144686X03001259

Davies, S. & Nolan, M. (2004). “Making the move”: Relatives’ experiences of the transition to a care home. Health and Social Care in the Community 12(6): 517–526.

De Pietro, C., Camenzind, P., Sturny, I., Crivelli, L., Edwards-Garavoglia, S., Spranger, A. & Quentin, W. (2015). Switzerland: Health system review. Health Systems in Transition 17(4): 1–288.

Di Santo, P. & Ceruzzi, F. (2010). INTERLINKS: Migrant Care Workers in Italy: A Case Study. Rome/Vienna: Studio Come.

Doh, M., Schmidt, L. I., Herbolsheimer, F., Jokisch, M. R., Schoch, J., Dutt, A. J., Wahl, H.-W. (2016). Neue Technologien im Alter. Ergebnisbericht zum Forschungsprojekt “FUTA”: Förderliche und hinderliche Faktoren im Umgang mit neuen Informations- und Kommunikations-Technologien im Alter.[New Technologies in Old Age. Report on the Results of the Research Project “FUTA”: Promoting and Hindering Factors in Dealing with New Information and Communication Technologies in Old Age.] Available on Abteilung für Psychologische Alternsforschung, Psychologisches Institut der Universität Heidelberg website: http://www.psychologie. pdf (Accessed: May 19, 2019).

Dyck, I., Kontos, P., Angus, J. & McKeever, P. (2005). The home as a site for long-term care: Meanings and management of bodies and spaces. Health & Place 11(2): 173–185. doi:10.1016/j.healthplace.2004.06.00177

England, K. & Dyck, I. (2011). Managing the body work of home care. Sociology of Health and Illness 3(2): 206–219. doi: 10.1111/j.1467-9566.2010.01331.x

Federal Statistical Office. (2015). Statistik der Hilfe und Pflege zu Hause: Ergebnisse 2014 : Zahlen und Trends. [Statistics help and care at home: Results 2014: Figures and trends]. Neuchâtel: Federal Statistical Office.

Federal Statistical Office. (2017). Spitex-Statistik 2011–2016. [Statistic of Out-of-Hospital Care]. Available on de/home/statistiken/gesundheit/gesundheitswesen/hilfe-pflege-hause.assetdetail.3782039.html (Accessed: May 28, 2018).

Frey, M., Meier, H., Suri, M. & Walthert, L. (2016). 24-Stunden-Betagtenbetreuung in Privathaushalten. Regulierungsfolgen-abschätzung zu den Auswirkungen der Lösungswege gemäss Bericht zum Postulat Schmid-Federer 12.3266 «Pendelmigration zur Alterspflege», B, S, S Volkswirtschaftliche Beratung, Studie im Auftrag des Staatssekretariats für Wirtschaft, Schlussbericht vom 29. Februar 2016. [24-Hours Care for the Elderly in Private Households. Regulatory Impact Assessment According to the Report on the Schmid-Federer Postulate 12.3266 “Circular Migration in the Context of Elderly Care”, B, S, S Economic consulting, study commissioned by the State Secretariat for Economic Affairs, final report of 29 February 2016.]

Füglister-Dousse, S., Dutoit, L. & Pellegrini, S. (2015). Soins de longue durée aux personnes âgées en Suisse: Evolutions 2006–2013 [Long-Term Care for the Elderly in Switzerland: Developments 2006–2013]. (Obsan Rapport No. 67). Neuenburg. Available on Schweizerisches Gesundheitsobservatorium website:¬tions/2015/obsan_67_rapport.pdf (Accessed: May 28, 2018)

Genet, N., Boerma, W., Kroneman, M., Hutchinson, A. & Saltman, R. B. (2012). Home Care across Europe. Current Structure and Future Challenges. European Observatory on Health Systems and Policies. Observatory Studies Series 27. Copenhagen: World Health Organisation.

Haak, M., Fänge, A., Iwarsson, S. & Ivanoff, S. D. (2007). Home as a signification of independence and autonomy: Experiences among very old Swedish people. Scandinavian Journal of Occupational Therapy 14(1): 16–24. doi:10.1080/11038120601024929

Hollstein, B. (2005): Reziprozität in familialen Generationenbeziehungen. [Reciprocity in generational family relationships]. In F. Adloff & S. Mau (eds.), Vom Geben und Nehmen. Zur Soziologie der Reziprozität [From Giving and Taking. On the Sociology of Reciprocity.] (pp. 187–210). Frankfurt a. Main: Campus Verlag.

Huang, S., Yeoh, B. & Toyota, M. (2012). Caring for the elderly: The embodied labour of migrant care workers in Singapore. Global Networks 12(2): 195–215.

Jähnke, A. & van Holten, K. (2013). Care-migration: Verschiedene Akteure im Privathaushalt: Lokale Zusammenarbeit und globale Vernetzung [Care migration: Different actors in the private household: Local cooperation and global networking]. NOVAcura 44(9): 32–35.

Jähnke, A. & van Holten, K. (2015). Vielfalt der Akteure in der häuslichen Versorgung. [Diversity of actors in domestic care]. FMC Impulse, (2). Available on (Accessed: May 18, 2019).

Kordasiewicz, A. (2015): Class guilt? Employers and their relationships with domestic workers in Poland. In A. Triandafyllidou & S. Marchetti (eds.), Employers, Agencies and Immigration. Paying for Care. Research in Migration and Ethnic Relations Series (pp. 53–72). Surrey & Burlington: Ashgate.

Kordasiewicz, A., Radziwinowiczowna, A. & Kloc-Nowak, W. (2018). Ethnomoralities of care in transnational families: Care intentions as a missing link between norms and arrangements. Journal of Family Stud¬ies 24(1): 76–93.

Lamura G. (2013). Pflegekräfte mit Migrationshintergrund in der Langzeitpflege. In: G. Bäcker G. & R. Heinze (eds.), Soziale Gerontologie in gesellschaftlicher Verantwortung [Social Gerontology in Social Responsibility]. (pp. 307–314). Wiesbaden: Springer VS.

Lettke, F. & Lüscher, K. (2002). Generationenambivalenz – Ein Beitrag zum Verständnis von Familie heute. [Generation ambivalence – A contribution to the understanding of the family]. Soziale Welt. Zeitschrift für sozialwissenschaftliche Forschung 53(4): 437–466.

Levine, C., Halper, D., Peist, A. & Gould, D. A. (2010). Bridging troubled waters: Family caregivers, transitions, and long-term care. Health Affairs 29(1): 116–124. doi:10.1377/hlthaff.2009.0520

Levine, C., Halper, D., Rutberg, J. L. & Gould, D. A. (2013). Engaging Family Caregivers as Partners in Transitions: TC-QulC: A Quality Improvement Collaborative. New York: United Hospital Fund. Available on www. (Accessed: May 18, 2019).

Lüscher, K. (2005). Ambivalenz. Eine Annäherung an das Problem der Generationen [An approach to the problem of generations]. In U. ureit & M. Wildt (eds.), Generationen. Zur Relevanz eines wissenschaftli¬chen Grundbegriffs [Generations. Relevance of a Basic Scientific Term] (pp. 53–78). Hamburg: Hamburger Edition.

Lutz, H. (2011). The New Maids: Transnational Women and the Care Economy. London & New York: Zed Books; Distributed in the USA exclusively by Palgrave Macmillan.

Mayring, P. (2007). Qualitative Inhaltsanalyse. Grundlagen und Techniken [Qualitative Content Analysis. Basic Principles and Techniques]. Weinheim: Beltz.

Medici, G. (2011). Hauswirtschaft und Betreuung im Privathaushalt: Rechtliche Rahmenbedingungen [Housekeeping and Support in Private House¬holds: Legal Framework Conditions]. Juristisches Dossier [Legal Dossier]. Zürich.

Medici, G. (2016). Verfassungsrechtliche Perspektive auf die Pendelmigration zur Alterspflege in schweizerischen Privathaushalten [Constitutional Perspective on Care Migration for the Elderly in Swiss Private Households]. Pflegerecht (2), 79–91.

Metz-Göckel, S., Morokvasić, M. & Münst, A. S. (2008). Migration and Mobility in an Enlarged Europe: A Gender Perspective. Opladen, Farmington Hills, MI: Budrich.

Milligan, C. (2000). “Bearing the burden”: Towards a restructured geography of caring. Area 32(1): 49–58. doi:10.1111/j.1475-4762.2000.tb00114.x

Milligan, C. (2005). From home to “home”: Situating emotions within the caregiving experience. Environment and Planning A: Economy and Space 37(12): 2105–2120.

Milligan, C. & Wiles, J. (2010). Landscapes of care. Progress in Human Geography 34(6): 736–754. doi:10.1177/0309132510364556

Nare, L. (2012). The ethics of transnational market familism: Inequalities and hierarchies in the Italian elderly care. Ethics and Social Welfare 7(2): 184–197.

Nolan, M. & Dellasega, C. (2000). «I really feel I’ve let him down»: Support¬ing family carers during long-term care placement for elders. Journal of Advanced Nursing 31(4): 759–767. doi:10.1046/j.1365-2648.2000.01346.x

OECD. (2011). Reviews of Health Systems: Switzerland 2011. Paris. Avail¬able on OECD website: (Accessed: May 18, 2018)

Otto, U., Abele, L., Klein, P. & Steffen, G. (2014). Älter werden in München: Die 55- bis 75-Jährigen: Ergebnisse einer repräsentativen Erhebung in 5 Stadtteiltypen.[Getting Older in Munich: The 55- to 75-Year-Olds: Results of a Representative Survey in 5 District Types]. Kurzfassung. Unveröffentlichtes Manuskript. [Short version. Unpublished manuscript] Stutt¬gart: Weeber+Partner.

Otto, U., Zanoni, S. & Wepf, H. (2015). Evaluation des Projekts «Älter werden im Quartier» Stadt Frauenfeld [Evaluation of the Project “Getting Older in the Neighbourhood” City of Frauenfeld]. Unveröffentlichter Zwischenbericht. [Unpublished Interim Report].

Peace, S. (2015). Meanings of home and age. In J. Twigg & W. Martin (eds.), Routledge Handbook of Cultural Gerontology (pp. 447–454). New York & Oxon: Routledge.

Petry, H., Naef, R., Rüesch, P., Mahrer-Imhof, R. & Dreizler, J. (2016). Erfahrungen von älteren Menschen und deren Familien mit einer Rund-um-die-Uhr-Betreuung durch Care MigrantInnen – Eine Grounded Theory Studie [Older Persons and their Families’ experience with live-in foreign home care workers – A grounded theory study]. Pflege 29(6), 301–314. doi:10.1024/1012-5302/a000515

Rapoport, A. (2005). On using “home” and “place”. In G.D. Rowles & H. Chaudbury (eds.). Home and identity in late life. (pp. 343–360). New York: Springer Publishing Company.

Rodrigues, R., Schulmann, K., Schmidt, A., Kalavrezou, N. & Matsaganis, M. (2013). The Indirect Costs of Long-term Care. Research Note 8 for the European Commission Directorate-General for Employment, Social Affairs and Inclusion.

Rostgaard, T., Glendinning, C., Gor, C., Szebehely, M., Theobald, H. & Timonen, V. (2001). LIVINDHOME Living Independently at Home: Reforms in Home Care in 9 European Countries. Copenhagen: Danish National Centre for Social Research.

Rudin, M. & Strub, S. (2014). Zeitlicher Umfang und monetäre Bewertung der Pflege und Betreuung durch Angehörige: Datenzusammenstellung, Factsheet [Time Scale and Monetary Evaluation of Care and Support by Relatives: Compilation of Data]. Bern. Available on Fachleute/Publikationen/Studien/PUpgM/?id=DF4B7107-A266-345C-B684D68E7956BF3D&method=article.detail&p=1&c=&ref_c=&m= (Accessed: May 18, 2018).

Ryan, A. & McKenna, H. (2013). “Familiarity” as a key factor influencing rural family carers’ experience of the nursing home placement of an older relative: A qualitative study. BMC Health Services Research 13, 252. doi:10.1186/1472-6963-13-252. Available on https://www.ncbi.nlm. (Accessed: 18 May, 2019).

Schilliger, S. (2014). Pflegen ohne Grenzen? Polnische Pendelmigrantinnen in der 24h-Betreuung. Eine Ethnographie des Privathaushalts als globalisier¬tem Arbeitsplatz [Care without Borders? Polish Care Migrants in 24-Hour Care. An Ethnography of the Private Household as a Globalized Workplace]. Dissertation. Basel: Universtät Basel.

Schwiter, K., Berndt, C. & Truong, J. (2015). Neoliberal austerity and the marketisation of elderly care. Social & Cultural Geography 19(7): 1–21. doi:10.1080/14649365.2015.1059473

Shutes, I. & Chiatti, C. (2012). Migrant labour and the marketization of care for older people: The employment of migrant care workers by families and service providers. Journal of European Social Policy 22(4): 392–405.

Silverstein, M. & Giarrusso, R. (2010). Aging and family life: A decade review. Journal of Marriage and the Family 72(5): 1039–1058. doi:10.1111/ j.1741-3737.2010.00749.x

Son, G.-R., Therrien, B. & Whall, A. (2002). Implicit memory and familiarity among elders with dementia. Journal of Nursing Scholarship 34(3): 263–267.

Steptoe, A., Deaton, A. & Stone, A. A. (2015). Subjective wellbeing, health, and ageing. The Lancet 385(9968): 640–648. doi:10.1016/S0140-6736(13) 61489-0

Strauss, A. & Corbin, J. (1990). Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: Sage.

Truong, J. (2011). Arbeit, Arbeitsidentitaet, Arbeitsplatz. Die neuen Wanderarbeiterinnen in der Sorgewirtschaft. [Work, work identity, workplace. The new migrant workers in the care economy]. Zurich: University of Zurich.

Truong, J., Berndt, C. & Schwiter, K. (2012). Arbeitsmarkt Privathaushalt. Charakteristika der Unternehmen, deren Beschaeftigungsstruktur und Arbeitsbedingungen. Eine Studie im Auftrag der Fachstelle fuer Gleichstellung der Stadt Zuerich [The Private Household as Labour Market. Characteristics of Companies, their Employment Structure and Working Conditions. A Study Commissioned by the Office for Equality of the City of Zurich]. Zurich.

Twigg, J. (2001). Bathing: The Body and Community Care. New York & Florence: Routledge; Taylor & Francis Group Distributor.

van Holten, K., Jähnke, A. & Bischofberger, I. (2013). Care-Migration – Transnationale Sorgearrangements im Privathaushalt. [Care Migration – Transnational Care Arrangements in the Private Household]. Obsan Bericht: Vol. 57. Neuchâtel: Schweizerisches Gesundheitsobservatorium. Avail¬able on (Accessed: May 18, 2019).

van Holten, K. & SoomAmmann, E. (2016). Negotiating the potato: The challenge of dealing with multiple diversities in elderly care. In V. Horn & C. Schweppe (eds.), Routledge Research in Transnationalism. Transnational Aging. Current Insights and Future Challenges (1st ed., pp. 200–216). New York: Routledge.

van Hooren, F. (2012). Varieties of migrant care work: Comparing patterns of migrant labour in social care. Journal of European Social Policy 22(2): 133-147.

Werner, S., Kraft, E., Mohagheghi, R., Meuli, N. & Egli, F. (2016). Angebot und Inanspruchnahme von intermediären Strukturen für ältere Menschen in der Schweiz: Ergebnisse aus einer Kantonsbefragung und einer Aus¬wertung der Statistik der sozialmedizinischen Institutionen [Provision and Utilization of Intermediary Services for Older People in Switzerland: Results from a Cantonal Survey and an Evaluation of Statistics from Social Medical Institutions]. Obsan Dossier, (52), 1–43. Available on http://www.¬sier_52_1.pd (Accessed: May 18, 2019).

West, C. & Fenstermaker, S. (1995). Doing difference. Gender and Society 9(1): 8–37.

Williams, F. (2012). Converging variations in migrant care work in Europe. Journal of European Social Policy 22(4): 363–376.

Yeates, N. (2011). Going global: The transnationalization of care. Development and Change 42(4): 1109–1130.