title: Does support from foreign domestic workers decrease the negative impact of informal caregiving? Results from Singapore survey on informal caregiving.
abstract: OBJECTIVE
  To assess the instrumental support from a foreign domestic worker (FDW) as a moderator of the association of 4 types of impairments (physical function, memory, behavior, and mood) among older persons (OPs) with caregiving-related outcomes among their informal caregivers (CGs).
  
  
  METHODS
  Data from a national survey of 1,190 Singaporeans aged 75 and older receiving human assistance for functional limitations and their CGs were used. Severity scores for the four OP impairments were calculated. A modified version of the Caregiver Reaction Assessment (CRA) assessed the impact of caregiving in four domains: disturbed schedule and poor health, lack of finances, lack of family support, and CG esteem. Linear regression models, one for each CRA domain, with interaction terms of the four impairment severity scores with FDW support, were developed.
  
  
  RESULTS
  FDW instrumental support, reported for 50% of the OPs, moderated the direct association of OP physical impairment with disturbed schedule and poor health (p = .009), OP memory impairment with disturbed schedule and poor health (p < .0001) and lack of finances (p = .02), and OP behavior impairment with lack of family support (p = .001). Although such support buffered the inverse association of OP behavior impairment with CG esteem (p = .01), it also buffered the positive association of OP mood impairment with CG esteem (p = .02).
  
  
  CONCLUSIONS
  FDW support is associated with better caregiving outcomes. Given its aging population, the number of FDWs in Singapore is likely to increase as families try to cope with caregiving for their older members. This has policy implications for (a) immigration patterns into Singapore and (b) training of and support networks for FDWs.
authors.affiliation: Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore.
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
authors.forename: Rahul
authors.initials: R
authors.lastname: Malhotra
authors.forename: Chetna
authors.initials: C
authors.lastname: Malhotra
authors.forename: Chandima
authors.initials: C
authors.lastname: Arambepola
authors.forename: Angelique
authors.initials: A
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000208:ethnology / Q000502:physiology* / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012846:Singapore / Q000208:ethnology; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Activities of daily living; Caregivers; Community survey; Foreign domestic workers; Frail elderly; Singapore; Social support.