New Taipei City Mayor Hou You-yi (侯友宜), the Chinese Nationalist Party’s (KMT) presidential candidate, has pledged to remove the Barthel index requirement — an assessment used in clinical practice and research to measure someone’s ability to complete activities of daily living — for elderly people seeking to hire a foreign caregiver.
Premier Chen Chien-jen (陳建仁) also vowed that the government would make it easier for families in need of hiring foreign caregivers so that everybody, regardless of age, illness or financial situation, would have access to care.
The long-term care plan does not subsidize the cost of hiring live-in migrant caregivers. As a monthly salary of NT$30,000 to NT$40,000 is a struggle for most families, only affluent families can employ migrant caregivers, while disadvantaged people apply for long-term care services. Without other modifications, most families would not benefit from relaxing migrant caregiver hiring rules.
Hong Kong’s and Singapore’s examples had people calling for the government to relax application rules for migrant caregivers. In these two places, people can apply for foreign caregivers without any illness or age requirements. The local governments would subsidize families with elderly members diagnosed with dementia or disabilities when they apply for foreign caregivers, as foreign caregiving is part of their long-term care policy.
The governments there also subsidize families with senior members diagnosed with dementia or disabilities when being placed in nursing homes or applying for in-home care. Taiwan’s Long-term Care Plan 2.0 does not subsidize any costs for hiring foreign caregivers, nor is there any financial aid for nursing home costs. The reason for this was to “discourage families from outsourcing the care of family members to others.”
The government should relax rules for foreign caregiver applications and introduce complementary measures as soon as possible. With the population in Taiwan aged 80 or above being about 1 million, while a large percentage of the population under 80 are using long-term care services, the need for foreign caregivers would see a massive jump once application rules are relaxed. As there are 30,000 “absconded” migrant caregivers out of 220,000, the situation would only worsen once rules are relaxed. Singapore’s solution for deterring migrant caregivers from leaving their jobs prematurely is heavy penalties, and employers who hire runaway caregivers could receive a jail sentence.
Once application rules are relaxed, families who have light care needs would no longer adopt Long-term Care 2.0 for a few hours of caregiving service, but would instead apply for migrant caregivers for all-day care. This would have a profound impact on native home caregivers and their job opportunities. Thus, the government would have to overhaul application rules for foreign caregivers along with Long-term Care 2.0 so that they can supplement each other instead of running as parallel systems.
One solution is to integrate foreign caregivers into the long-term care plan, and provide subsidies to families who are hiring foreign caregivers for elderly people who are assessed as having dementia or are disabled, while others pay the full costs themselves.
As for foreign caregivers who have received government subsidies, they would need training and supervision to ensure nursing quality. Native home caregivers should not fear competition, as they have advantages as native speakers and better caregiving skills, and are fit to take on more challenging cases. Only in this way can families with caregiving needs benefit from relaxation of application rules.
Shen Chen-lan is a physician.
Translated by Rita Wang
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