SINGAPORE - Domestic worker Nalin (not her real name) does not get enough sleep every day.

She has been caring for a 92-year-old with dementia for two years, looking after her throughout the night.

During the day, she is unable to rest, as she worries about leaving her care recipient unsupervised.

Another domestic worker, Kevaly (not her real name), has been taking care of an 89-year-old stroke patient with early-stage dementia and who uses a wheelchair for nine months.

When Kevaly felt ill, her employer pressured her to continue working and accompany her charge to senior day care despite having been given a medical certificate by the doctor.

These domestic workers were among 25 whose struggles with overwork and a lack of support were told in a research report released by the Association of Women for Action and Research (Aware) and Humanitarian Organisation for Migration Economics (Home) on Wednesday (Nov 11).

Their ages ranged from 27 to 53, and they were mostly from the Philippines and Myanmar. The domestic workers had worked about five years and four months on average in Singapore.

Besides the domestic workers, researchers interviewed four migrant domestic worker (MDW) employment agencies, seven employers of domestic workers for eldercare and five providers of formal eldercare training between December 2019 and September 2020.

Titled "Neither Family Nor Employee", the research considered the caregiver burden faced by migrant domestic workers caring for the elderly in Singapore.

In an online press conference, Ms Shailey Hingorani, head of research and advocacy at Aware, said: "As we rapidly age as a society, our reliance on MDWs is likely to increase.

"Unless we pay specific attention to the consequences of caregiving to the mental and physical health of MDWs, we run the risk of compromising the quality of care given to our elders - a lose-lose scenario."

Ms Jaya Anil Kumar, a case manager at Home, said a lot of domestic workers "are afraid to voice their concerns and fears".

She added that many of the domestic workers interviewed said they were overworked, and had their mental health impacted as a result.

When asked about the small sample size, Ms Hingorani said that it was a qualitative study and in-depth interviews had to be conducted to understand the domestic workers' subjective evaluation of the caregiver burden they faced.

She added that the researchers also spoke to stakeholders such as academics, employment agencies and eldercare trainers to ensure that the findings and recommendations were consistent with the eldercare landscape and whether the recommendations were feasible.

The findings were also presented to six maids in an online focus group discussion for validation.

The report found three key areas in which the domestic workers faced challenges, and proposed recommendations to address the issues.

Some were inaccurately matched to their care recipients. Of the migrant domestic workers interviewed, 20 per cent were providing a higher level of care than they had been prepared for before they were hired.

Home and Aware suggested creating a standard care-needs matrix to identify the level of care needed, and setting up an accreditation system to certify migrant domestic workers' caregiving skills and ensuring that the workers are adequately trained by providing incentives to employers to hire trained workers.

The report also noted that migrant domestic workers were often overworked, resulting in caregiver burden. About 21 of the maids had their sleep disrupted regularly, with more than half having experienced more than two disruptions a night.

The NGOs recommended that legislation be amended for better protection to clearly define the working-hours job scope as well as guaranteed access to respite care services.

Third, the researches found a lack of informational and emotional support for challenging caregiving situations, which included workers being subjected to verbal and physical abuse from care recipients.

Out of 11 maids who were caring for an elderly person with dementia, six faced verbal abuse while four faced physical abuse.

The NGOs proposed creating migrant domestic workers-centred caregiver support resources such as a caregiver support group for these workers.

Ms Hingorani said that in the long term, Singapore should professionalise live-in caregivers and homecare workers.

This would strengthen valuation and compensation of care work and make the caregiving industry more attractive, she added.