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 the elderly woman unsupervised.

Kevaly (not her real name), who is also a maid, has been taking care of an 89-year-old wheelchair-bound stroke patient with early-stage dementia for nine months.

When Kevaly fell ill, her employer pressured her to continue working and accompany her charge to senior daycare, even though Kevaly had a medical certificate from a doctor.

They were among 25 maids 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) yesterday in an online press conference.

Their ages ranged from 27 to 53, and they were mostly from the Philippines and Myanmar.

They had worked for about five years and four months on average in Singapore.

The researchers also interviewed four maid agencies, seven employers of maids in eldercare and five providers of formal eldercare training between last December and September this year.

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

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 on 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 interviewed said they were overworked and had their mental health impacted.

When asked about the small sample size, Ms Hingorani said that it was a qualitative study and in-depth interviews had to be conducted.

The researchers also spoke to stakeholders such as academics, employment agencies and eldercare trainers to ensure the findings were consistent with the eldercare landscape and the recommendations 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 maids faced challenges.

Some were inaccurately matched to their care recipients.

Of the maids 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 maids' caregiving skills and ensure they are adequately trained, by providing incentives to employers to hire trained maids.

The report also noted that the maids were often overworked, resulting in caregiver burden.

About 21 of the maids had their sleep disrupted regularly, with more than half having more than two disruptions a night.

The non-governmental organisations recommended that legislation be amended for better protection in clearly defining the working hours, as well as guaranteed access to respite care services.

Third, the researchers found a lack of information and emotional support for challenging caregiving situations, which included maids 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 maid-centred resources, such as a caregiver support group for maids.