Lived caregiving experience of foreign domestic workers (FDWs) for non-cancer palliative patients in Singapore (a secondary qualitative data analysis)

With changing family structures in Singapore, reliance on foreign domestic workers (FDWs) for eldercare, including palliative care, is increasing. Despite easing family caregivers’ burden and benefiting patient outcomes, FDWs—typically female migrants—often face significant challenges. These challenges are especially pronounced in palliative care, where demands are more specialized and intense. Many FDWs report stress due to limited rest, social support, and behavioral management demands. Understanding their experiences is essential to inform interventions that enhance sustainability of care. This study explores the caregiving experiences of FDWs supporting non-cancer patients at end-of-life in Singapore. We conducted a qualitative secondary analysis of 15 interview transcripts from a study involving a home-based palliative care program for non-cancer patients. Data were analysed both deductively and inductively using an adapted conceptual framework that integrated three models: the Informal Caregiving Integrative Model (ICIM), Inherent Tension of Caregiving Model, and Risk and Resistance Model of Adjustment. This comprehensive approach holistically considers caregiver demands and resources, environmental influences on outcomes, and dynamic processes shaping caregiver strain. New emergent themes were incorporated inductively. FDWs’ experiences were classified using Pristavec’s five caregiving profiles—“Dissatisfied”, “Balanced”, “Relationship”, “Satisfied”, and “Intensive”. 60% of FDWs were characterized as having a “Balanced” caregiving experience. All FDWs across experience profiles reported psychological stress and physical fatigue. However, each profile revealed distinct experiences, influenced by coping strategies, boundary-setting, and personal outlook. Positive framing and effective coping were found to be associated with better caregiver well-being, regardless of caregiving intensity. This study highlights the nuanced experiences of FDWs providing palliative care to non-cancer patients. Findings underscore the need for targeted support interventions to strengthen FDWs’ coping abilities and reduce caregiver burden. Tailored caregiver programs that acknowledge individual variability in experience and response to caregiving demands may enhance care sustainability and worker well-being. Future research should explore culturally and contextually appropriate models of support for FDWs in end-of-life care.