The government has found an unofficial solution to Israel's nursing shortage: foreign caregivers – most from the Philippines – looking after the elderly in hospitals around the clock.
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Currently 54,000 legal caregivers live in Israel, on top of an estimated 40,000 illegal ones. The country's 476 nurses per 100,000 people is extremely low on the OECD table – only South Korea (451) and Mexico (246) do worse, compared with 946 for Britain and 1,098 for Germany.
In 2010, Israel issued 959 new nursing licenses, a decline of 49 percent from 2002. A plan to expand nursing-training programs has been drawn up, but bureaucratic hurdles have kept it from being carried out.
This situation sparked a study by Prof. Liat Ayalon of Bar-Ilan University's School of Social Work. Researchers interviewed 20 foreign workers, 17 elderly patients, 16 family members and 20 nurses. They found that the jobs a foreign worker is permitted to do at hospitals has not been defined.
“The meeting between the elderly person’s caregiver and his family with the hospital staff could cause difficulties and conflicts among everyone involved," Ayalon wrote.
She found that foreign caregivers take on roles that would otherwise be filled by nurses or family members. The study found two major conflicts: one regarding the caregivers' presence and one their absence.
“Because of the great ambiguity linked to the foreign caregiver’s employment at the hospital, he's subject to criticism in every situation. When the caregiver is present in the hospital, he's criticized by the hospital staff, and when he's absent, he's criticized by the family," Ayalon says.
“The foreign caregivers are in the hospital 24 hours a day, providing emotional support as a replacement for the family and supervision that's the job of the nursing staff. It's a problem when they're working instead of the skilled nursing staff, which is sinking under the burden. And the state is closing its eyes, because for the state it's convenient that this situation continue.”
The researchers recommend that foreign caregivers' role at the hospitals be clearly defined. “We need to find where they fit in in hospital life to make the job of providing treatment easier,” Ayalon says. Her findings were recently presented at a conference of the Israel Association for Geriatric Medicine.
The study was conducted with funding from the chief scientist at the Industry, Trade and Labor Ministry in cooperation with researchers Sarah Halevy-Levin, Dr. Zvi Ben-Yitzhak and Prof. Gideon Friedman of Hadassah University Hospital, Ein Karem.