From care relationship between a migrant home caregiver and her older care recipient to couplehood

In the State of Israel, where the number of elderly people requiring long-term care in the community is constantly on the rise, one of the long-term care solutions for the elderly is migrant home caregivers that come from developing countries like the Philippines. The migrant home caregiver’s roles include addressing functional and instrumental needs alongside fulfilling the emotional-social needs of the older long-term care recipient. The care relationship blurs the boundaries between the parties’ formal and informal relationships. This study examines the phenomenon of cases in which this blurred boundary between the migrant home caregiver and the older care recipient turns into couplehood.

There is research literature in Israel and worldwide about phenomena that relate to the present subject, such as a (second) couplehood relationship in old age, couplehood relationships of Filipino migrant home caregivers in the world and in Israel, and relationships that go beyond caring. A combination of all these phenomena into one unique phenomenon has not yet been studied in the context of long-term care. The couplehood relationship between the parties raises questions regarding their motives. The woman, who comes from a developing country to the State of Israel, which is considered a developed country, is interested to improve her socioeconomic status, while the elderly man is interested in a young woman he finds attractive to fulfill his functional or intimate needs. Moreover, the couplehood relationship of the interviewees might be considered unusual by the two communities they belong to – the Israeli and the Filipino – because of the duality in both societies between religion and tradition, and between modernity and permissiveness.

The purpose of the study was to examine how the couples perceive their transition from a care relationship to a couplehood relationship, in light of differences in age, function, economic standing, class, religion, language and culture.

Two theories can explain the phenomenon of couplehood relationships examined in this study. The first theoretical framework is based on evolutionary-psychological theories that explain the gender variance in peoples’ choice of partner and is dependent on the goal of the relationship. According to this theory, the motives for choosing a partner are Darwinian and related to sexual gratification or the desire to bear children. A second, supplemental theoretical framework chosen for this study is social exchange theory. According to this theory, the partners choose a companion according to cost-benefit calculations in which each partner expects to receive a reward of equal value in exchange for what they give to their partner.

The research method chosen is a qualitative one, which differs from quantitative approaches in that it makes it possible to understand the uniqueness, the complexity, and the difficulties associated with the researched phenomenon. The study population included five men and five women that met the following criteria: 1. A relationship that began as care relationship between a Filipino migrant home caregiver and an elderly care recipient 2. The relationship between the migrant worker and the elderly man later became one of couplehood. In order to make it easier to locate a study population, an age threshold of 55 and over was set for a man and no age restriction was set for the woman. The study population was found by advertising in the media and press of the Filipino community in Israel. Moreover, geriatrics professionals and informants in the Filipino community were approached. The study population sample was based on snowball sampling and convenience sampling. The research tool was a semi-structured interview with each of the interviewees. The data collection method as a separate interview was selected due to the inherent advantages of this method. Thus, it was possible to receive the interviewees’ individual stories about themselves and about their spouses. The interview data analysis method was categorical in order to reach main themes inductively.

Based on this qualitative research method, I observed three main themes that were common to all the interviewees: A) The ‘internal sphere,’ which includes the various relationships between the men and the women: caring, ideal couple relationships and those with difficulties, ‘seam’ relationships (on the border between caring and couplehood), and the question of improving the woman’s status as a motive in the relationship. B) The couple’s relationship vis-a-vis the ‘external sphere’ comprised of familial and extra-familial circles. C) The couple’s relationship in the eyes of God. The ‘(inter-)religious sphere’ is associated with the strength of faith in God among some of the women and how the interviewees related to the religious gap between them.

In the ‘internal sphere,’ there are diverse perspectives on the interviewees’ motives for the couplehood relationship. The quality care that the Filipino women provided, coupled with the development of mutual feelings of dependence associated with the care, is a motive in the interviewees’ perspective. In addition, psycho-evolutionary motives associated with fulfilling the interpersonal-intimate needs of the parties enable mutual closeness.

From the interviewees’ perspective, the socio-economic improvement in the women’s status as a motive for her involvement in a relationship of couplehood with the man is not unequivocal. On the one hand, the interviewees present their couplehood as ideal social exchange relationships, where the man receives care and the woman benefits from an improved socio-economic status. On the other hand, the interviewees attempted to validate the legitimacy of their relationship with each other as people that are not in a relationship only to improve the woman’s socio-economic status: the women’s perspectives of their roles as spouses and/or caregivers, the spouse’s positive qualities as motive for the relationship, and, from the perspectives of some interviewees, the absence of a connection between the woman’s improved status and the relationship, call into question improved socio-economic status as a dominant motive in the relationship.

In the ‘external sphere,’ the interviewees validate their relationship in several ways in order to lend it legitimacy. In the nuclear familial circle, most of them wish to have children, and the fulfilment of this natural need to have offspring legitimizes the relationship in the interviewees’ eyes. In the relationship with the woman’s family of origin, some of the women report negative attitudes of their family members abroad regarding their relationship with an elderly and disabled man. However, they and their spouses provide the woman’s family with financial assistance, out of a shared perception of the woman’s obligation to her family overseas. Vis-a-vis the extra-familial circle (friends, Israeli society, and the Population and Immigration Authority), some of the interviewees reported being negatively labeled in caregiving roles or that the woman’s couplehood stems from her desire to improve her socio-economic status. Most of the interviewees want and receive recognition of their relationships from the Population and Immigration Authority, though a minority of them reported skepticism on the part of the Authority.

In the religious sphere, some of the women justify their couplehood with an elderly and disabled man as stemming from a strong faith in God. The inter-religious gap is perceived as significant in the ‘internal’ and ‘external’ spheres, and in order to gain legitimacy for their couplehood relationships, the women develop an affinity to the Jewish religion by observing some Jewish traditions and, in some cases, developing a desire to convert.

The variety of motives in couplehood relationships between migrant home caregivers and older care recipients, as demonstrated by the study’s findings, makes it possible to change the negative stereotypical perception of couplehood between elderly males and Filipino migrant workers in both Israeli and Filipino societies. In addition, a study that deals with ‘non-classical’ couples increases awareness in Israeli society of the couples studied and their counterparts, and reinforces the legitimacy of the interviewees in receiving recognition of their relationships vis-a-vis the spouse and in relation to the external environment. Receiving such recognition makes it possible to shift the couples’ status from the social margins to the mainstream.