Although foreign domestic workers (FDWs) play a significant role in caring for frail seniors in Singapore and are vulnerable to caregiving burden, there has been little research conducted hitherto. We explored caregiver burden and its determinants in this study.

FDWs (N = 221, Mage = 32.3, SD = 6.23) recruited from a hospital geriatric unit completed the Zarit Burden Interview (ZBI) administered in English, Bahasa Melayu, or Burmese. Univariate and multivariate regression were employed to investigate factors influencing caregiving burden in FDWs.

Majority were Indonesians (60.0%), married (57.5%) with children (62.4%), with secondary-level education (59.7%), and providing care for >1 year (79.9%). Importantly, 25.1% reported physical health problems and 23.1% encountered language difficulties with employers. Univariate analysis revealed three significant factors associated with caregiving burden: nationality (p < 0.001), lack of privacy (p = 0.029), and caring for persons with dementia (PWD) (p = 0.001). On multivariate regression, FDWs who cared for PWD were 5.47 times (p = 0.013) more likely to experience burden, while FDWs who encountered language difficulties were 5.46 times (p = 0.030) more likely to experience burden. Filipinos FDWs were 9.73 times more likely to express burden (p < 0.001) compared to their Indonesian and Burmese counterparts.

The study highlights caregiver burden in FDWs and potential ways to alleviate it by empowering FDWs with dementia-specific caregiving skills, providing language training opportunities, and supporting particular FDW ethnic groups with more emotional and practical help.

Foreign domestic workers (FDWs) play an important role in long-term caregiving of seniors at home. However, how FDWs cope with the caregiving demands, the dynamic interaction between familial and FDW caregivers and its impact on care recipients remain largely un-explored. Existing caregiver interventions mainly target familial caregivers; little assistance is available for FDW caregivers. This study explores FDWs’ challenges, coping strategies, and the support they need in caring for seniors.

FDWs were recruited from a geriatric ward and outpatient clinic of a tertiary hospital in Singapore. Qualitative in-depth interviews were conducted with 25 FDWs caring for frail seniors and five healthcare staff. Interviews were transcribed and analyzed using thematic analysis.

FDWs were from Indonesia, Philippines, and Myanmar. Nineteen cared for seniors with dementia (SWDs). We derived six subthemes, clustered into three salient themes: two described social support to FDWs by the senior's family members, two described their coping strategies, and two described their job satisfaction. Those who cared for SWDs faced more difficulties. We derived two family models of care: FDW-centered family dynamics, where family members rely on FDWs to perform most duties, causing poor impact on seniors’ well-being and team-based family dynamics, where family members and FDWs share the caregiving burden, resulting in better impact on seniors’ well-being.

FDWs face significant challenges in eldercare. Improving FDWs’ access to training courses in eldercare, providing them with more emotional support, engaging employers to create healthy caregiving spaces at home, and improving access to senior care services can be helpful.