Aaron Zhu


Abstract

Care workers in high-income countries face a significant gap due to aging population and labor shortage, and compared to existing HCI literature, research on the invisible work of age care home workers remains a noticeable deficiency. This study addresses this gap through an ethnographic investigation of migrant care workers at a non-profit long term aged care home in Singapore. The findings reveal the diverse forms of invisible work they face, including challenges related to their migrant identity, communication with multiple stakeholders, balancing caregiving roles, and constraints imposed by efficiency-focused technology. We explore the complex relationship between technology’s role in automating or enhancing the visibility of invisible work and its impact on improving well-being and agency of care workers. These findings provide insights for existing aged care homes to reimagine socio-technical systems that better support workers’ invisible work and promote more sustainable caregiving practices.

 Background
In the context of Singapore's aging population, Long term care work heavily relies on foreign female care workers, and the demanding workload combined with lower salaries compared to their benchmarked peers in other APAC economies leads to a high turnover rate within the industry.

Current Technologies Reshape Care Workplace

Technological interventions in nursing home often focus on the needs of care recipients and management, with top-down implementation that overlooks the complexity of ground staff’s care work. This approach fails to provide the detailed support required for frontline workers and may even have negative effects.  We focus on the concept of “articulation work” in CSCW and HCI to explore the additional burden borne by nursing home workers due to the introduction of new technologies. Care workers end up becoming "babysitters" for technology. There is a significant research gap regarding the impact of existing healthcare technologies on the workflows and well-being of care workers.



Impact of Technologies on Care Workers

#Electronic Medical Records (EMR) System
The standardization brought by EMRs has made the complexity of nursing work even more invisible. What was once based on experience and judgment is now reduced to quantifiable data and standardized care steps.

#Robotics in Care

The automation brought by robots in caregiving has a significant impact on care staffs. In both emotional support and task-oriented aspects, care workers are required to put in extra effort to collaborate with the robots. According to the four dimensions of care , under the existing care worker technology systems, human experience is required at each stage. These dimensions include identifying care needs,  generating the will to care, executing care, fill in the gaps in technology, and to further respond to the changing needs of care recipient.

Field Observation in Nursing Home

We conducted observation at a non-profit nursing home in Singapore, taking a shift in parakeet Ward as an example. With a 1 to 6 care ratio, ground care workers carry out intensive work schedules.

Workshop

Based on our findings, we invited ten designers and researchers to share ideas for improving the well-being of care workers, specifically focusing on speculative scenarios that address this invisible labor. Drawing on these critical narratives, we created a fictional nursing column for Singapore's Straits Times in 2030, showcasing the entangled ethics and responsibilities of future care settings.

#Speculative scenarios and product examples



Four Types of Invisible Works

After the research team iterated on the topic based on relevant literature, our findings reveal four types of invisible labor undertaken by migrant care workers in Singaporean nursing homes. These forms of invisible labor are shaped by the workers’ intersecting migrant identities, technology, the institutional hierarchy of the nursing home, and the multi-stakeholder care networks in which they are embedded.


Design Consideration


Reflection