Teaching and Learning About Home Care in Israel

By Geralyn Magan

Teaching and learning were both on the itinerary when Robyn Stone visited Israel in May.

The Global Ageing Network’s Director of Research went to the Middle East at the invitation of JDC-ESHEL, a non-governmental organization (NGO) that has been planning and developing services for older Israelis for 35 years. The organization functions under the auspices of the American Jewish Joint Distribution Committee (JDC), an American-based NGO that provides relief, rescue, and reconstruction services to Jewish and non-Jewish clients around the world.

“I was so impressed by this nonprofit organization,” says Stone. “The JDC is not a government entity, but it has a strong influence on government policy. It serves as a natural research laboratory that conducts pilot projects, tests ideas, and then sends its findings to the government so those findings can be incorporated into real policies. I think we have a lot to learn from the Israelis.”

TEACHING ISRAELIS ABOUT THE VALUE OF APPLIED RESEARCH

During a week of meetings with JDC-ESHEL staff and stakeholders, Stone offered technical assistance on a variety of topics, including how Israel could expand its home care sector without sacrificing quality.

“Right now, the Israelis are trying to learn what the training should be, how you make that training more competency-based, and how you ensure quality,” says Stone. “These are the same questions we are asking, so I suspect we will learn from each other.”

Israel’s training issues have become more challenging in recent years as the country welcomed approximately 45,000 foreign-born caregivers from the Philippines, Moldova, Nepal, India, Sri Lanka, and other countries. Stone relied heavily on the evidence base around cultural competency as she provided Israeli educators with strategies for training those foreign-born workers. She also used her keynote address at JDC-ESHEL’s annual conference to underscore the importance of an evidence base in helping providers address other service-delivery challenges.

“Stories are great,” Stone told conference participants. “But, at the same time, hard evidence is really essential. Storytelling and data are not enemies. They actually go together.”

LEARNING HOW TO INTEGRATE FOREIGN WORKERS INTO HOME CARE

When she wasn’t offering technical assistance, Stone was asking her own questions about the role that foreign workers are playing in Israel’s evolving home care sector, and about the infrastructure that Israel has created to help foreign workers succeed.

Israel’s population of foreign workers, which has grown significantly since the 1990s, is concentrated in 3 sectors: caregiving, agriculture, and construction. The caregiving sector employs the largest number of foreign workers: 45,122 caregivers, or 59% of all foreign workers. While most foreign workers stay in Israel for up to 3 years, workers in the caregiving sector usually stay longer.

“The Israelis have made a specific choice to relieve their worker shortages by bringing in workers from other countries, and they are systematically developing an infrastructure for this program so it does not become an underground economy,” says Stone.

Since 2012, Israel has signed a series of formal agreements with countries from which its foreign-born workers hail. The agreements have helped protect workers by preventing unscrupulous parties from charging illegal recruitment fees.

Other worker protections include the following:

  • While private recruitment agencies find placements for foreign workers in the caregiving sector, the care recipient acts as the worker’s direct employer.

  • Employers must pay for a worker’s medical insurance, provide him or her with proper accommodation within the home, and guarantee full-time employment.

  • Workers experiencing problems with an employer can call a telephone hotline that was established in 2012. Issues surfacing through the hotline – the majority of complaints relate to employer issues (43%) and wages (34%) – are addressed by government enforcement units.

“It was interesting to see how organized the foreign worker program is, and how very thoughtful the Israelis have been about training and protecting the rights of these workers, and helping them become integrated into the family,” says Stone. “They haven’t figured it all out, but they are working on it.”