Loneliness and Social Isolation of Older Adults and Quality of Dyadic Relationships with Migrant Domestic Workers: A Mixed-Method Study.

Loneliness among older individuals is widespread globally, leading to increasing public health and policy concerns. Migrant domestic workers (MDWs) offer continuous services for older adults worldwide, recompensing for dwindling support from family members. The study objectives were to explain how the quality of dyadic relationships with MDWs is associated with older adults' loneliness and further explore older adults' perceived experiences of care by MDWs. A mixed-methods study was conducted from 2021 to 2023. Convenience and snowball samplings of older adults aged ≥60 living with MDWs were recruited by elderly community centers in Hong Kong for a survey, and purposive sampling of in-depth interviews followed. The survey comprised several well-validated scales assessing loneliness, perceived social networks, and the quality of dyadic relationships. Face-to-face in-depth interviews were audio-recorded and transcribed for preliminary content analysis. A total of 288 older adults participated in the first phase of the survey interviews. Among them, 19 joined the in-depth interviews in the second phase. There is a high prevalence of loneliness among older adults being cared for by MDWs in Hong Kong. In addition, the results showed that social loneliness negatively and significantly correlated with perceived dyadic relationship quality and social network. Two major interrelated themes were identified along with eight subthemes: (1) established relational interaction with MDWs and (2) enjoyed functional assistance and support from MDWs. Our study findings illustrated that good dyadic relationships among MDWs and older adults enhance older adults' social connections and networking, alleviating loneliness and social isolation. Appropriate strategies are suggested to strengthen older adults' social support and improve the quality of dyadic relationships with MDWs, which may reduce loneliness among older adults.