“We see many requests to switch home caregivers. Not because they (workers) lack skill or training, but because the client would like someone with lighter skin”. This observation, offered by a Singaporean NGO worker, is prevalent in East Asia. Racism is embedded in the most intimate spaces of care. Migrant care workers navigate patient-centered interactions while developing their own ethical frameworks that challenge mainstream market ethics.

The intersection of eldercare and migration reveals critical blind spots in dominant understandings of care ethics and practice. Economic labor supply and demand debates tend to overshadow deeper questions about subjective valuations of care. While feminist philosophers have long theorized care as relational and contextual, most frameworks remain rooted in Western, individualist assumptions that inadequately capture the complex dynamics when care crosses racial, national, and cultural boundaries. As my research on eldercare systems in Singapore and Taiwan demonstrates, we need theoretical approaches that account for how structural inequalities shape intimate care relationships and divisions of emotional labor while recognizing the agency and wisdom that migrant care workers bring to the table.

The Intimate Politics of Racialized Eldercare

In Singapore and Taiwan, the over-reliance on foreign domestic workers (FDWs) must be understood as part of a capitalist state strategy to minimize healthcare costs. Taiwanese citizens have, on average, an easier time hiring FDWs, but the root problem of an asymmetrical working relationship remains unresolved. This power-over dynamic is not merely economic but fundamentally racialized, creating an “intimate apartheid” in care arrangements.

Older adults’ racist attitudes cannot be dismissed as individual pathology or the inevitable result of cognitive decline. These incidents represent moments where broader social hierarchies are negotiated in vulnerable situations; when elderly care recipients reject touch or make derogatory comments about their caregivers’ cultural backgrounds.

In Singapore and Taiwan, aging in place, also stay-at-home (live-in) care by adult daughters and/or daughters-in-law assisted by FDWs, is the most popular option. This default arrangement obscures gendered and racist dynamics in expectations of who must care. A harmonious facade of a migrant-in-the-family model masks deeper structural inequalities while framing racism as a personal failure instead of a systemic issue embedded in care arrangements.

Migrant care workers develop sophisticated strategies for navigating and sometimes even transforming these relationships. They might gradually introduce care recipients to foods from their home countries, share stories that humanize their experiences, or use humor to diffuse tense moments. These practices represent forms of care ethics and practice that extend far beyond the physical tasks outlined in employment contracts.

My interviews with FDWs reveal the migrant women’s sophisticated understanding of global to local inequities that their migratory circumstances of need are grounded in. As one anonymous interviewee explained, “people don’t realize that by treating us badly, like cheaply, people are also harming their own old people” – the devaluation of care work directly compromises its quality, creating a “race to the bottom” of eldercare standards that ultimately harms all parties.

Decolonizing Care Through Migrant Perspectives: Cross-Cultural Care

Despite a diversifying and dynamic Global South, care remains a relatively unvariegated concept with roots in European settler colonial logics, indentured labor, and modern slavery. Mainstream care ethics emphasizes concepts like attentiveness, responsibility, competence, and responsiveness. While valuable, these frameworks often assume care relationships between relative equals and fail to account for colonialism, capitalism, and coerced migration.

Migrant care workers often act out alternative ethical frameworks rooted in different cultural concepts of reciprocity, interdependence, and collective responsibility. For instance, many Filipino domestic workers I encountered expressed an ethic of sayang (shower with grace and love) toward their patients while harbouring their own immediate and extended family networks in mind. Similarly, some Indonesian migrant women drew on Islamic concepts of barakah (divine blessing associated with abundance and prosperity) to frame their care work as spiritually meaningful even in exploitative conditions. In this sense, they creativelyclaim agency and maintain dignity while providing intimate care to elderly persons who may harbor racist prejudice against them. These workers are doing more than just surviving exploitation; they reconfigure the contours of dyadic care relationships.

When we center migrant care workers’ perspectives, new possibilities emerge for addressing racism in eldercare settings. Rather than treating racist attitudes as fixed characteristics of care recipients, migrant workers often approach these situations as opportunities for gradual transformation through relationship building with patients.

Rosa (pseudonym), a Filipino caregiver I interviewed, had gradually won over an elderly Taiwanese man who initially refused her care: “At first, he would only speak to me through his daughter. But I kept bringing him small portions of food I cooked, asking about his favorite Taiwanese dishes, and sharing stories about my own grandmother. After three months, he started teaching me Taiwanese phrases and asking about my family.” This transformation occurred through initiatives to care across cultural boundaries while expressing affection and concern.

This and other examples show migrant care workers as cultural mediators who translate different care practices in the face of racism via sustained relationship building. In community events such as the purple parade choir shown above, FDWs assert not only a right to be cared for by the host society, but also a truly intersectional, holistic, and equitable notion of cross-movement solidarity where migrant workers’ rights advocacy must occur alongside other social justice struggles. Their practice suggests that addressing racism in care settings requires more than policy interventions; it demands recognition of care work as impactful cultural and political labor.

Toward Equitable, Just Care 

Care systems are in need of structural changes that recognize care workers as knowledge holders and intellectual partners, not just service providers. We need policies that support transnational care practices rather than treating them as problems to be managed. This could involve reforming visa systems that separate workers from their own families, creating pathways for professional development that build on workers’ existing knowledge, and developing care models that draw on diverse cultural practices rather than imposing standardized Western approaches.The intimate politics of racialized eldercare embodies colonial hierarchies and the potential for its disruption through everyday care practices. Can our care systems learn from the transformative social justice practices that migrant care workers have developed? In centering their voices and lived experiences, we might discover more just, equitable, and effective approaches that serve both care recipients and providers for the better.

Lynn Yu Ling Ng is a Banting Postdoctoral Fellow in the Department of Politics, Faculty of Liberal Arts & Professional Studies, at York University, Canada. She is author of the forthcoming book From Competition to Cooperation: Reworking Care Relations in Eldercare with the University of British Columbia (UBC) Press.

This work is courtesy of a Filipino Foreign Domestic Worker (FDW) and caregiver for the elderly in Singapore and licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.