Making the Invisible Visible: The Pandemic and Migrant Care Work in Long-Term Care

Round 1

Reviewer 1 Report

Thank you for the opportunity to review your manuscript.

I hope the following suggestions are helpful.

Please consider changing the title as Long term care has a different meaning in North America. I would ask that you use a different term than long term care in the title.   

Page 49, you use the word 'individualised', I am not sure this is the best word, suggest you just remove it and reword the sentence.

please avoid using the word 'but'

Line 58 - 59 you state "For example, in Austria, commuting live-in-cares....." It was hard to understand what means, for example do they commute to work every day or do they live with the families they provide care for. Please reword this so it is clear.

Lines 76 and 77 you state '75% of those who have care needs can rely on someone providing informal care and 78% do not use formal care services' These numbers do not add up, can you please re-phrase this. (same with lines 78 and 79)

On line 81 you state that care givers receive and allowance of C550 - how often do they receive this? weekly? monthly?

Line 118 - you state 'only about one third of them are still live-in carers' Please change 'about' to 'approximately'  Also this is not a clear statement, can you please clarify.

Line 151 - you state 'Spain boasted' what do you mean by the word 'boasted' perhaps use a different word.

Line 200 - subtitle 2.1 what do you mean by 'flashing' can you change this to a different word please

Line 486 - 487 you state 'for instance, remittances of migrant carers make up to more than 6 billion in Italy in alone' - this comment does not seem to fit with the sentance, also it is not clear what you are trying to state. Please re-word.

Author Response

Many thanks for the useful comments and proposals for amendments. We addressed all (see bullet points):

Please consider changing the title as Long term care has a different meaning in North America. I would ask that you use a different term than long term care in the title.   

•  As this is an article about Europe and as even WHO is using ‘long-term care’ to cover the entire system of formal and informal care, we would like to keep the term and the title as it is

Page 49, you use the word 'individualised', I am not sure this is the best word, suggest you just remove it and reword the sentence.

• Changed and reworded (‘isolated’)

please avoid using the word 'but'

• We thank the reviewer for the hint and reduced the number of ‘but’ across the article

Line 58 - 59 you state "For example, in Austria, commuting live-in-cares....." It was hard to understand what means, for example do they commute to work every day or do they live with the families they provide care for. Please reword this so it is clear.

• Changed and reworded

Lines 76 and 77 you state '75% of those who have care needs can rely on someone providing informal care and 78% do not use formal care services' These numbers do not add up, can you please re-phrase this. (same with lines 78 and 79)

• Thank you for the diligent reading – we reworded and provide more detail: “At least 54% of those with care needs are cared for by one or several informal carers alone, 34% of those living at home have a mixed arrangement of formal and informal care, and only 12% are cared for exclusively by formal care services, including residential care”

On line 81 you state that care givers receive and allowance of C550 - how often do they receive this? weekly? monthly?

• Yes, we specified the frequency and the rationale of the allowance

Line 118 - you state 'only about one third of them are still live-in carers' Please change 'about' to 'approximately'  Also this is not a clear statement, can you please clarify.

• We applied ‘approximately’ and reworded

Line 151 - you state 'Spain boasted' what do you mean by the word 'boasted' perhaps use a different word.

• Changed and reworded (report)

Line 200 - subtitle 2.1 what do you mean by 'flashing' can you change this to a different word please

• Changed and reworded (glance)

Line 486 - 487 you state 'for instance, remittances of migrant carers make up to more than 6 billion in Italy in alone' - this comment does not seem to fit with the sentance, also it is not clear what you are trying to state. Please re-word.

• We appreciate the comment and reworded the sentence

Reviewer 2 Report

Dear author(s),

Thank you for the interesting read. However, there are some improvements suggested for the current version of manuscript. 

The aim should be clearly stated.

Literature section should be separately dedicated to explain the development of critical review. 

Methods need improvement. It should be clearly explained how the self-biases were controlled. Sampling techniques, development of research instrument, methodological flow and validity and reliability.

Conclusion should be given under separate heading.

You should also provide managerial implications in a separate section, followed by future directions.

Good luck.

Author Response

Many thanks for the comments. We addressed all of them accordingly (see bullet points)

The aim should be clearly stated.

• We used the term ‘aim’ to address this comment

Literature section should be separately dedicated to explain the development of critical review. 

• We have difficulty to understand the meaning of this comment, but introduced a sub-section on methods (see also below) to explain our approaches and procedures

Methods need improvement. It should be clearly explained how the self-biases were controlled. Sampling techniques, development of research instrument, methodological flow and validity and reliability.

• We introduced a sub-section (1.2) on methods and procedures. We do not understand the request regarding ‘sampling techniques’ etc. as this is not an article based on quantitative methods.

Conclusion should be given under separate heading.

• We introduced a final section ‘Conclusion’

You should also provide managerial implications in a separate section, followed by future directions.

• We do not understand the meaning of this comment (managerial implications) – we have outlined future directions and policy recommendations

Round 2

Reviewer 2 Report

Dear author(s),

Unfortunately, you did not respond to most suggestion by simply stating "you do not understand the comment". This is a pity. A reviewer is spending time to read and review while the response is you do not understand the comment. 

Literature review should be a separate section. 

Methodology need improvement. Literature cannot be a part of methodology. 

Irrespective of the type of research, the sampling technique reflects the selection process. 

You must revise the work as per earlier comments.

Author Response

Response to Reviewer 2

We thank you kindly for your comments and your time spent reviewing the manuscript. We were confused with your initial review as we had understood some of the terminology to be more relevant for quantitative methods (i.e. sampling technique). We have now tried to address your comments as best as possible given our interpretation of them, namely by outlining in further detail the methodological approach we took (starting from line 178 in the paper). We carried out a literature review in a field with very limited academic literature on the topic. We used a research protocol and set terms and inclusion criteria, however even a broad search using a variety of related terms across 3 academic search engines retrieved 31 hits, from which 2 articles were relevant to be used in the article. We then amended our strategy to take a more exploratory approach, including grey literature sourced through google scholar and google. The inclusion criteria at this stage consisted of any literature touching on live-in care during the pandemic in at least one of the three countries as well as mitigating policy measures since 2020.  Potential literature could have included scientific articles, online reports, newspaper articles, relevant laws, ordinances and official guidelines. We took an iterative approach, following up on relevant literature mentioned in the identified documents.

We found this to be an acceptable approach given that the topic is quite niche as it is, let alone the fact that our timeframe is narrowed down to the last 2.5 years. It was necessary to take this approach to portray the situation of live-in carers after the outbreak of Sars-Cov-II in the three countries due to the limited amount of research done on this topic to date.

With this in mind, we try to address your latest specific comments here:

Comment: Literature review should be a separate section.

Response: The point of the article was to review what has happened in the 3 countries concerning live-in care since the pandemic began, highlighting the visibility that has been brought to migrant care workers and mitigating policy measures. We hope that it is understandable that the literature review thus cannot be a separate section, as this is what we are basing our results on. We review the literature that we found throughout parts 2 and 3, before discussing their implications and policy relevance in section 4.

Comment: Methodology need improvement. Literature cannot be a part of methodology.

Response: As mentioned above, our methodology revolves around a review of the available literature on live-in care during the pandemic in Austria, Italy and Spain. Therefore, the bulk of the paper highlights the literature that we found, including those in national languages. We have nonetheless tried to expand on our methodological approach, providing details as to why we included grey literature (starting from line 178).

Comment: Irrespective of the type of research, the sampling technique reflects the selection process.

Response: As mentioned above, given the limited literature on the subject, we did not limit the review to articles from academic journals. As long as the literature touched on live-in care during the pandemic in at least one of the three countries, it was included in our analysis. We have highlighted this in more details now in the methods section (line 178).

And finally, we take the opportunity here to address what we interpreted your previous comment to mean:

Comment: Methods need improvement. It should be clearly explained how the self-biases were controlled. Sampling techniques, development of research instrument, methodological flow and validity and reliability.

Response:

As we hinted at above, we had to go beyond articles in academic journals in our review to include the relevant information in our research, also in the national languages. Any literature identified through our searches that touched on live-in care during the pandemic and mitigating policy measures was included in our analysis, including the use of search items in the national languages (Italian, German, Spanish). The validity and reliability of our study is described through the presentation of the method we used which describes the different steps we took to select the literature we reviewed. 

Round 3

Reviewer 2 Report

Greetings,

Thank you for the revision.