Does Mauritius need a Professional Care Ladder Now?

From Unskilled Carers to Silver Economy

By Vina Ballgobin

“A society that does not value its older people denies its roots and endangers its future. Let us strive to build cultures where the elderly are respected and regarded as a source of wisdom and guidance.”
— Nelson Mandela

Mauritius is at a demographic crossroads. The ageing population is set to become a majority (life expectancy at birth for men – 72.5 and women – 78.6; one out of every 4 Mauritians is 55+). However, job profiles in Mauritius to care for Senior Citizens (Seniors) belong mainly to two categories:

* “Domestic worker” also known as “Housemaid”;

* “Garde-Malade”, also known as “Carer” or “Home-Based Care Worker” or “Health Care Assistant” (HCA).

Basically, there is an archaic “one-size-fits-all” approach that is failing our Seniors, their families and the workers themselves. The legislative framework — specifically the Domestic Workers (Remuneration) Regulations 2019 — offers an insight into major shortcomings that currently create significant stress for Senior Citizens and families and high turnover of employees (housemaid or garde-malade).

The Elderly. Pic – Aum Care Group

Duties of a “Household employee”: Overstretched and under-defined

The current duties of a “household employee” means an employee who is required to perform one or more of the following duties: undertake manual work in a house, run errands and baby-sit (Government Notice No. 210 of 2019). This usually includes “cleaning” (sweeping, mopping, dusting, and deep cleaning of bathrooms/kitchens); “laundry” (washing, drying, and ironing clothes) and “kitchen support” (washing dishes, cutting vegetables and sometimes preparing basic meal/tea).

“Household employee/Cook” means an employee who is required to perform one or more of the duties of a household employee and a cook — preparing and cooking food for household members and guests; serving food; cleaning of the kitchen and equipment under his/her care, and carrying out “any other cognate duties” (Government Notice No. 210 of 2019).

By labelling “Elderly assistance” as a side-task, the law implies it requires no extra skill. This leads to families hiring “Household employees/Cooks” for specialised needs. Can ad-hoc care to Seniors be unacceptable in 2026? Today, the majority of Mauritian Household employees/Cooks understandably refuse any other cognate duty. Those who accept such responsibilities often suffer from worker burnout, compromising the Senior’s safety and theirs too. Thus, the “Care” domain must be separated from other domestic profiles and established as its own professional tier.

Duties of a “Carer”: The Experience vs Expertise Crisis

A “garde-malade” means an employee who is employed for the purpose of looking after a sick or a disabled person (Government Notice No. 210 of 2019). A “Carer” usually looks into the physical and basic medical well-being of the “Senior Citizen”. Duties usually include personal hygiene (bathing, dressing, and “toileting” including changing adult diapers); mobility (positioning/lifting patients to prevent bedsores and assisting with walking); medical monitoring (checking blood pressure, reading glucometers, ensuring medication is taken on time); nutrition (feeding patients who cannot feed themselves and monitoring fluid intake); and reporting (observing abnormalities in urine/stools and reporting to family and/or doctors).

Three critical failures in the current system

1. Safety Risks. Given that it is a “scarcity area”, many “ad-hoc carers” have no formal training at all to carry out such responsibilities but are recruited by families. They risk their own health, and the patient is at risk during positioning/heavy lifting or medical monitoring, for example.

2. Undeclared Employment. Some families hire a three-in-one “Household employee/Cook/Garde-malade” with “ad-hoc carer responsibilities”. Very often, people above 60 years propose to do this job, negotiate a salary, thus leading to poor care for the elderly person and undeclared remuneration.

3. A Registry Vacuum. Families rely on “private companies” with flashy websites but, most often, very little or no verified competencies. Mauritius desperately needs an official Ministry-vetted registry of such companies offering care practitioners’ services that a Mauritian can consult to take an informed decision.

Limitations of job occupation descriptions

Existing job descriptions are helpful but do not take into account the elderly and their specific needs. Beyond the visible struggles of physical hygiene and mobility, there remains a critical “blind spot” in our care system: those elderly living on the edge of a domestic crisis.

The “Invisible” Senior and the Hospital-to-Home Gap. Some “Semi-independent Seniors” appear fit enough to take care of themselves, but they suffer from “invisible” cognitive decline (what we commonly call “maladie vieillesse” — masking undiagnosed dementia). Local newspapers frequently report domestic “accidents”, such as gas stove fires (and severe burns) and the public notices Seniors falling unconscious at bus stations owing to unmanaged blood pressure or wrong intake of medications. With 149 types of dementia, how can we ensure that a Senior is safe alone without regular cognitive assessments? Currently, there is no follow-up for semi-independent Seniors (aged 60 to 90) who live alone following a hospital discharge.

Gap between Ministries – The 90+ Social Security Doctor. While a Social Security Doctor is appointed to follow the 90+ Seniors with free monthly visits, critical questions remain: What does the doctor know about his new patient when they meet for the first time? Is there any data-sharing between ministries? Are families or responsible people informed of the doctor’s official duties? Is this doctor trained to privately screen for ill-treatment and/or depression and/or other mental health issues? If yes, to whom does the doctor report for social follow-up?

The “Relativity” Gap for employees. The 2024/2025 wage adjustments increased the minimum wage for the occupations mentioned but specialisation was ignored. Paradoxically, expertise is not rewarded. Is there any legal distinction between a “garde-malade” for a healthy 70-year-old Senior and one for a bedbound 70-year-old with late-stage Alzheimer; a “carer with real professional gerontology skills” holding a Diploma and an “ad-hoc carer” claiming to have 10 years of professional experience?

Professionalised care models for Senior Citizens

Many countries, facing the same demographic trends as Mauritius, have already moved toward a “Career Ladder” approach, “professionalising” elderly care, whereby a basic assistant can progress to a specialist or manager position through lifelong learning.

1. Scotland
The Scottish Social Services Council (SSSC) requires all “Care workers” to be registered and qualified. Any individual cannot just decide to work as a “carer”: the person should hold specific certifications based on the Scottish Credit and Qualifications Framework (SCQF), moving from Level 6 (entry point) to Level 7 (more advanced role) to Levels 8-9 (diploma holder).
– Support Worker (Level 6): Personal care and social support in daily life. Mandatory basic training in ethics, dignity, and safety.
– Practitioner (Level 7): More responsibilities such as administering medication, coordinating with nurses, and supervising support workers.
– Supervisor/Manager (Levels 8-9): Management of entire care teams or care homes. Training in quality standards and legal complia

2. Northern Europe – Sweden, Denmark, and Norway

In the “Nordic Model”, care for Seniors belongs to a highly skilled profession.
– Social Care Assistant (Undersköterska): The “backbone” of the system and a protected title in Sweden. Trained in basic medicine, psychology, and elderly-specific nutrition.
– Dementia Specialist (Silviahemssyster): A specialized role (pioneered in Sweden) specifically for dementia and Alzheimer patients. Trained to use specific therapeutic techniques to maintain the patient’s cognitive function.
– Prevention & Health Promoter: In Denmark, the job category “Preventative Home Visits” is fundamental. Professionals visit “healthy Seniors” to assess their homes for fall risks and sickness, thus reducing any unnecessary strain on public hospitals.

3. Eastern Europe – Poland or the Czech Republic
In the “Integrated” and “Family Support” Model, it is essential to bridge the gap between medical and social care.
– Personal Assistant for Independent Living: Unlike a “housemaid”, this employee is hired specifically to help the Seniors remain part of the community—accompanying them to cultural events, helping with digital banking, and ensuring they aren’t isolated.
– Community Care Coordinator: This employee acts as the link between the family, the local doctor, and the social services, ensuring the Seniors’ needs are not ignored because they do not fit in one specific category or because of communication gaps across different services.

Proposals for Republic of Mauritius

* Compulsory Training. The Mauritian job occupations are not adapted anymore to the 21st century needs of Seniors. Those who choose these jobs need compulsory training and certifications (in any language depending on the region — Bhojpuri or Kreol). Equivalence should be made available for those who recruit foreign carers who already hold a certification.

* Lifelong learning. Five-year assessments should become mandatory (to learn new techniques and care facilities) and new certifications issued upon successful completion. Employees — both Mauritians and foreigners — would be motivated to climb the ladder provided they earn a better salary.

* Flexible paths. Not every carer can work with every Senior. During their training, “Carers” should be informed about flexible paths, and they may be able to choose to provide high-quality care for specific conditions (Alzheimer/Dementia/Other mental health issues; Heavy physical ailments; Accompaniment during last stages, among others).

* (a) A public registry of social care practitioners and their training levels must be accessible on Ministry/Ministries websites. This will help to shift the perception from that of a “colonial servant” role to that of a respected “technical employee”.
(b) The names of “Recruitment Agencies” hiring foreign labour should also be accessible online. Their professional fees, competencies and legal duties must be clearly mentioned. Currently fee structures are inconsistent; it seems that some “agents” operate without clear registration. In the outdated list online, recruitment periods have lapsed between 2022 and 2024.

The Mauritian Professional Care Ladder – A First Draft

Five main levels are proposed for tasks to match specific stages of health-related issues of Seniors.

Salary scale considerations

The National Minimum Wage (Amendment) Regulations 2026 and the Workers’ Rights – Additional Remuneration (2026) Regulations 2026 give the latest government wage adjustments.

Monthly Basic Salary Rates (Effective Jan 2026)

* If the basic salary is below Rs 20,000, the Mauritius Revenue Authority (MRA) pays a “CSG Income Allowance” directly into the worker’s bank account to make up the difference.
** The hourly rate for a “Garde-malade” appears lower because their “normal” working hours are calculated differently (often involving 12-hour shifts or 72-hour weeks) compared to the standard 48-hour week of a “Housemaid”.

Sub-levels for Fairness and Meritocracy

To ensure a professionalized system, the following sub-levels should be considered:

* General: Standard cleaning (Level 1a).

* Maintenance: Cleaning of windowpanes, doors, interior/exterior walls, and yard cleaning (Level 1b).

* Appliance Care: Kitchen cleaning, including electronic appliances such as refrigerators, ovens, and microwave ovens (Level 1c).

* Surface & Volume: Salary scaling based on the surface area of the house/yard and the number of residents (affecting laundry and meal preparation volumes).

* Sanitization: Deep-sanitization of medical equipment (e.g., oxygen concentrators, automatic beds, or nebulizers) and high-pressure washing (Level 2a).

* Nutrition: Meal preparation and grocery purchasing (Level 2b).

* Liaison: Specialized care coordination and weekly diet planning (Level 2c).

* Professional Tier: Level 3+ requires Professional Indemnity Insurance, shifting risk from the family to a professional service provider. This level also mandates First Aid & Cardiopulmonary Resuscitation (CPR) Certification, renewed every 2 years.

Conclusion: The Economic Case for a Starting Point

Mauritius has a long way to go in the “Elderly Care” domain, but every transition requires a starting point. Untrained or “ad hoc carers” permanently run the risk of legal accountability for shortcomings that lead to accidental injury or death of Seniors.

Adopting a tiered “Professional Career Ladder” brings about a shift from a reactive system to a proactive one. Furthermore, the introduction of “Preventative Home Visits” would ensure a more cost-efficient use of taxpayers’ money. By identifying risks such as malnutrition, medication errors, and fall hazards before they become emergencies, the burden on overloaded public hospital staff will be significantly reduced.

As the government moves toward the “Digital Health Record” system, this ladder ensures that “Specialized Carers” at Levels 4 and 5 are equipped to use digital tools and communicate in real-time with Social Security Doctors, eliminating critical information gaps.

For many lower and middle-class families, the cost of a private care home (maison de retraite) is often prohibitive. In the absence of a master plan for State-run homes—perhaps through the conversion of unused colleges—and a dearth of skilled professionals, the government must recruit competent overseers to train a new generation of carers. This is essential as more Seniors continue to live independently in their own homes.

Ultimately, the “Silver Economy” should be viewed as more than just a demographic shift; it is an opportunity for youth professionalisation, targeted recruitment of trained Mauritians or foreigners, and national health sustainability. More importantly, it serves as a fundamental marker of human dignity for our elders.

The problem is not only how to provide for the old, but how to live with the old. To do this, we must learn to perceive the person in the older person, to recognize the infinite value of every human life, regardless of age or infirmity.” — Abraham Joshua Heschel

Mauritius Times ePaper Friday 3 Arpil 2026