Who cares for the caregivers? Job satisfaction, performance and loyalty among home caregivers of people with Alzheimer’s disease in Tunisia

Purpose This study aims to explore the mechanisms that link job satisfaction, sense of self-efficacy and job loyalty of carers caring for Alzheimer’s patients at home in Tunisia, a non-Western context almost absent from the existing literature. Design/methodology/approach Exploratory qualitative study based on 12 semi-structured individual interviews (55 min on average, in Tunisian Arabic dialect), analyzed by manual reflexive thematic analysis in six steps (Braun and Clarke, 2006). Manual independent double-coding was performed on more than 30% of the data (inter-coder agreement rate: 87%). Theoretical saturation was confirmed at the 9th interview. Findings Satisfaction is ambivalent: meaning in work, but suffering linked to the confusion between care and household tasks, and to transport costs. The feeling of self-efficacy is built through experience, without training. Loyalty is pragmatic. Original result: recognition, whether from the family or the association, conditions the link between perceived performance and loyalty. Research limitations/implications Sample limited to a single association in Greater Tunis; the perspectives of families and patients were not included. A national quantitative study is needed to deepen these results on a larger scale. Practical implications Clarify missions with families, institutionalize recognition, create peer groups and formalize the legal status of home care auxiliaries. Social implications In a country where institutionalization is culturally rejected, the quality of Alzheimer’s care at home depends directly on the stability and well-being of caregivers. Originality/value To the best of the author’s knowledge, this is the first qualitative study on the satisfaction, performance and loyalty of Alzheimer’s care assistants in Tunisia. It also documents a mediation mechanism grounded in employee recognition.