There are no German contracts, no German health insurance. Cash on hand, though not much. Nearly three-quarters of a million women – mostly from Poland, Slovakia, Romania and Bulgaria – caring for the German elderly, in whose house they live. Without these women, there would be a care crisis. However, officially, they don’t exist.
An estimated 90% of live-in care work is done illegally in Germany. The country’s growing elderly population is increasingly choosing to stay at home: Three-quarters of the estimated 4.1 million people who need daily care do so. Thus, there was a surge in demand for household care which successive governments – until now – have failed to regulate. Black market agents continue to undermine legal institutions by avoiding social security contributions and ignoring minimum wages.
A loophole in German law means that the employment model works for someone whose house you also live in has not been recognized for a long time, creating a “gray area”. But hiring someone without a contract and without contributing to social security “is a crime,” stressed attorney Frederic Seebohm, who is head of Germany’s professional association for live-in care workers.
An estimated 300,000 families – there are no official figures – who employ care workers in this “gray area” fully understand they are breaking the law, he said.
Change the rules of the game
The care reform recently announced by German Health Minister Jens Spahn, however, “could be a game changer,” said Seebohm. Spahn laid out broad guidelines for reform in October 2020, saying that “care is the biggest social challenge of the decade.”
Although the plan has not yet been presented in parliament, the proposal in the working draft would equate to recognition that direct care is a widespread reality. And they will be a step towards regulating the sector, even if the legal basis for the work needs to be further refined.
Although many German seniors live in care facilities, an increasing number are choosing to live in their own homes
Austria is well ahead of Germany in regulating the domestic care sector. The state allows living-in care workers to identify themselves as self-employed. Such is the case of Anna Tadrzak, a 50-year-old nurse from Poland, who found work through an agency based in Vienna. Caritas takes care of everything. She works shifts of two to four weeks, and then takes breaks for the same length of time.
Austrian ‘good system’
It’s a great system, he says, because in practice care work involves being on call 24 hours a day. “When a client calls you five times a night, then you serve them five times a night. Every day is different, ”said Tadrzak. The nature and scope of work also differ from family needs and expectations. “Clients don’t just want sitters; they want cooks, cleaners, and buyers. Sometimes you give a little time and they take up a lot of time – and you can end up without any privacy.”
The inherent difficulty of setting limits in terms of time and duties means that, without regulations, care workers are left exploited in Germany. The black market agent business model relies on the proximity of countries with significantly lower average incomes, but whose citizens benefit from freedom of movement within the EU. Germany-based agencies form partnerships with organizations in Eastern Europe who do recruitment for them, and then place nursing workers with German families without registering them with local municipalities, arranging Health Insurance or check their qualifications.
From invisible workers to critical workers
The COVID crisis expresses the urgent need to bring maintenance work out of the shadows, says Frederic Seebohm. The sudden closure of national borders during the lockdown in spring 2020 made it difficult for “non-essential workers” – including those without German citizenship or residence – to return to the country. This means that caregivers must immediately recognize as critical workers – somewhat paradoxically, given that the state has long neglected the majority who engaged informally altogether.
It is also imperative for health workers to have access to the German health system. They may not only need medical care if they need it themselves fell ill with COVID-19 – without adequate testing and access to vaccinations, they are at risk of infecting the highly vulnerable people they care for.
However, the urgency of tackling the care sector in the coronavirus crisis is only the tip of the iceberg. The demand for care workers in Germany and Austria far exceeds supply. “In Austria, there will be a shortage of between 80,000 and 100,000 care workers by 2030,” said Stefanie Zollner-Rieder, a specialist at Caritas, the agency where Anne Tadrzak works. “The Austrian model is working well so far – but the coronavirus has shown us that it needs to be made resistant.”
Short-term crises, long-term trends
Germany has one of the highest proportions of the population over 65 in the EU. Relatively low fertility rates (1.4 children per woman) and a longer life expectancy (now around 79 for men and 83 for women born today) will only fuel this demographic trend over the next few decades, leaving Germany with the question that it is. looms over how to finance the growing need for care.
The proposed reforms, which are expected to form the basis for increased financial support for those in need of care, are politically relevant in Germany as preparations for national elections in September are already underway. Although it may be too late for the current election period, Frederic Seebohm remains optimistic about the possibility of reform in the sector, given that the majority of parties agree on the need for change.
The challenge of funding more care relates to ensuring that this increased demand does not translate into more jobs being shifted into “gray zones” and worsening conditions for caregivers, especially those not yet regulated by law.
A work of love
As well as highlighting the precariousness of the care sector, the COVID crisis has highlighted the importance of care work and the important role that Eastern European women play so strongly for. Reforms in Germany could also lead to changes in the way people view the importance of caring for the elderly.
“I put my heart and soul into my work. It’s not just about money – and it’s not that much anyway,” explained Anna Tadrzak by phone from Vienna. “It takes a lot of effort and patience, but I’m happy with my job in Austria, I’m happy with Caritas and with my profession.” He was surprised to receive a call from a journalist. “In 15 years, nobody has been interested in my job,” he said.