Skip to content
Globe Icon

Migrantization of long-term care provision in Europe. A comparative analysis of Germany, Italy, Sweden and Poland

2022 Conference Presentation

8 September 2022

Migrantization of long-term care provision in Europe. A comparative analysis of Germany, Italy, Sweden and Poland

Heinz Rothgang , University of Bremen , Germany

Karin Gottschall, Anna Safuta, Kristin Noack, Marlene Seiffarth, Greta-Marleen Storath
Collaborative Research Centre 1342 and SOCIUM, University of Bremen


Background: Since the 1990s, many countries in the world have been experiencing a process of migrantization of the long-term care workforce, defined as the incorporation of migrant workers into formal and/or family care. Previous research has identified two models of migrantization (the migrant-in-the-family model and the migrant-in-formal-care model), depending on migrant carers' working place. However, cross-country variations in the intensity of migrantization and in its loci, i.e. in the family, within formal provision, or both, need more thorough investigation.

Objectives: The objectives of this contribution are to describe, compare and explain the migrantization of long-term care in four European countries, representing different welfare state types: Germany, Italy, Poland and Sweden.

Methods: The findings are based on secondary literature, document analysis, secondary analysis of national statistics and altogether 78 semi-structured expert interviews with representatives from care providers, care workers, unions, politicians and administrators, and care-dependent people on regional and national level in the four countries under consideration.

Descriptive Findings: The four countries show different patterns of migrantization: Sweden is characterised by the migrant-in-formal-care model, Italy and Poland by the migrant-in-the-family model, while Germany combines both models. Despite these differences, migrant workers are now needed in all four examined countries.

Explanatory Findings: In order to explain the extent and the form of care migrantization characteristics of the receiving and the source countries as well as the migration regime which spans these countries must be considered. In this presentation we will focus on the receiving countries, i.e. the demand side of care migrantization. Considerable demand for migrant caregivers occurs if the joint capacities of informal(family) care-givers and affordable formal care services, be it home care or nursing home care, fall short of actual care needs. The reasons for such shortages in domestic care-giving capacities may vary and do vary across the four countries at stake. A second necessary condition is the availability of respective funds. Thus, the migrant-in-the-family model in Germany and Italy is fostered by the existence of cash benefits that can be used to finance migrant live-ins. Without such benefits this model would be limited to wealthy households and could never develop into a mass phenomenon. The migrant-in-formal-care model also requires a demand for services and a corresponding demand for care workers respectively. As the German and the Swedish case seem to indicate, this condition can only be met if there is considerable public financing for formal care and more or less qualified care workers. Apart from those necessary conditions there are also supportive cultural patterns that are favourable to certain developments.

Conclusions: Such transnational care dependencies have to be taken into account when designing and reforming national care, labour market and migration policies.