Eastern Nursing Care

For most people, it's difficult to decide which steps to take when parents or a spouse are in need of care: nursing home or home-based care? For many families, it's a financial decision, as pensions are often insufficient to pay expensive nursing homes.

Many families also don't want to pull their relatives out of familiar surroundings and decide for care at home. But few families have the job and private freedom to take over the care themselves. The solution is often illegal help from eastern Europe.

In Germany, there has been a growing number of eastern European caregivers in this sector. They work 24 hours a day, helping with bathing and getting dressed, as well as taking care of the household.

In order to fulfill these tasks around the clock, they often live with the elderly. Eastern European nurses are thus for the most part not anonymous caregivers, but sometimes become new family members for those in need. It is this interpersonal relationship which makes the difference, said Claus Fussek, a social worker and leading care expert in Germany.

"What distinguishes these mostly women, who speak German and are motivated, is that they have time," Fussek said. This was a factor particularly necessary in caring for people with Alzheimer's disease or dementia.

"They have time to help with meals, to give someone a hug, they can accompany someone to the bathroom without time pressure or go for a walk with someone," Fussek said. "These are all things which many German caregivers would like to do, of course, but do not have the time to do so."

German geriatric nurses are losing their jobs

There are reportedly up to 100,000 geriatric caregivers from eastern Europe in Germany. There are no official numbers, as it mostly involves illegal employment. These eastern European women have neither a work permit nor do they make social insurance payments.

For around-the-clock care, they earn between 800 euros ($1,025) and 1,200 euros per month. It's good pay for them and an affordable alternative for German families. Home care has meanwhile become unthinkable without eastern Europeans, Fussek said, adding that the caretaking system would collapse in Germany otherwise as there is a lack of affordable alternatives. That is why the demand for illegal nurses is so high, Fussek said.

But the providers' federal association bpa said 24-hour care is only necessary in seldom cases. According to bpa head Bernd Tews, the dumping prices of eastern European nurses endanger the job market in the German home care sector.

"Of course, it isn't just jobs which are in danger, but also various facilities have already shut down or had to fire staff because people are taking advantage of care with these illegal workers," Tews said.

Germany needs legal and affordable home care

Since 2005, it has been possible to hire eastern European caregivers legally, with the support of the Central Employment Agency. But hardly anyone is taking advantage of the possibility. Over the past one-and-a-half years, only some 3,000 eastern European nurses have been placed.

Legally employed, these women cost around 1,100 euros per month. But since social insurance contributions must be paid, the nurses are left with just 500 euros. So illegality remains lucrative for both sides. In addition, the eastern European caregivers are not officially allowed to work as nurses, but merely as so-called household help.

"I don't know who thought that up," Fussek said. "I don't know of any household in which I would hire someone to do 38.5 hours of housework. That is a concept that is far from the practice. The problem is too complicated that you could try to solve it with such solutions."

And practical solutions are desperately needed. Two million people in Germany are currently dependent on nursing care -- and the number keeps increasing. In the next 15 years, three million people are expected to need care. In order to meet this demographic trend in Germany, legal and affordable alternatives for people in need of care and their family members are necessary.