By Kai Leichsenring, Andrea Schmidt, Annette Bauer
To address expected shortages in care provided to people in their own home, either provided by migrant care workers or by family carers, the Austrian Government has allocated an additional 100 million euros to the social care sector.
Shortages are expected because of an increase in the number of family carers who will become infected with COVID-19 and too unwell to look after their family member, and because of fewer migrant care workers being able to continue providing care as the borders are closing. The first will affect in particular the 300,000 (60% of the altogether 500,000 people with long-term care needs), who are exclusively cared for by their family. The latter will affect the 30,000 (6%) of those with long-term care needs, who are cared for primarily by migrant care workers. Migrant care workers commute from a neighbouring country – in particular from Romania, Czech Republic or Slovakia – to provide care to a person in their home. They are also called live-in migrant care workers because they live in the same house as the person they care for. They often do so for a limited time period – typically half a month – and return for the rest of their month to their families. The COVID-19 crisis has exposed some of the weaknesses of the Austrian long-term care system, including the strong reliance on the provision of home care by migrant care workers. Whilst for now, most migrant care workers have agreed to stay with the person they care for, this might bring new challenges to ensure the workers remain physically and mentally well away from their family and home. It is also unclear how long migrant care workers are prepared to stay with the person they care for as the crises continues, and whether the government will find ways to allow for border crossing of migrant care workers.
With the money, the government also plans to reopen currently closed rehabilitation centres to provide additional bed capacity for people who cannot be looked after in their own home anymore. If necessary, e.g. in case of sickness of the main family or migrant carer, people could be transitioned into rehabilitation centres. This kind of additional support will be particularly critical for people who require 24 hours care and support. Indeed, there are number of challenges linked to this kind of transition, and for many people – such as for people with dementia – this might not be an option. Alternative solutions that are considered include mobile teams, extension of home care and day care provision. However, as the latter are closed under the current conditions, new ways of organising these facilities would need to be developed.
In addition to providing extra beds, staff, testing kits and personal protective equipment would need to be made available. Furthermore, the government plans to increase capacity of telephone hotlines for people in need of care and their family carers. The government has loosened current regulations so that people who did the national service (mainly males who have opted for providing civilian duties instead of military service when this was still mandatory) can step in to provide basic care. It is yet unclear whether people currently trained to become care professionals, or unemployed persons with a desire to work in long-term care could be also asked to step in to increase capacities in the long-term care sector.
Questions remain at the moment how to ensure the supply of sufficient testing kits and personal protective equipment. In addition, whilst providers of home care (almost entirely private non-profit organizations) could step in to provide staff, many challenges need to be resolved first. Questions that are currently unanswered regarding the potential transfer to rehabilitation centres include: Will family carers (or the personal carer) be able to move into the residential units as well? Will family carers be able to visit? How will family carers and staff be protected? How to assure quality of care if people without formal caring qualifications carry out caring tasks including personal care?
The national carers associations has highlighted the need for providing mental health support to mitigate the psychological impacts for family carers, migrant workers and personnel employed in care facilities, which they expect will be substantial. They include impacts linked to great uncertainties family carers face about being able to move in together or visit their loved ones if they are moved to a residential facility. Furthermore, there are likely to be financial worries about abilities to continue financing future care as more people become unemployed.
Last but not least, there is a gender dimension, too. Countries like Austria with a strong orientation towards family-based care rely, to a large extent, on middle-aged women (partly at a higher risk of being affected severely by COVID-19 if they are infected) both as family carers and long-term care professionals. It is likely that these unpaid carers will face the mental health burden of having to organise care in the expected future absence of migrant care workers, while also potentially facing health risks when working as care professionals as long as the pandemic continues. By the same token, migrant care workers (also primarily middle-aged women) are also faced with the double burden of having to worry about family members in their home countries, to be weighed against being able to maintain an income as a live-in migrant care worker in Austria.
- The Austrian government allocated 100 million euros to address long-term care challenges in relation to COVID-19
- From this money, among other things, currently closed rehabilitation and therapy centres will be reopened to provide bed capacity
- Those most likely to require beds are those who have problems to keep up their migrant-carer arrangement due to closing borders; those whose family carers become infected and too unwell, or stop caring to protect themselves against COVID-19; those in need for 24 hours care
- The government has also loosened regulations so that unqualified staff can step in and provide care
- Residential facilities need also to address a number of questions such as whether they accept carers moving in with the person they care for, or allowed to visit them (currently not)
- In addition, other solutions are needed as moving into residential facilities might not be an option for some people (e.g. those with dementia) – alternatives might include allowing migrant workers to cross borders, and extending home care provision through mobile services
Suggested citation: Leichsenring K, Schmidt AE, Bauer A (2020) Report: Planning for expected shortages in migrant and family care in Austria. Article in LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE. Available at https://ltccovid.org/2020/03/26/report-planning-for-expected-shortages-in-migrant-and-family-care-in-austria/