LTCcovid Country Profiles

Responses to 2.08.01. Impacts of the pandemic on migrant Long-Term Care workers

The LTCcovid International Living report is a “wiki-style” report addressing 68 questions on characteristics of Long-Term Care (LTC) systems, impacts of COVID-19 on LTC, measures adopted to mitigate these impacts and new reforms countries are adopting to address structural problems in LTC systems and to improved preparedness for future events. It was compiled and updated voluntarily by experts on LTC all over the world. Members of the Social Care COVID-19 Resilience and Recovery project moderated the entries and edited as needed. It was updated regularly until the end of 2022.

The report can be read by question/topic (below) or by country: COVID-19 and Long-Term Care country profiles.

To cite this report (please note the date in which it was consulted as the contents changes over time):

Comas-Herrera A, Marczak J, Byrd W, Lorenz-Dant K, Patel D, Pharoah D (eds.) and LTCcovid contributors.  (2022) LTCcovid International living report on COVID-19 and Long-Term Care. LTCcovid, Care Policy & Evaluation Centre, London School of Economics and Political Science.

Copyright is with the LTCCovid and Care Policy and Evaluation Centre, LSE.



The pandemic has exacerbated the already precarious working and living conditions of migrant care workers, particularly those who provide live-in care.

The particular situation and experiences of live-in migrant carers

Kuhlmann et al (2020) explored the situation of migrant carers in Austria, Germany, Italy, Poland and Romania and developed a framework to gather empirical material on the LTC system, the LTC labour market, LTC care migration policies and COVID-19 specific regulation for LTC migrant carers. The study shows the importance of understanding the interactions between LTC policy and labour market and migration policies. COVID-19 has made the fragile labour market arrangements of migrant carers more visible and shown the importance of improving international care workforce governance.

An article by Giordano (2020) explores the position of migrant carers of older people at the intersection multiple systems of oppression that characterise their distinctive experiences, with being women, migrants, live-in carers, family breadwinners and their position as “quasi-family members” being key to understanding their dilemmas in relation to keeping their jobs and renouncing to their freedoms or leaving their employment.


Giordano C. (2020) Freedom or money? The dilemma of migrant live-in elderly carers in times of COVID-19. Feminist Frontiers 28(S1): 137-150.

Kuhlmann E, Falkenbach M, Klasa K, Pavolini E, Ungureanu MI. Migrant carers in Europe in times of COVID-19: a call to action for European health workforce governance and a public health approach. Eur J Public Health. 2020 Sep 1;30(Supplement_4):iv22-iv27.


International reports and sources

Systematic review of the experiences of care home staff during the pandemic (covering evidence from March 2020 to March 2021):

Kristina Lily Gray, Heather Birtles, Katharina Reichelt & Ian Andrew James (2021) The experiences of care home staff during the COVID-19 pandemic: A systematic review, Aging & Mental Health, DOI: 10.1080/13607863.2021.2013433

As the LTC sector in Denmark is formal, there is no particular role for migrant care workers outside the sector.

Last updated: June 5th, 2023

There is evidence on the psychosocial effects of the pandemic on migrant carers which highlights a particularly unique feature of Israel’s LTC system. These carers are often vulnerable members of the workforce, working minimum wages on precarious work visas without a pathway to citizenship or permanent residency (unlike other high-income countries). During COVID-19, East Asian caregivers also faced harassment and discrimination. Issues of gender equality amongst unpaid carers were reported.

Last updated: January 2nd, 2022   Contributors: LIAT AYALON  |  Shoshana Lauter  |  

The CUMADE project (Care matters. Gender impact on caregivers of elderly and dependent persons in times of COVID-19) carried out interviews with care workers, including those employed privately (often informally) in domestic settings, the majority of whom were migrant women).

A first consequence of the pandemic has been the dismissal of many female workers, accompanied by a drop in hiring. The reasons that explain the temporary or permanent suspension of jobs are diverse. However, apart from the deaths caused by the covid, the pandemic changes in the employment and economic situations of the employing families (teleworking, loss of jobs) temporarily dispensing with the worker and sometimes taking direct responsibility for the care of their family members. The pandemic also involves changes in the composition of households: older people with dependency moving in with their children, and children who move into their parents’ homes. These situations that can lead families to do without the worker. The fear of contagion and the perception of risk within households have also caused the temporary suspension of contracts or dismissals (Offenhenden and Bofill-Poch, 2021).

However, the impact varied according to the hiring regime of migrant caregivers. For example, the new conditions generated by the pandemic (economic precariousness, restricted mobility, restricted access to services) have increased the demand for live-in female workers. One of the characteristics that usually stands out in live-in work is the claim of the total availability of the worker’s time. In general terms, the increase in the working day has not been remunerated. Likewise, female workers have seen their mobility restricted, giving greater control to their employers and seeing their privacy and rest times reduced (Offenhenden and Bofill-Poch, 2021).

The labour changes caused by the pandemic and confinement have made it even more difficult for workers with family responsibilities to reconcile work and family. Strategies have ranged from delegating care to older sisters to quitting work. For some workers who have gone from the external to the internal (live-in) regime, confinement has meant not being able to attend to the care needs of their children. That has generated deep discomfort in the workers, who have not been able to care for their children at a challenging time due to home confinement (Offenhenden and Bofill-Poch, 2021).

On the other hand, those workers who did not have savings or alternative income, faced with the loss of employment or the drastic reduction of their working hours, have had to resort to mutual aid groups, social assistance entities and religious organisations to cover basic needs (accommodation and food). Moreover, the pandemic also affected the ability to send remittances and take care of his family’s costs from a distance. To send remittances (apart from the fact that the closing of call shops made it enormously difficult), women have reduced their daily expenses and prioritised costs in their countries of origin. In some cases, this leads to debts being generated in the families of origin due to the impossibility of sending money during confinement (Offenhenden and Bofill-Poch, 2021).


Offenhenden, María y Bofill-Poch, Sílvia (2021), “Trabajadoras de hogar y cuidados”, en Comas-d’Argemir, Dolors y Bofill-Poch, Sílvia (eds.) (2021): El cuidado importa. Impacto de género en las cuidadoras/es de mayores y dependientes en tiempos de la Covid-19, Fondo Supera COVID-19 Santander-CSIC-CRUE Universidades Españolas.

Last updated: March 21st, 2022   Contributors: Carlos Chirinos  |  

Visa Relaxation for Migrant Care Workers

In in December 2021 , addressing unprecedented challenges prompted by the pandemic, the government announced a temporary relaxation of immigration rules for overseas care workers in an attempt to recruit and retain care staff. Care assistants and home and social care workers are to be added to the Shortage Occupation List (SOL) in early 2022 and will be eligible for a 12-month health and care visa; allowing migrants to fill gaps in workforces. It is proposed that these measures will be in place for at least 12 months (DHSC, 2021; BBC News).


DHSC, (2021). Biggest visa boost for social care as Health and Care Visa scheme expanded. DHSC Press Release, Retrieved from: on 11/03/2022

Last updated: March 11th, 2022   Contributors: Daisy Pharoah  |  

Contributors to the LTCcovid Living International Report, so far:

Elisa Aguzzoli, Liat Ayalon, David Bell, Shuli Brammli-Greenberg, Erica BreuerJorge Browne Salas, Jenni Burton, William Byrd, Sara CharlesworthAdelina Comas-Herrera, Natasha Curry, Gemma Drou, Stefanie Ettelt, Maria-Aurora Fenech, Thomas Fischer, Nerina Girasol, Chris Hatton, Kerstin HämelNina Hemmings, David Henderson, Kathryn Hinsliff-Smith, Iva Holmerova, Stefania Ilinca, Hongsoo Kim, Margrieta Langins, Shoshana Lauter, Kai Leichsenring, Elizabeth Lemmon, Klara Lorenz-Dant, Lee-Fay Low, Joanna Marczak, Elisabetta Notarnicola, Cian O’DonovanCamille Oung, Disha Patel, Martina Paulikova, Eleonora Perobelli, Daisy Pharoah, Stacey Rand, Tine Rostgaard, Olafur H. Samuelsson, Maximilien Salcher-Konrad, Benjamin Schlaepfer, Cheng Shi, Cassandra Simmons, Andrea E. SchmidtAgnieszka Sowa-Kofta, Wendy Taylor, Thordis Hulda Tomasdottir, Sharona Tsadok-Rosenbluth, Sara Ulla Diez, Lisa van Tol, Patrick Alexander Wachholz, Jae Yoon Yi, Jessica J. Yu

This report has built on previous LTCcovid country reports and is supported by the Social Care COVID-19 Resilience and Recovery project, which is funded by the National Institute for Health Research (NIHR) Policy Research Programme (NIHR202333) and by the International Long-Term Care Policy Network and the Care Policy and Evaluation Centre at the London School of Economics and Political Science. The views expressed in this publication are those of the author(s) and not necessarily those of the funders.