![]() While on paper, workers would often have a legal form of employment, either through the rules of the EU’s Posted Workers Directive or by being self-employed in their home country, “you have a completely different reality that is lived but not recorded anywhere,” Oblacewicz told EURACTIV. Often, the families are promised 24-hour support for their elderly relatives by placement agencies, but “this is not even possible in a legal way”, explained Justyna Oblacewicz of “Faire Mobilität”, a helpdesk funded by the German government and trade unions to legally advise affected workers. While exact numbers are unknown, estimates range from 300,000 to 700,000 migrants working in such an arrangement. The biggest group of migrants in the German care sector thus operates in a legal grey area, so-called live-in care, which means they go directly into the homes of the elderly and support their families in caring for their elder relatives at home. But with traditional multi-generation households declining, demand for support by external personnel is high. Most elderly people with a need for care are provided for in their own homes, not in stationary facilities such as nursing homes. ![]() While foreign-born workers are spread across all kinds of medical professions, from doctors and nurses to supporting and more administrative professions, the highest share is recorded among elderly care workers, where 25% of all workers have migrated from abroad. Of 4.2 million people working in the German health and care sector as a whole, 690,000 have been born abroad, according to the expert council. “Without immigrant professionals at all levels of the health system, as the COVID-19 pandemic has shown at the latest, the German health system would face a collapse,” a report by the German Expert Council on Integration and Migration reads. With an ageing population whose demand for care is growing steadily, and with labour shortages already abundant, migrant workers form an essential part of the German care sector. The German health and old-age care system is dependent on migrant workers, according to experts, with 690,000 people born in another country working in the sector.
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