Live-in migrant care worker arrangements in Germany and the Netherlands: motivations and justifications in family decision-making

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Vincent Horn
Cornelia Schweppe
Anita Böcker
María Bruquetas-Callejo


Private households in ageing societies increasingly employ live-in migrant carers (LIMCs) to care for relatives in need of 24/7 care and supervision. Whilst LIMC arrangements are a common practice in Germany, they are only recently emerging in the Netherlands. Taking this development as a starting point, this study uses the countries’ different long-term care (LTC) regimes as the analytical framework to explore and compare the motivations and justifications of German and Dutch family carers who opt for an LIMC arrangment. Findings show that Dutch and German LTC regimes impact differently the decision-making processes of families, as well as on patterns of justification, through a combination of policies and social norms and their related expectations towards care and care work in old age.


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Anderson, A. (2012). Europe’s care regimes and the role of migrant care workers within them. Journal of Population Ageing 5(2): 135–146.

Bange, T. & Röthing, I. (2007). Qualität ja, aber nicht um jeden Preis [Quality yes, but not at any cost]. Wohlfahrt Intern 9: 8–11.

Behr, T. (2015). Aufbruch Pflege: Hintergründe – Analysen – Entwicklungsperspektiven [Departure Care: Backgrounds – Analysis – Development Perspec¬tives] Wiesbaden: Springer Gabler Verlag.

Bestmann, B., Wüstholz, E. & Verheyen, F. (2014). Pflegen: Belastung und sozialer Zusammenhalt. Eine Befragung zur Situation von pflegenden Angehörigen [Caring: Burden and Social Cohesion. A Survey on the Situation of Family Caregivers]. Hamburg: Techniker Krankenkasse.

Bettio, F. & Plantenga, J. (2004). Comparing care regimes in Europe. Feminist Economist 10(1), 85–115.

Bettio, F., Simonazzi, A. & Villa, P. (2006). Changes in care regimes and female migration: The “care drain” in the Mediterranean. Journal of European Social Policy 16(3): 271–285.

Bettio, F. & Verashchagina, A. (2012). Long-Term Care for the Elderly. Provisions and Providers in 33 European Countries. Luxembourg: Publications Office of the European Union.

Böcker, A. G. M., Horn, V. & Schweppe, C. (2017). Old age care regimes and the emergence of transnational long-term care arrangements for the elderly. In L. Good Gingrich & S. Köngeter (eds.), Transnational Social Policy, Social Welfare in a World on the Move (pp. 222–242). New York: Routledge.

Bredewold, F., Duyvendak, J. W., Kampen, T., Tonkens, E. & Verplanke, L. (2018). De verhuizing van de verzorgingsstaat. Hoe de overheid nabij komt. Amsterdam: Van Gennep.

Cangiano, A. (2014). Elder care and migrant labor in Europe: A demographic outlook. Population and Development Review 40(1): 131–154.

Centraal Bureau voor de Statistiek (2018). Personen in huishoudens naar leeftijd en geslacht [Persons in Households by Age and Gender]. Available on &D1=0-1,11&D2=0&D3=0,66-96&D4=0,5,10,21-23&HDR=G3,T&STB=G1,G2&VW=T (Accessed: May 15, 2018).

Colombo, F., Llena-Nozal, A., Mercier, J. & Tjadens, F. (2011). Help Wanted? Providing and Paying for Long-Term Care. Paris: OECD.

Costa-Font, J. (2017). “Institutionalization Aversion” and the Willingness to Pay for Home Health Care. CESifo Working Papers No 6703. Munich: Munich Society for the Promotion of Economic Research.

Da Roit, B., & Le Bihan, B. (2010). Similar and yet so different: Cash-for-care in six European countries’ long-term care policies. Milbank Quarterly, 88, 286–309.

Da Roit, B. & van Bochove, M. (2017). Migrant care work going Dutch? The emergence of a live-in migrant care market and the restructuring of the Dutch long-term care system. Social Policy & Administration 51(1): 76–94.

Da Roit, B. & Weicht, B. (2013). Migrant care work and care, migration and employment regimes: A fuzzy-set analysis. Journal of European Social Policy 23(5): 469–486.

Da Roit, B., Le Bihan, B. & Österle, A. (2007). Long-term care policies in Italy, Austria and France: Variations in cash-for-care schemes. Social Policy Administration 41(6): 653–671.

Di Santo, P. & Ceruzzi, F. (2010). Migrant Care Workers in Italy. A Case Study. Report presented for the project “Health system and long-term care for older people in Europe.” Available on http://interlinks.euro. (Accessed: May 24, 2018).

Eurostat (2018). Unemployment Statistics, April 2018. Available on http:// (Accessed: May 10, 2018).

Finch, J. & Mason, J. (1993). Negotiating Family Responsibilities. London/ New York: Routledge.

Gori, C. (2012). ‘Home care in Italy: A system on the move, in the opposite direction to what we expect’. Health and Social Care in the Community 20(3): 255–264.

Greß, S. & Stegmüller, K. (2016). Gesetzliche Personalbemessung in der stationären Altenpflege: Gutachterliche

Stellungnahme für die Vereinte Dienstleistungsgewerkschaft (ver.di). [Statutory assessment of staff in in-patient care for the elderly: Expert opinion for the Vereinte Dienstleistungsgewerkschaft (ver.di)]. Fulda: pg-papers: Diskussionspapiere aus dem Fachbereich Pflege und Gesundheit 1/2016

Gress, S. & Stegmüller, K. (2016). Gesetzliche Personalbemessung in der stationären Altenpflege [Statutory Assessment of Staff in In-Patient Care for the Elderly]. Fuda: Expert opion for the Vereinte Diensleistungsgewerkschaft (ver.di).

Grootegoed, E., Van Barneveld, E. & Duyvendak, J. W. (2015). What is customary about customary care? How Dutch welfare policy defines what citizens have to consider “normal” care at home. Critical Social Policy 35(1): 110–131.

Hielscher.V., Kirchen-Peters, S. & Nock, L. (2017). Pflege in den eigenen vier Wänden: Zeitaufwand und Kosten [Care in the privacy of one’s home: Expenditure of time and costs]. Hans-Böckler-Stiftung, Düsseldorf: Study Nr. 363.

Kniejska, P. (2015). All-inclusive-Pflege aus Polen in der Schattenzone [All-Inclusive-Care from Poland in the Shadow Zone]. In: WISO direkt. May 2015. Bonn: Abteilung Wirtschafts- und Sozialpolitik der Friedrich-Ebert-Stiftung

Kniejska, P. (2016). Migrant Care Workers aus Polen in der häuslichen Pflege: Zwischen familiärer Nähe und beruflicher Distanz [Migrant Care Workers from Poland in Home-Based Care: Between Family Proximity and Professional Distance]. Wiesbaden: VS Verlag für Sozialwissenschaften.

Krawietz, J. (2014). Pflege grenzüberschreitend organisieren. Eine Studie zur transnationalen Vermittlung von Care-Arbeit [Organizing Care Across Boundaries. A Study on Transnational Care Agencies]. Frankfurt am Main: Mabuse.

Lipszyc, B., Sail, E. & Xavier, A. (2012). European Economy. Long-Term Care: Need, Use And Expenditure in the EU-27. Economic Papers 469. Brussels: Directorate-General for Economic and Financial Affairs.

Lutz, H. & Palenga-Möllenbeck, E. (2010). Care work migration in Germany: Semi-compliance and complicity. Social Policy & Society 9(3): 419–430.

Maarse, H. & Jeurissen, P. (2016). The policy and politics of the 2015 long-term care reform in the Netherlands. Health Policy 120(3): 241–245.

MDS (Medizinischer Dienst des Spitzenverbandes der Krankenkassen). (2017). Qualität in der ambulanten und stationären Pflege [Quality in Inpatient and Outpatient Care]. Essen: Medizinischer Dienst des Spitzenver¬bandes Bund der Krankenkassen.

Monitor Langdurige Zorg (Long-term Care Monitor). (2018). Gebruik bijdrageplichtige Wlz-zorg [Use of Long-term Care]. Available on (Accessed: May 15, 2018).

Mosca, I., van der Wees, P. J., Mot, E. S., Wammes, J. J. G. & Jeurissen, P. P. T. (2017). Sustainability of long-term care: Puzzling tasks ahead for policy-makers. International Journal of Health Policy and Management 6(4): 195–205.

Mot, E. (2010). The Dutch System of Long-Term Care. CPB Document 204. The Hague: CPB Netherlands Bureau for Economic Policy Analysis.

Mot, E., Aouragh, A., De Groot, M. & Mannaerts, H. (2010). The Long-Term Care System for the Elderly in the Netherlands. ENEPRI Research. Report No. 90. Brussels: Centre for European Policy Studies.

Neuhaus, A., Isfort, M. & Weidner, F. (2009). Situation und Bedarfe von Familien mit mittel- und osteuropäischen Haushaltshilfen [Situation and Demand of Families with Care Workers from Central and Eastern Europe]. Köln: Deutsches Institut für angewandte Pflegeforschung e.V.

OECD (Organisation for Economic Cooperation and Development). (2017). Health at a Glance 2017: OECD Indicators. Paris: OECD Publishing.

Pfau-Effinger, B. (2005). Culture and welfare state policies: Reflections on a complex interrelation. Journal of Social Policy 34(1): 3–20.

Pinquart, M. (2016). Belastungs- und Entlastungsfaktoren pflegender Angehöriger – die Bedeutung der Erwerbstätigkeit [Burden and burden relief factors of family caregivers – the importance of employment]. In: Zentrum für Qualität in der Pflege (ed.), Vereinbarkeit von Beruf und Pflege (pp. 60–72). Berlin: Zentrum für Qualität in der Pflege.

Rossow, V. & Leiber, S. (2017). Zwischen Vermarktlichung und Europäis¬ierung: Die wachsende Bedeutung transnational agierender Vermittlungsagenturen in der häuslichen Pflege in Deutschland [Between marketization and europeanization: The Increasing significance of transnationally operating placement agencies in home care in Germany]. Sozialer Fortschritt 66: 285–302.

Sadiraj, K., Oudijk, D., van Kempen, H. & Stevens, J. (2011). De opmars van het PGB. De ontwikkeling van het persoonsgebonden budget in nationaal en internationaal perspectief [The Rise of the PGB. The Development of the Personal Budget in National and International Perspective]. Den Haag: Sociaal en Cultureel PlanbureauSchwiter.

Scheiwe, K. (2010). Die soziale Absicherung häuslicher Pflege über Grenzen hinweg – Rechtliche Grauzonen, (Ir-)Regularität und Legitimität [Social protection of domestic care across borders – Legal grey zones, (ir-)regularity and legitimacy]. In K. Scheiwe & J. Krawietz (eds.), Trans-nationale Sorgearbeit: Rechtliche Rahmenbedingungen und gesellschaftliche Praxis (pp. 123–150). Wiesbaden: VS Verlag für Sozialwissenschaften.

Schwiter, K., Berndt, C. & Truong, J. (2018). Neoliberal austerity and the marketisation of elderly care. Social & Cultural Geography 19(3): 379–399.

Sociale Verzekeringsbank (2016). Jaarcijfers [Annual Figures]. Available on (Accessed: May 8, 2018).

Statista (2018). Kosten eines Pflegeheimplatzes in deutschland nach Pflegestufe im Jahr 2011 [Costs for a place in a residential care home by degree of dependency]. Available on studie/196945/umfrage/kosten-eines-pflegeheimplatzes-in-deutsch¬land/ (Accessed: February 10, 2018).

Statistisches Bundesamt (2017). Pflegestatistik 2015. Pflege im Rahmen der Pflegeversicherung. Deutschlandergebnisse [Statistics on LTC Recipients 2015]. Wiesbaden: Statistisches Bundesamt.

Stiftung Warentest (2017). Pflege zu Hause. Die besten Vermittler für Betreuungskräfte aus Osteuropa [Care at Home. The Best Placement Agencies for Care Workers from Eastern Europe]. Edition May 2017.

Tonkens, E. (2011). The embrace of responsibility: Citizenship and governance of social care in the Netherlands. In J. Newman & E. Tonkens (eds.), Participation, Responsibility and Choice: Summoning the Active Citizen in Western European Welfare States (pp. 45–66). Amsterdam: Amsterdam University Press.

Van Bochove, M., zur Kleinsmeide, D. & Ashu, S. (2017). Kwetsbaar en dan. Hoe inwonende buitenlandse zorgverleners en hun werkgevers omgaan met precaire arbeid [Vulnerable and Then. How Foreign Resident Carers and Their Employers Deal with Precarious Work]. Onderzoeksrapport. Rotterdam: Erasmus University Rotterdam.

Van den Broek, T. (2016). Supporting Ageing Parents: Comparative Analyses of Upward Generational Support. Rotterdam: Erasmus University Rotterdam.

Van Grafhorst, A. (2014). Verantwoorde buitenlandse zorg aan huis. Een verkennend onderzoek naar inwonende buitenlandse zorgverleners in Nederland [Responsible Care of Foreign Caregivers at Home. An Exploratory Study of Foreign Caregivers in the Netherlands]. Amsterdam: WEMOS.

Van Hooren, F. (2012). Varieties of migrant care work: Comparing patterns of migrant labour in social care. Journal of European Social Policy 22(2): 133–147.

Van Hooren, F. (2014). Migrant care work in Europe: Variety and institutional determinants. In M. Léon (ed.), The Transformation of Care in European Societies (pp. 62–82). London: Palgrave Macmillan.113

Van Hooren, F. & Becker, U. (2012). One welfare state, two care regimes: Understanding developments in child and elderly care policies in the Netherlands. Social Policy & Administration 46(1): 83–107.

Wetzstein, M., Rommel, A. & Lange, C. (2015). Pflegende Angehörige – Deutschlands größter Pflegedienst [Family Caregivers – Germany’s Largest Care Service]. GBE kompakt 6(3). Berlin: Robert Koch-Institut.

Williams, F. (2012). Converging variations in migrant care work in Europe. Journal of European Social Policy 22(4): 363–376.

ZQP (Zentrum für Qualität in der Pflege). (2017). ZQP-Report Gewaltprävention in der Pflege [ZQP-Report Violence Prevention in Care]. Berlin: Zentrum für Qualität in der Pflege.