This article is republished from The Conversation under a Creative Commons license.
Who will care for your ageing relatives when you can’t? It’s a question that many families in Europe are having to answer, as demographic changes caused by Europe’s ageing populations become more deeply embedded.
As loved ones get older or face long-term illnesses and disabilities, the demand for care is skyrocketing. But the workforce isn’t keeping up. One in five Europeans is already 65 or older, and by 2050, that number will hit 30%. This demographic shift will drive a 23.5% increase in demand for long-term care workers—but where will they come from?
Right now, the numbers don’t add up. Europe’s long-term care sector employs around 6.3 million people, yet there is already a massive shortfall of carers. Millions of families are stepping in, with 44 million Europeans—mostly women—providing unpaid, informal care for elderly relatives. This burden is neither sufficiently acknowledged nor sustainable. Our recent research shows the extent to which migrant care workers bridge this gap.
Across the EU, nearly 10% of long-term care workers are foreign-born. Some come from within the EU, but many arrive from South America (20%), Africa (12%), and Asia (10%). Once in Europe, they plug a critical gap in the care system, taking on jobs that local workers won’t or can’t do.
Despite their essential role, migrant care workers frequently suffer poor treatment. Many work on temporary contracts, earning lower wages than their European counterparts and contending with exploitative conditions. Some work in undeclared jobs, leading to informal roles with no legal protections, making them vulnerable to abuse.
In Norway, migrant carers tend to be given lower-status jobs, even when their qualifications match or exceed those of their local colleagues. They are also perceived as less professional, despite their experience and training. In Germany, a family hiring a Polish caregiver through an agency was shocked to learn she received just €1,000 (£860) per month, while they were paying €2,800 (£2400)—with the agency pocketing the difference.
In some EU countries, restrictive immigration policies make things harder for migrant care workers. In Cyprus and Malta, for example, migrant care workers on temporary visas are denied access to social benefits, even after years of service. Many also struggle with language barriers, making it harder to assert their rights or have their qualifications recognized.
Labor Shortages
Nearly all EU countries face critical labor shortages in long-term care. The problem is worse in lower-income EU countries, where attracting and retaining care workers is more difficult. Low wages and difficult working conditions make these jobs unattractive to locals, pushing many to seek employment in western European countries with better pay.
The disparities are stark. In the Netherlands, long-term care workers earn 96% of the national average hourly wage. In Bulgaria, it is just 62%. Many eastern European and Baltic states also suffer from a lack of home care services, forcing families to rely on underfunded nursing homes or informal, unregulated care.
The European Commission introduced the skills and talents package in 2022, to improve conditions and legal migration processes for workers in sectors with shortages. This included a proposal for the EU Talent Pool—a digital platform to connect employers in the EU with skilled workers from non-EU countries. The European Parliament’s civil liberties committee endorsed the plan in March of this year, paving the way for a new approach to international recruitment.
If properly implemented, this initiative could help fill Europe’s care workforce gap and provide a legal, structured pathway for skilled migrants to join the sector. But public resistance to migration remains a huge barrier.
Anti-immigration Sentiment
Europeans want their elderly relatives to receive quality care, but many are unwilling to accept that foreign workers are one of the ways to make that happen. This tension between public attitudes and economic realities threatens the future of long-term care in Europe.
Research shows that western European Millennials (born 1982–1991) are now more anti-immigrant than those born between 1952–1961.
The EU recognizes the need for foreign workers, yet politicians are reluctant to make the case publicly. Public attitudes towards migration remain deeply divided, with preference often given to migrants from other EU countries or from Ukraine, following Russia’s 2022 invasion.
The EU’s reliance on migrant care workers will only increase in the coming decades. However, simply recruiting more foreign workers is not a sustainable solution unless the system itself changes.
Several measures could help ensure that migrant care workers receive fair treatment. Firstly, introducing a specific care visa for non-EU workers would ensure they have legal status and job security. Stronger legal protections against exploitative contracts and unfair wages are necessary. And making it easier to recognize foreign qualifications would allow skilled workers to take on roles that better match their experience.
Fairer wages and working conditions are essential to attract and retain both migrant and local workers. International cooperation between the EU and third countries could also create ethical, regulated migration pathways.
The bottom line is this: Europe’s population is getting older, and without migrant workers, millions of families will struggle to find care for their loved ones. Europe must support and protect workers, both migrant and local, in the care system for its own sake.
Zuzanna Marciniak-Nuqui, Senior Analyst, RAND Europe
Joanna Hofman, Senior Research Leader, RAND Europe
This article is republished from The Conversation under a Creative Commons license. Read the original article.
