In many countries, care for older people in private households is taken over by care workers from abroad. This type of care arrangement is often called ‘24-hour care’ or ‘live-in care’. Live-in care workers are paid caregivers who provide long-term care while living in the care recipient’s private household, often for several weeks or months at a time. As these arrangements are often informal and irregular, there are no reliable official statistics. However, estimates suggest that between one to two million persons—predominantly women—work in this sector across Europe. As the population ages, the demand for care is expected to rise. Projections suggest that by 2070 the number of people aged 50+ who need long-term care (LTC) will be about 21% higher than in 2020, making live-in care workers even more essential.
At the intersection of welfare, gender, migration, and labour market regimes, live-in care workers often lack appropriate social protection for themselves and their families, and they may be paid below legal minimum wages. In EU-receiving countries, the situation also differs depending on whether live-in care workers come from another EU-country or from a third country, as other regulations apply.
From a family perspective, it is important to note that live-in care workers often leave their own family members behind. Many have underaged children or older relatives who need care in their home countries, but whom they cannot look after in person while working abroad. The need for care and medical treatments of relatives could even be a reason for working as a care worker in higher-income countries. At the same time, in the ‘receiving” countries, many families see live-in care arrangements as a highly needed care option for the relatives who need assistance.
Generally, these arrangements include a high degree of uncertainty and vulnerability not only for care workers, but also for those in need of care, and both their families.
This policy brief therefore looks at the live-in care from the perspectives of both the care workers’ families and the care receiving families. It does not deny that live-in arrangements have a legitimate place within the scope of care. Instead, it calls for a comprehensive framework which includes ethically sound policy responses that do justice to care workers and their families in the home countries, as well as to older people and their families in the host countries. Doing so, the policy brief lists some proposals that are suitable for informing national and European policy agendas by adding a ‘family” perspective to it.
Content:
- European and global challenge
- Challenges for the person and family in need of care
- Challenges for the care worker
- Monetary and social protection insecurities
- Social, health, and psychological challenges
- Challenges for the transnational family of the care worker
- Emotional and social consequences
- Wider societal implications for the countries involved
- Country specifications
- European regulation
- Recommendations
- All levels and all perspectives must be involved
- The basis: Improving care systems for better relieve for the families
- Improving working conditions
- Measures within the sending country
Download
Country Reports on 24-hour care / live-in care
The policy brief is accompanied by a separated overview, which showcases some country-specific insights on the topic.
While the TraFaDy policy brief on 24h / Live-in Care work outlines general challenges and recommendations related to live-in care workers in Europe, circumstances and regulations differ across countries. This applies both to “receiving” countries (such as Italy, Germany, and Austria) and to “sending” countries (such as Bulgaria, Slovakia, Hungary, and Poland, as well as non-EU third countries (e.g. Georgia, Ukraine). To showcase these differences, some country-specific insights are presented in the following overview. The countries presented here are:
- Austria (Ursula Trummer)
- Estonia (Anastassia Zabrodskaja)
- Georgia (Lela Goginava)
- Germany (Ute Karl, Sven Iversen)
- Slovakia (Martina Wilsch)
- Turkey (Esra Demirkol Colosio)
BACKGROUND OF THE DOCUMENTS
This policy brief is the outcome of several meetings and discussions with researchers and members from all working groups. Major cornerstones of the policy brief are the presentations and discussions in three online meetings, that focused on specific country examples. Additionally the policy was discussed in the TraFaDy meeting on ‘Policy and impact – Effective policies supporting transnational families” in March 2026 in Budapest.
The following TraFaDy members have contributed:
| – Heliona Bellani (Miço) – Attila Böhm – Eglantina Dervishi – Sven Iversen | – Maria Izzo – Ute Karl – Anne Carolina Ramos – Tanja Schroot | – Ursula Trummer – Martina Wilsch – Anastasia Zabrodskaja |
Country reports: Esra Demirkol Colosio (TR), Lela Goginava (GE), Sven Iversen & Ute Karl (GER), Ursula Trummer (A) Martina Wilsch (SK), Anastasia Zabrodskaja (EE)
Country examples discussed in meetings: Austria (Ursula Trummer, July 2025), Italy (Tanja Schroot, November 2025), Slovakia (Martina Wilsch, February 2026) and Albania (Elona Dhëmbo, February 2026).
Contact
Coordination: Sven Iversen, TraFaDy Vice Chair
Contact: Sven@trafady.eu