The situation of domestic care workers of older people is becoming increasingly vulnerable

The gradual withdrawal of the state from home care for the elderly over decades has led to a strong marketisation of the sector across Europe. Although this process is still in its early stages in Hungary, certain trends are already emerging. Noémi Katona, Assistant Professor at Corvinus and Dóra Gábriel, Researcher at the Institute of Sociology of the Centre for Social Sciences, analysed the current situation of home care for the elderly in Hungary in an international volume on the subject published earlier this year.  

The phenomenon of an ageing society also hits our country hard, with 49.5% of the Hungarian population projected to be in the older age group by 2055. Meanwhile, the elderly care sector bleeds from numerous wounds: there are waiting lists for years for state-run residential care homes, and there are not enough qualified carers in the sector due to low wages and poor working conditions. These circumstances all push families in need towards private care, while the majority of Hungarian families cannot afford any form of paid assistance. The vast majority of people affected are therefore forced to manage the day-to-day care of their elderly loved ones within the family.  

One of the researchers’ main findings is that the sector is dominated by huge social inequalities, both for carers and for the cared-for. Informal contacts and personal recommendations permeate all segments of the market. This is a global trend in elderly care, but in Hungary it is particularly true that the parties involved mostly meet on an informal basis, with the majority of carers employed in the grey zone.  

How families and carers find each other: the carer pyramid 

In their study, Noémi Katona and Dóra Gábriel classify the actors mediating the matching of caregivers and those requiring care in the home into five types. Researchers have found that the way in which the mediation is carried out is a major determinant of the caregiver’s expectations and subsequent working conditions, as well as of the guarantee that the family of the cared-for person receives on the quality of the caregiver’s work.  

 Firms at the top of the pyramid, employing carers on a contract basis as employees, are able to offer their workers the greatest safety at the workplace and rights, while at the bottom of the pyramid, through informal networks, carers face much more vulnerable working conditions. However, the authors also add that the services of the companies and intermediary agencies at the top of the pyramid are typically only affordable by wealthier Hungarian families.  

The companies that link carers to families are registered companies, but for the most part they only act as intermediaries, with no guarantee for the carers they place. The primary revenue of many of these companies comes from the training they provide to carers registered on their site. Placement agencies often collect registration fees not only from the families of the carers, but also from the carers. These agencies stay in contact with families and carers after the placement and provide 24-hour care services on request. They have a database of usually 300-500 trained specialists to choose from for families in need. The companies that do provide staff are typically small, with only 10-20 permanent carers.  

In informal networks, families in need help each other with referrals, and in thematic free online forums, families and carers of people in need of care at home find each other without intermediaries. According to the researchers, most of those involved find each other through online platforms and informal networks.  

The majority of home care workers are vulnerable 

“Carers in more precarious situations are under greater pressure to accept jobs that involve tougher working conditions and increased vulnerability. Many caregivers struggle with housing and other social problems and find it difficult to exit this very precarious situation,” explains Noémi Katona, Researcher at Corvinus.  

The shortage of skilled workers is also a huge problem in the care of the elderly in the home at the moment. According to the researchers, there is a strong migration of carers in the region. As this sector currently pays the lowest wages in the country, many foreign language-speaking carers have left the country in recent years, most of whom now work in German-speaking areas. They are replaced by many Hungarian national carers from Transylvania and Transcarpathia, who are typically unskilled but experienced in home care.