Exhibition

CARE WORK = INVISIBLE LABOUR

People want and need to be cared for and looked after. Functioning together in a society that is healthy, peaceful and worth living in should not be taken for granted. There is a lot of work involved, such as running a household, bringing up children, and caring for the sick and needy. All these activities have no commodity value because they do not produce tangible products. Therefore, in economics they are referred to as non-productive activities, colloquially they are considered invisible labour. A study by the charity Oxfam found that the value of unpaid domestic, care and welfare work alone is equivalent to about 11 trillion US dollars a year if it were paid at the minimum wage. This work is mainly performed by women.

In current scientific considerations, the entirety of paid and unpaid person-oriented care services is summarised in the English term care work, which is difficult to translate into German. The term focuses on the job responsibilities of the occupational activities. Furthermore, it emphasises that in most cases, where such work is provided as a financially remunerated service, it is precariously paid. Unpaid and paid care work are often intertwined. If there is a need for care in a family, for example due to the illness of an elderly person, it is often no longer possible for the person to be fully cared for by relatives. Then a solution must be pursued through paid care and nursing staff.

The measures to contain the Corona pandemic led to enormous additional burdens in intra-family care relationships, as professional care relationships were in many cases no longer possible. It was mainly women who, in addition to home office, young children and children in home-schooling, also looked after elderly relatives in need of care who would have been otherwise cared for by external persons. Visits to elderly and nursing homes, on the other hand, were not possible at all for a long time, which meant a great psychological burden for many families.

LABOUR WITHOUT BORDERS

The solution to the care problem is increasingly found in carers from other countries. The majority of women working in this occupation come from Eastern and South-Eastern Europe and take over the household of a person to be assisted for a period of usually two weeks. They provide support in everyday life and take on simple nursing tasks. After that they return to their country of origin. As they are not residents of Austria, the carers are not registered as migrants. Their status is described as transnational.

The legal requirements of their work were legislated in 2006/07 with the so-called ‘Schüssel Decree’. The Home Care Act (33[g1]rd[/g1] Federal Act enacting provisions on the care of persons in private households HBeG) received its nickname because it was adopted after a media scandal involving the then Federal Chancellor, Schüssel. A journalist had found out that Schüssel had his mother-in-law looked after by an irregularly employed and utterly underpaid nurse from Slovakia.

Due to the ‘amnesty for the employment of illegal carers’, there was subsequently a surge in care relationships under the Home Care Act. The UNDOK contact point for trade union support for undocumented workers in Austria nevertheless suspects that a high number of carers are still employed in non-regular employment.

 

When border closures aimed at containing the Corona pandemic prevented carers from Eastern and South Eastern Europe from entering the country, representatives of the provincial governments and the Chamber of Commerce called on carers who were in Austria to extend their employment. In this context, any work assignment longer than 14 days is in contradiction to the Home Care Act, which states in section 1.(2)3. that after a work period of no more than 14 days, there must be an uninterrupted period of leisure of at least the same duration.

The recent evidence of national borders created a new, transnational phenomenon: The mutual concerns of and for carers and assisted persons that cross borders.

THE CARE CHAIN

In Austria, the average age of the population is steadily rising. In contrast to Scandinavian countries, there is no reaction to this by improving the system of public care and nursing. Therefore, the need for home carers is increasing. For people living in Austria, the profession of 24/7 carer is not lucrative due the low remuneration of an average of 1000 € gross. Therefore, transnational carers are increasingly being recruited into the country.

These people are absent from their countries of origin for the time they spend working abroad. They are absent from local health systems as well as from their families. This phenomenon is called the international care chain.

The international care chain is criticised by academics as a neo-colonial labour structure. In some media reports, the carers have even been called ‘modern slaves’. This is because workers, mainly women, from Eastern and South-Eastern European countries with lower wage levels are brought to Western European countries to provide 24/7 care and are employed there in precarious income conditions.

During the border closures to contain the Corona pandemic, the care chain was interrupted. When it became clear that necessary care services could no longer be adequately provided without this outsourcing system, the Austrian federal government decided to at least partially restore the care chain through organised flights and special trains for carers, instead of considering long-term alternatives for improving the care system.

CARE DURING THE COVID-19 EXCEPTIONS PHASE

Only 1.6 percent of the officially registered 24/7 carers are residents of Austria. The border closures and travel restrictions imposed to contain the Corona virus (Covid-19) therefore led to a crisis in the Austrian system of care.

The crisis of care in the Corona period made shortcomings in the social system and discriminatory structures within the transnational care network very apparent. People in need of care, mostly members of the high-risk group, were often suddenly left to themselves or to depend on family help. For their relatives, this situation caused an enormous additional burden.

Since women on average handle as much as 85 percent of the care work, they were hit particularly hard. Besides the children who stayed at home due to the closures of kindergartens and schools, elderly relatives now also had to be looked after.

Organisations providing care services and relatives of persons in need of care therefore insisted on a special regulation on entry and exit requirements for carers from other EU countries. With considerable media attention, carers from Bulgaria and Romania were brought to Austria by charter flights and special trains. The costs of transport were covered by the provincial governments, but there was no compensation for the time lost during the quarantine period of at least two weeks when the carers entered and left the country.

It remains to be seen whether the crisis situation will lead to changes in the unstable care system in the long run. For a long time, hopes were pinned on the care reform, of which the first implementations were already announced for the beginning of 2021. However, because of the Corona crisis, the major reform package was postponed.

Transnational 24/7 carers were largely excluded from the digital participation process, which was open to all interested parties until mid-August 2020. This was because the extensive questionnaires were only available in German and had to be filled out in this language.

Carers do not require any specific training. Some have gained experience in the medical field, inpatient care for the elderly or in caring for relatives and/or have attended a care course. Nevertheless, one of the greatest burdens mentioned by the 24/7 carers interviewed was not the work itself, but dealing with bureaucratic pitfalls. The bureaucratic burden is high and can lead to a major loss of income if handled incorrectly. When dealing with bureaucracy, carers are often confronted with institutional racism. These include forms that are difficult to understand and not available in translation, or fees that are set much higher for persons not registered in Austria. Many of these hurdles are caused by the legal status of most carers as self-employed professionals which is not regulated by labour legislation.

However, some improvements have been made to the bureaucratic system since the legalisation of the professional services. And last but not least, the carers have learned how to deal with the hurdles and share this knowledge with their colleagues. Facebook groups are an important communication tool. They provide a virtual space for people with similar problems and interests who cannot meet in person because of their work situation.

Self-employed carers who were unable to commence their service due to the border closures to contain the Corona pandemic were entitled to receive money from the Hardship Fund. However, the initial conditions made it difficult for transnational 24/7 carers to apply. Hurdle number 1 was having an Austrian tax number, which most of them lacked because their income is so low that they do not have to pay any tax on it. Hurdle number 2 was an Austrian bank account, which is difficult to open without a residence address in Austria or can only be obtained at higher charges. Persons who have a low pension in their country of origin and therefore work as carers in Austria were generally not eligible to apply. This was because the forms were only available in German and had to be filled out in this language.

Carers who extended their stay because their replacement could not enter the country due to the border closures were eligible to apply for the so-called ‘stay-there bonus’ of 500 €. The forms for this purpose were different in all federal states, only available in German and had to be filled out in this language. The ‘stay-there bonus’ was paid to the assisted person with the request to pass the money on to the carers. This should prevent misuse.

SELF-EMPLOYMENT

According to the Home Care Act, carers can either be employed or self-employed in Austria. Currently, the majority of carers operate on a self-employed basis. This means that labour law provisions, for example on working hours or minimum wage, have no effect. The law stipulates that a working period may not exceed 14 days, after which an uninterrupted period of time off for at least the same duration must be granted. It is not specified what is to be considered as time of arrival and departure.

As single-person enterprises (EPUs), carers are members of the Chamber of Commerce (Wirtschaftskammer, WKO). They represent the largest share of members among all EPUs. Their interests are represented by the specialist group for counselling and assistance to persons. As self-employed workers, they cannot organise in trade unions.

The WKO publishes the quarterly magazine ‘DAHEIM BETREUT’ in four languages for carers and provides sample agreements in twelve languages. These agreements protect carers from exploitation by their employers or agencies.

When the federal government decided to fly in carers from Romania and Bulgaria in order to curb the care crisis, the Chamber of Commerce took over their accommodation in shared rooms in hotels for the 14-day quarantine period. However, the requests of carers to defer the chamber fees until the end of the year due to their loss of earnings and the additional costs for corona tests and quarantine periods were not granted. Only a deferment of one month was achieved.

COMPULSORY SOCIAL SECURITY

As self-employed carers, they must get health and pension insurance through the Social Insurance Institution for Self-Employed Persons (SVS). The conditions for transnational carers are the same as for all other professionals and self-employed persons. For carers, paying the minimum amount means that they use almost 1/3 of their income for this purpose.

Social security benefits are seldom claimed by transnational carers. Doctor’s appointments are mostly made in the countries of origin, where the costs are lower than in Austria. The pension entitlements are minimal due to the low earnings and amount to about € 10 per year of work.

Many carers who are already retired in their countries of origin have a valid health insurance there anyway. Carers are often already retired and work in the field to supplement their income. One of the reasons for low pensions is the fact that many women have spent years doing unpaid care work in their own families.

In the past, there were often difficulties with payments and reminders due to outstanding back payments of social security contributions. One reason for this is that the forms are complicated and not available in translation, and therefore incorrect information has been provided unknowingly. Another reason is payment failures by agencies. In some cases, agencies have only pretended to pay the insurance costs for the carers, but have never actually paid them. Hidden charges, such as increased bank charges for payments from abroad, can also accumulate debts to the SVS. For many carers, additional payments pose a threat to their existence due to their low income.

The costs of compulsory Corona tests for carers are not covered by the SVS. When the federal government started offering free tests to all travellers returning from Corona risk areas in mid-August 2020, incoming carers still had to cover the costs of their own tests. After months of protest, at least 2/3 of the test costs were covered by the federal government.

AGENCIES

The majority of 24/7 carers are placed through agencies. For persons in need of care and their families, this has the benefit of providing them with rapid support in an emergency. Placement through agencies also has benefits for carers. They can change jobs quickly if needed and thus avoid any loss of earnings. The motivation to change jobs may have different causes. Due to the close relationship with the assisted persons, there may be personal differences. However, it is more common for carers to lose their assignment due to a transfer to a care home or the death of the assisted person.

Despite this, employment agencies for personal carers have a negative reputation. In fact, there were and still are considerable shortcomings here. Some agencies charge high fees for relatively limited services: They only keep large databases of personal data, but do not worry about the qualifications of the carers or the quality of the job. Cases of misappropriation of funds have been reported as well.

When choosing an agency, it is important to make sure that the care personnel are known to the agency and are selected according to their professional competence and character to suit the person to be cared for. In addition, employees with sound basic medical knowledge should regularly check the place of work and the degree of care of the assisted person in order to prevent the carers from being overworked. It is also important that agreements are transparent for all parties involved. As carers work independently, separate agreements must be concluded with them and the agency. The amount for social security contributions is to be added to the carers’ contributions so that they are responsible for paying them. With such simple measures, any fraudulent intentions on the part of agencies can be prevented.

Some agencies organise transport services. In rural areas, this has the advantage that carers can get to the place of work quickly and easily. However, some of the transport services are very expensive and must be used anyway.

With the legalisation of the profession of personal caregivers, Vorarlberg was the only Austrian province to decide to take care of the placement itself. Since then, more than half of the caregivers have been placed by the “Betreuungspool“, which is close to the province. Caregivers of the “Betreuungspool” earn significantly better than the average, for 160 € per year they are insured for liability and legal protection, are accompanied by a case and care management, psychologists and a geronto-psychiatric service and can attend dementia seminars. Clients pay a relatively low placement fee, so that the service is no more expensive for them than through agencies.

Until July 2015, there was no regulation in the Trade Regulation Act on the Organisation of Carers and thus no possibility to control this trade. Ever since the activity of placement agencies was defined as an independent trade under Section 161, the situation has slightly improved. However, it seems that due to the high need for supervision in Austria, the labour inspectorate does not monitor the situation very closely. Only agency representatives are responsible for advocacy as chairpersons of the specialist group for personal counselling and care within the Chamber of Commerce.

The province of Lower Austria was the only Austrian province to fly in carers from Romania and Bulgaria during the border closures to contain the Corona pandemic. The organisation of the flights and the selection of the carers was carried out by the head of the specialist group of the Lower Austrian Chamber of Commerce, which operates a placement agency. He was subsequently accused of giving preferential treatment to the carers of his own agency.

FAMILY BENEFIT

Carers with children under 24 who work in Austria receive the family benefit. In 2019, family benefits were politically indexed. For carers from Eastern and South Eastern Europe, this means that they would receive from a quarter (Slovenia) to more than half (Bulgaria) less of the monthly support. For women who have to pay childcare workers for the time they are at work, this is a tremendous existential cut.

Families living in Austria received a child bonus of € 360 per child due to their additional expenses during the Corona crisis. Carers who do not have their primary residence in Austria only received this amount on a pro rata basis according to the indexation chart. IG 24, a support organisation for carers, has submitted a complaint to the European Commission in cooperation with the Styrian Anti-Discrimination Agency and the Volkshilfe.

On 16 June 2022, the European Court of Justice (ECJ) declared Austria’s indexation of family allowances unlawful. Austria is now threatened with back payments.

CERTIFICATE OF RESIDENCE

According to the Settlement and Residence Act (Niederlassungs- und Aufenthaltsgesetz, NAG), anyone who is going to be in Austria for longer than three months at a time has to register and will be issued a certificate of residence. This residence certificate entitles the holder to become a permanent resident in Austria after five years.

This regulation does not apply to carers. If they stick to the recommended pace of two weeks work – two weeks off, they lack the continuity of stay. Therefore, carers who have been working in Austria for more than five years are not eligible to apply for permanent residence.

The uncertain residence status brings about many disadvantages for the carers. If they are unable to make their return journey, for example because they are seriously ill, they may face deportation in the worst case. An application for a medical treatment is not possible without permanent residence in Austria.

An extension of the work period in Austria does not improve the chances of obtaining a residence certificate for carers, as this measure is spontaneous and not a permanently practised arrangement.

THIS WORK HUMANISES

Care work differs from productive work in that it does not produce a visible product. Instead, work is performed by people for and with people. Humanity and the preservation or restoration of health are thus its primary purpose. Unpaid care work is therefore considered reproductive work.

Interpersonal qualities are not only essential in the relationship between the carer and the assisted person. The evaluation and recognition of the work of carers is also reflected in the acceptance by the respective families as well as by society and politics. In general, however, care work receives little appreciation – neither financially nor in terms of ideals. 

The essential importance of care work for our society often only becomes apparent when it cannot be performed. When border closures to contain the Corona pandemic prevented transnational 24/7 carers from entering the country, they and their labour received more media attention than ever before.

Carers are not required to have any specific training. Most of them take a course before starting their first job, which is often offered by the placing agency. The quality of these courses varies greatly. In many courses, only the most basic level of the language of the target country is taught. High-quality courses are becoming increasingly available, but in some cases future carers have to cover the costs themselves. At the same time, there is a strong demand among the carers for training and regular advanced training in order to have more security in their profession. Nevertheless, this is not compatible with working hours and earnings. Slovenia is one of the few countries where the Labour Office offers relatively extensive and high quality care courses for people registered as unemployed. It also helps with job placement through selected partner agencies after completion of the courses.

Many core competences of carers cannot be developed and acquired in training. These include empathy, cordiality and the willingness to adapt to the respective household. Learning to keep a professional distance is often a difficult process and a narrow line, crossing which cannot always be avoided. Only carers with essential medical training are allowed to provide medical care to their clients.

Being flexible is one of the most important competencies for 24/7 carers. During the Corona crisis, carers were required to be extremely flexible: in their willingness to extend their schedule; in their willingness to accept quarantine periods without receiving a compensation payment; in their willingness to take Corona tests and pay for them themselves; and last but not least, in their willingness to care for clients who were often severely disturbed by the crisis.

The recognition of competences is an important expression of the appreciation of any work. Emotional appreciation of the activity is crucial for a good supervisory relationship. But financial remuneration is also a sign of appreciation. In general, occupations in the care sector are paid much less than productive jobs in industry and manual trades. They are only classified as ‘systemically relevant’ in times of crisis, which became evident during the Covid 19 pandemic.

In Austria, personal care workers usually earn hardly more than € 1000 per month. Vorarlberg is an exception. The local agency “Betreuungspool” pays daily rates of 85 to 120 €, which is at least 200 € more, depending on the work to be done. As self-employed persons, they have to pay social security and taxes on their earnings if they exceed the tax threshold. Often they also have to cover their own travel costs to and from the place of work.

The working time is officially 14 days of 22 hours. Carers are legally entitled to a daily two-hour break, but this is often not possible due to the lack of a substitute carer. Carers are always on call at night. As restlessness is one of the common symptoms of dementia, many carers are called several times a night and hardly get any sleep during their work assignments.

In contrast to representatives of other systemically relevant professions, transnational carers were neither granted paid quarantine periods nor the reimbursement of costs for corona tests. The European Council did not want to discuss the indexation of the child benefit and the child bonus, which had been criticised as being discriminatory. The stay-there bonus for carers, who often stayed in Austria for months longer than planned, was set at € 500, the lowest amount proposed. To avoid fraud, the amount was not transferred to the accounts of the carers but to the families of the assisted persons.

Language is not the only means of communication, but it is an important one. The carers are aware of this. Speaking regularly would not only be important for the prevention of dementia in the assisted persons, it would make the work much more pleasant for the carers. Unfortunately, the language courses that carers take before they commence their work are usually only sufficient for the most basic communication. If the assisted persons speak some dialect, they often cannot understand anything.

Despite this, language courses for carers are seldom attended in Austria. The carers simply do not have the time. Most of them still try to improve their language skills. If they cannot or do not want to train with the assisted persons, they often learn via online platforms.

Comprehending the ‘official language’ requires a very high level of fluency. The fact that all forms for financial support were only available in German at the time of Corona and had to be filled out in this language was a major hurdle for transnational carers. This could only be managed with the help of volunteer initiatives or supportive families.

24/7 care in the home of the assisted person can only happen in close contact with their family. This is because it is usually the relatives who organise the care. They conclude or terminate agreements. They have to take over for the carer during breaks, if necessary. In some cases, relatives also have to provide light medical care, such as giving injections, unless carers are specially trained to perform this task.

Last but not least, the family of the assisted person is important in its mediation function. The elderly, especially people with dementia, are often sceptical of strangers. The idea of living in a house with a stranger often scares them. Relatives can be very helpful in relieving this fear and also in reducing other defences.

During the Corona crisis, some families stepped in where state support seemed to be lacking. They helped to fill in forms and a few who could afford it also paid advance fees to carers, even if they could not take up their duties because of the border closures. It has been shown that in many cases carers enjoy almost the status of family members.

When carers come to Austria for their placement, they usually leave their family behind in their country of origin. A large number of carers choose the transnational work model only when their own children are already independent. Men are often provided with pre-cooked meals so that they are not burdened with feminised care activities.

Some carers have children in need of care. Here, in most cases, the intra-family care chain through grandmothers is activated. This is because the men are often working themselves or do not want to take over childcare because of the socially traditional understanding of gender roles. In some cases, external childcare has to be organised and paid for.

Carers are often under the misconception that they are abandoning their families. They also maintain regular contact during their work assignments – mostly via video platforms. During their time off work, they devote a lot of time to their families.

The extension of the working cycle that was demanded by representatives of the Chamber of Commerce and politics from transnationally operating carers in the Corona period inevitably meant neglecting the care services for their own families. This aspect was not taken into account when talking about the additional burden on families.

Everyone needs privacy. This is often not so easy to grant in a close, in-home care relationship. By law, the carers are provided with their own room. In reality, however, it is often just a sofa in the living room for them to sleep on, a wardrobe for their clothes and the few personal things they have.

It is important for many carers to be able to leave the house at least once a day. Many go for a walk in all weathers to air out their minds. The only time they cannot be called by the assisted persons is when they are out of the house.

The constant workload causes most carers to give up their profession after a few years. Therefore, advocacy groups demand regular supervision for carers.

For many carers, the increasing lack of privacy and the further restriction of freedom of movement, as well as the additional insecurity caused by the lock-down measures, have led to more burnout and depression.

When people discuss migration, the term integration tends to come up quickly. For transnational carers, integration into Austrian society is nearly impossible. Because they hardly have any free time in which they could socialise. Apart from short breaks, they spend their time in the home of the assisted person. They may only arrive and depart directly at the beginning and end of work, as they take turns with a second carer and typically stay in the same room. If the trip is organised by the agency in minibuses, this does not even leave time for a handover meeting.

Carers therefore usually regard Austria only as their place of work. They feel at home in their country of origin, where they have both time and opportunity for a social life.

Those carers who agreed to enter the country and to remain in quarantine for two weeks without remuneration during the border closures to contain the Corona pandemic did so largely out of a sense of responsibility towards the assisted person and their family. This shows that there is a high degree of integration within the family.

This exhibition does not present any objects. This was decided by the interviewed carers. The tools they often use for their work – such as mops, cleaning buckets, cooking pots, briefs – seemed too banal for them to exhibit. There are hardly any personal objects, on the other hand.

For reasons of professionalism, carers avoid changing their place of work with their personal belongings. The only exception here is herbs and spices from their homeland, which they use to enrich the meals – often to the delight of the assisted persons. Any other objects are used mainly to feel more comfortable in their small private areas, to organise themselves well and to keep in touch with their country of origin. Besides telephone, laptop and diary, the most common paraphernalia mentioned in the interviews with carers were their own bed linen and towels.

WAS THERE SOMETHING ELSE?

Physical impairments are only one of the reasons why elderly people need care. In old age, mental impairments are common, for example due to dementia. Dementia is a chronic progressive disease of the brain. The most common cause of dementia is Alzheimer’s disease. The primary symptom of dementia is memory impairment. In addition, people often have other behavioural problems that cannot be easily attributed to the disease and need a professional diagnosis.

Carers are often overwhelmed by dementia. If they have no training or little experience in the profession, they lack knowledge about the symptoms of the disease.

Experienced carers have therefore insisted on providing information about dementia in the exhibition. As this topic is very extensive, please refer to the certified dementia guidebook of IG-Pflege. It can be ordered free of charge via the IG-Pflege website or downloaded as a pdf document. The Vorarlberg “Betreuungspool” offers dementia seminars for caregivers and relatives.

Carers who have engaged with the topic have found knowledge about the disease and its symptoms very helpful. They therefore want both relatives and carers to learn to recognise signs of dementia and thus be able to classify the behaviour of dementia patients and consult doctors if medication is necessary.

People with dementia are sensitive to disruptions of the usual daily routine and to an atmosphere characterised by uncertainty. That is why dementia patients and their families were hit particularly hard when they could no longer be cared for by their usual 24/7 carers due to the measures taken to contain the Corona pandemic.

THE END

Often, following the death of an assisted person is part of the work of 24/7 carers. ‘People pass away with you, you are the last person they see, it’s a very special relationship’. This is how an experienced carer expressed the particular intimacy that can develop in a caring relationship – it is also what she now likes very much about her job.

For carers, the death of the assisted person not only has emotional consequences, but also means a profound change in their lives. In accordance with the Home Care Act, the employment relationship ends immediately upon the death of the assisted person, so carers have to reorientate themselves immediately. This includes organising the journey home or accommodation if necessary, as well as bridging the gap during an unpaid period or quickly settling into a new job. Carers are often excluded from participating in parting rituals such as the funeral because of the distance. Therapeutic services for coping with the experience of death are not covered by the SVS and must be financed by themselves, if necessary.

Hospice associations worldwide appealed to not leave dying persons alone even in times of visitation bans to contain the Corona pandemic and to keep in regular contact through means of digital communication. Transnational 24/7 carers, who are often important confidants for the persons in their care, were only able to maintain this contact with the help of the families. Remuneration for this digital end-of-life care was not foreseen.

The Story Continues

Employment relationships in 24/7 care are precarious and not compatible with labour law. While this fact has been known for a long time, it was not officially confirmed until June 2021.

In Germany, a Bulgarian 24/7 carer sued for maximum working hours and minimum wage – and won the case. This precedent also affects Austria. The reason for this is that 24/7 carers are extremely mobile and flexible. If the working conditions in Germany are better than in Austria, many carers will prefer to work there. Instead of the current pseudo self-employment without social security in case of illness, they expect to be permanently employed and to be relieved through a 2-shift system. The Austrian Minister of Health therefore announced a boost in care reform in July. At the same time, however, international talks were started to extend the care chain of Europe with South America. Specifically, the ‘import’ of nurses from Colombia is being discussed.

As part of the nursing reform, 150 positions for 150 community nurses have already been earmarked. Starting in 2022, they are to monitor the working conditions in 24/7 care throughout Austria and support the carers with medical care services.

The Future

The need for nursing and care will certainly increase in the future. The reason for this is not only the increasing number of elderly and very old people in general. More and more migrants, who were supported in old age by their families in the past, are no longer able or willing to fall back to this system. To meet the increased demand, technical solutions are also being sought in addition to staff improvements.

Care robots like the Pepper presented here are already being used in homes. However, care robots are at best able to assist with animation and are not a substitute for care and support services provided by people, personal sympathy and empathy. Likewise, electronic support systems, such as reminder memos for taking medication, are only of limited suitability, especially for people with dementia. Technical assistance systems are currently very prone to errors in their technical functionality.