Elderly Care Reforms in Germany: Policies, Implementation and Inequalities

As in many western countries, in Germany the expansion and marketization of elderly care services were followed by a worsening of working conditions in the female-connotated sector. In response to the poor working conditions, reform policies were instituted on the national level with the aim of improving labour conditions and thus ensuring a socially sustainable elderly care services infrastructure.

This paper seeks to determine whether elderly care reforms contribute to a reduction of inequalities among care workers within the sector as a decisive element of a socially sustainable care infrastructure. To this end, it selects the implementation of two key reforms in nursing home facilities – policies for increasing staffing levels and policies for promoting international recruitment of care staff. The increase in staffing levels in nursing homes is implemented by a significant change in the composition and cooperation of differently skilled care staff. In this research, skill levels are defined as central component of class and therefore inequality dynamics on this basis are explored. The increasing recruitment of care migrants suggests inequality dynamics based on migration status, which are also explored. Conceptually, the paper draws on the paradigm of multi-level intersectionality for an analysis of the intersection of inequalities based on class and migration status in the female-connotated sector. Multilevel intersectional research assumes that inequality is the product of an interplay of various factors on different societal levels. On the macro level, this research includes social policies; on the meso level work organizations as well as working conditions and practices and on the micro level, social practices and social interactions between individuals. Empirically, it is based on a research project including a nationwide questionnaire study and case studies in nursing homes, which examine the implementation and outcomes of the reforms in nursing homes.