As in many other European countries, the Austrian society is faced with challenges to organise care services for the growing share of senior people. Two tendencies can be identified to address occurring care gaps in the face of demographic transition: on the one hand, market-mediated provision of care and, on the other hand, the potential for care within communities.
In this article, we shed light on the ongoing marketisation of care work with respect to agency-mediated live-in care, conducted mostly by women from Eastern European countries, living and working as caregivers in Austrian households. Moreover, we focus on multi-faceted forms of communitisation in terms of caring communities, local and neighbourhood initiatives and alternative living arrangements for seniors. These developments, among others, can be analysed as controversial and ambivalent societal reactions to the ongoing “crisis of care” (Maier 2022).
Persistency and Fragility: Care Gaps within the Welfare State
Within the Austrian society, the ideal of living at home in old age is culturally and institutionally firmly anchored (cf. Bauer et al. 2014; Prieler 2021). At the same time, Austria’s welfare state shows different scopes of responsibility: “while the long-term care allowance [“Pflegegeld”] is a national responsibility, services are the responsibility of the provinces” (Österle 2021: 7). This means a primarily addressing of families, with state investments directed towards this. Idealising family care is supported by a variety of political measures. Despite public expansions of inpatient, day-care and mobile services, senior care provision “has traditionally been embedded in both family structures and state institutions securing and enabling those structures” (Weicht 2019: 264).
Despite equalisations, inequalities are shaping the feminised working environment of the care sector. Regarding the shift from a male-breadwinner to a so-called adult worker model, Austria is described as a “gendered model of explicit familialism, which reiterates the male breadwinner and female caregiver ideology” (Mairhuber/Sardadvar 2018: 66; Leitner 2014). Not only in the area of family-based provision, but also in the service sector administered by provincial authorities and the third sector (non-profit welfare agencies), working pressure is increasing and gaps are emerging.
Live-in-Care and Caring Communities as Reactions to Care Crisis
Especially since the legalisation of the self-employment model in 2007, agency-mediated live-in care has become an important pillar of care provisioning for seniors (Aulenbacher et al 2021; Österle 2021). On a European market for care work, agencies sell care (as a “fictitious commodity” in a Polanyian sense – cf. Aulenbacher et al. 2020) to more affluent societies, responding to growing demands.
Live-in care is organised as a market-oriented self-employment model, in which care in private homes of the cared-for is operated as a business, and caregivers as well as agencies are represented by the Chamber of Commerce. What is known in everyday language as “24-hour care” points discursively to the permanent availability of the caregivers. Mediated by currently around 1000 agencies of different size, these for- and non-profit organisations have become powerful actors, as they have a decisive influence on the conditions under which it is provided (Aulenbacher et al. 2021). This has resulted in a dynamically developing care market – transnationally and within the welfare state.
Live-in care workers are often referred to as virtual or imagined family members. Accordingly, relatives and family caregivers often associate care tasks with qualities that are typically assigned to families, like intimacy, love, or housekeeping (Weicht 2019). Thus, migrant caregivers, who live in the shared household, are often seen as substitute for family care. This relates to gender norms and family logics that are ingrained in the Austrian care regime (Aulenbacher et al. 2018). The arrangement is further consolidated through quality seals and additional financial subsidies (Aulenbacher et al. 2021; Österle 2021). Mostly large – for-profit and non-profit – agencies hold a special quality seal, trying to stand out against other agencies. In this way, agencies are seeking to make live-in care more competitive and sustainable (Aulenbacher et al. 2020).
However, movements have become apparent. Providers at regional levels and welfare agencies are trying find new ways to improve the arrangement through higher degrees of transparency, slightly enhanced working conditions, more integrated cooperation with mobile and medical services. Although the sector is growing steadily, the condition of the arrangement remains controversial. Critics focus on precarious working and living conditions, and coalitions of caregivers are formed (Aulenbacher et al. 2022; Maier 2022). These initiatives and NGOs are revealing problematic conditions of working in a foreign household and the challenges of pendulum migration.
In addition to tendencies towards marketisation, various community initiatives are gaining relevance, aiming at understanding care for senior citizens as a task to be dealt with collaboratively and at establishing more reciprocity-oriented care networks (Dressel et al. 2022; Wegleitner &Schuchter 2018; Wegleitner & Schuchter 2021).
What unites these diverse forms of communitisation, in all their heterogeneity, is to strengthen new cultures of care, cooperation and community-building. They often strive to bring together residents of a municipality or region with local family caregivers in order to raise awareness about issues of vulnerability, dying, death and loss, and how care work is currently allocated. As one project report puts it, it is a matter of “perceiving, organising and maintaining a multifaceted fabric of (caring) relationships” (Wegleitner & Schuchter 2021: 10).
Caring community projects are set up and supported by government institutions, in cooperation with local or confessional services and civil society actors. Currently, projects are promoted using the motto “Towards Good Neighbourhoods” or “Caring Communities for Future”, focusing on interaction between civil society initiatives and professionals. These (pilot) projects aim to improve the quality of life and health of citizens and reduce the burden on the health and care system.
Community-based forms of care are still a niche phenomenon in Austria, which is gaining in importance. Financial incentives, support programs, the variety of projects as well as political and scientific debates on community-based forms of care indicate their increasing relevance. As societal reactions to insufficient public provision and to “fragmentation, bureaucratisation and commodification of care” (Wegleitner & Schuchter 2019: 5), caring communities can be interpreted as Polanyian counter-movements. At the same time, their organisation and embedding in the welfare state are controversial. The reorganisation of logics of (and through) communitisation may result in altered forms of division of labour. Gender inequalities can potentially be challenged but also de-thematised (Aulenbacher et al. 2018; Reimer & Riegraf 2016; Wegleitner & Schuchter 2018). In this context, questions arise about the extent to which more reciprocal community initiatives can contribute to new family, generational and gender arrangements. Or more generally: whether it could lead to questioning of traditional orientations that have shaped the provision of care so far.
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