Nursing care is becoming the Achilles heel of the economy

An aging Germany is running out of caregivers. Since the situation is much the same in other EU countries, caregivers for the elderly are now being specifically recruited from around the world. But that’s not easy.

Measuring blood sugar, putting on compression socks, administering medication – for Mai Nguyn Thi Quynh this is by now routine. For eleven months, the twenty-four year old woman has been training in Stuttgart to become a skilled geriatric nurse. Parallel to that she is learning German, since the young woman came to Germany only for the training. “The initial time in Germany was not easy, because everything was completely new for me,” Mai recalls. In addition, she did not understand or speak German that well. “That is why I sometimes felt homesick and lonely.”

Mai Nguyen Thi Quynh is part of a group of one hundred Vietnamese who came to Germany in the fall of 2013 as part of a pilot project. The project is being carried out by the German Society for International Cooperation (SIC) and the Federal Labor Office. Vietnam is a country with a young population. Sixty percent of Vietnamese were born after 1975. Wages are low and anyone who gets trained in the healthcare sector has a hard time finding a job in Vietnam. More than one thousand Vietnamese replied to the German invitation.

Only applicants who had already learned a trade in the healthcare field were selected. The preceding intensive language course at the Goethe Institute in Hanoi, accompanied by intercultural training, lasted only half a year, during which time only basic language skills could be taught.

A new path and a learning process

That is simply not enough, as Reinhild Renée Ernst, the head of the project at the SIC, sums up the situation. “No one from the group had previously been to Germany, most had never left Vietnam.” She notes that it is a big hurdle to begin an education – shortened no less – at the so-called language level A2. “Even if they all come with a lot of knowledge, because they are already qualified nurses,” declares Ernst.

It’s simply a new path and learning process, the head of the project analyzes. As a result, in the next course, which has just begun with another one hundred Vietnamese, the language training is being expanded to one year and will end with the level B2, which means that those who complete it should be able to communicate spontaneously and fluently.

From “Willkommenskultur” [a welcoming culture] to “Bleibekultur” [a culture encouraging migrants to stay]

This makes it much easier for everyone, including employers, who currently still have to free up their trainees for two afternoons a week for language class. Still, Jochen Mager, who runs the Workers’ Welfare Association’s senior center Pfostenwäldle in Stuttgart, strikes a positive balance after the first year. The project is worth it and pays, he says. “We are now already doing everything to develop a culture encouraging people to stay.”

At the moment trainees were still preparing for their exam, but a year goes by quickly, he says. “And we are already seeing that we have very capable workers and we definitely want to keep them at our facility after the exam.”

After the preparation in Hanoi, the one hundred Vietnamese were distributed in small groups to nursing homes all over Germany. Eight trainees came to the senior center Pfostenwäldle. Relative to the need for caregivers by the Stuttgart facility, this is only a drop in the bucket. Following the good experiences with the pilot project, Jochen Mager therefore wants to take the recruitment of additional workers from Vietnam into his own hands.

Immigration alone is not enough

Talks about setting up his own school class in Hanoi are already under way, he says. “I believe that we are on a very good path if we bring the Vietnamese trainees to Germany as a building block – and I want to emphasize that, as a building block.” But even though immigration from Vietnam and the cooperation with that country “are off to a very good start,” Mager concedes: “We will surely not be able to solve all of our problems with Vietnamese, Chinese, or Spaniards.”

The job of caregivers for the elderly is already among the understaffed or short-staffed occupations in Germany. Jobs remain unfilled everywhere, but that is only the beginning. According to estimates by experts, the number of those in need of care will rise in the wake of the demographic change from currently 2.3 million to around 3.4 million by 2030. If nothing changes fundamentally, there will be a shortage of around 150,000 certified caregivers in ten years, in 2030 there could be half a million unfilled jobs.

The job must become more attractive

Anna Koniecko-Sippel of the Bavarian Red Cross takes a skeptical view of the future. For years, she says, skilled workers have been recruited abroad, but that is not changing anything about the great shortage. “We have elderly care nurses from Poland, Croatia, Vietnam, Bosnia, it’s not enough.” A training drive also failed to provide any improvement. “We trained our own classes for our organization, but we can no longer do that because we do not have enough applications. And once people have been trained, they seek something better and don’t want to remain in elderly care. They want to study and do something else.”

That has to do largely with the profession’s lack of attractiveness. The pay for elderly care nurses is comparatively poor, and they enjoy little recognition and appreciation within society. At the same time, the profession is very demanding and taxing. It is urgent for this mismatch to change, warns Dennis Ostwald of the economic institute WifOR.

Caring for parents or going to work?

According to Ostwald, the caregiving sector is the Achilles heel of the overall economy and of prosperity. “If we can no longer care for the elderly because we have a shortage of skilled workers, this has repercussions for other sectors.” He said there was a lack of skilled workers in other sectors too. “And what will happen if workers there demand a collective bargaining agreement for a 32-hour week, because they want to use four hours to care for their parents?,” asks Oswald.

What lies ahead for nursing care is thus most likely the discussion that has been going on about childcare in recent years, but on a larger scale. One hundred trainees from Vietnam and another hundred in a subsequent project, that is far too little for Ostwald. What he has in mind goes much further: 2000 additional caregivers per year from third countries, so his calculation, that is the right approach. For a start.