Home care for the elderly is as important and time consuming as childcare. Picking the right person for the job is crucial. Also crucial are the conditions offered to the people providing the home care. This is a profession in itself and is defined as such by the International Labour Organisation's Domestic Workers Convention no. 189. The convention offers protection and recognises the right to decent work conditions for these workers.
We spoke to one such worker, Anisoara, with 18 years of experience in the area, in order to find out what her typical day is like. Right now she cares for three elderly people she spends a few hours with every day. Here is what she told us:
"I help them take their medication, I do their shopping, I take them to the doctor, I wash them, I cook and I clean for them."
In spite of Convention 189, Anisoara's profession is not recognised by all European states, and reality does not always match regulation. She explained what that means:
"I worked for a company that had a contract with the sector city hall. I was working there legally, but city hall ran out of funds to pay for domestic workers at this company. I lost my job and now I work in private, as it were. The elderly people who could not afford a caretaker of their own were left without any help whatsoever."
This situation shows the vulnerability of both domestic workers and the people who need home care. Those of them whose family cannot afford a caretaker are left with no help, unless the local authorities pay a company to provide a domestic worker. The latter are sometimes forced to work under the counter, with none of the rights provided by legal employment. Here is Anisoara once again:
"I don't have a job contract, and I cannot afford social and medical insurance. I haven't been to the doctor in years, even though I have high blood pressure and other problems as well."
The Habilitas Humanitarian Association trains domestic workers. Its vice-president, Rodica Caciula, gave us a few details about the legal or less than legal situation of these caretakers:
"Domestic workers are listed in the Code of Occupations in Romania and are denominated as 'home caretakers for the elderly'. It also defines the highest level of qualification for this occupation, which is gained by doing 360 hours of training, 240 hours of practice, and 120 hours of theoretical training. However, there are a lot of people who have no training, who get hired privately rather than a company or by the state or local authorities. We don't know for sure how many of them are legally employed - it seems few of them are documented workers - many of them work on the so-called grey area of the labour market."
One solution for providing protection for domestic workers and the people they take care of is ratifying Convention 189. This is the advice of the European Economic and Social Committee, which recently issued a request to EU member states to ratify this convention. Dumitru Fornea, a member of this Committee, told us about the advantages of issuing stricter legislation to regulate home care:
"This is a very important convention. So far very few states have ratified it - Belgium, Ireland, Portugal, Germany, Finland and Switzerland - others will gradually join as well, since this is a condition for continuing any serious discussion in terms of legalising this occupation and restoring dignity to these people. This sector seems marginal. But, if we look at the aging of the population and the need for medical assistance, the importance of this sector is growing. However, all these are considered to be marginal aspects of social regulations. Now we are trying to restore dignity to the workers in this sector."
In addition, stricter legislation and enforcement also protects the elderly. Here is Rodica Caciula:
"It is important for a domestic worker to be hired either by a company or by the local authorities because the elderly run the risk of being abused by a caretaker. If there is no paperwork, there can be no investigation by the authorities, either social workers or labour inspectors, therefore we cannot know what happens in the home of the elderly person and their caretaker. There is also the possibility for the worker to be exhausted, with no replacement to take over, no vacation, with no regulation applying to their work. There are lots of cases of single, defenceless elderly people being abused in their home by domestic workers. This is why it is important for this convention to be ratified. If all these domestic workers had contract-based work, they would become a major segment of the labour force in Romania."
Until better legislation and regulation comes into effect, Anisoara and the people in her situation, as well as the people they care for, often as disadvantaged as the caretakers, continue to make do as best they can.