Fractures in the Austrian Model of Long-Term Care: What are the Lessons from the First Wave of the COVID-19 Pandemic?

Context: The COVID-19 pandemic highlights limitations of long-term care (LTC) systems in Europe, which continue to be divided between health and social care, and between formal and informal care. Objective: This article focuses on Austria’s LTC sector and its critical features that became visible during the outbreak of the COVID-19 pandemic. Method: The analysis was carried out via desk-research, which covered literature, on-going qualitative analysis of media coverage, and statements and reports by interest organisations and governmental agencies between March and August 2020. Where necessary, useful and feasible, update information on ensuing developments until the end of 2020 was added during a final revision. Findings: In Austria, the number of cases as well as the number and share of deaths in care homes were lower than in other countries until August 2020. Yet, the crisis brought several idiosyncrasies to the fore, most prominently a lack of support for informal caregivers and lack of acknowledgements of the rights of live-in personal (migrant) carers. We find that the COVID-19 crisis has shed light on the fact that existing inequalities are being aggravated by gender and migration issues. Implications: (i) The crisis highlights the need for better communication, integrated care and health information flows between health and social care; (ii) Clear guidelines are required to balance older people’s right to self-determination versus (public) health concerns; (iii) Increasing reliance on migrant carers from Eastern Europe has led to a dualisation of the LTC labour market in the past decades, which needs to be countered by increased quality standards and endeavours to fundamentally change the employment situation of live-in carers; (iv) Informal carers are vulnerable groups that deserve special attention and call for expansion of community services in long-term care.