The share of migrant workers in the long-term care (LTC) workforce across the world has been increasing. Despite similar trends in terms of overall LTC migrantisation, countries differ in the ways in which migrant workers are involved in national care regimes. Previous research identified several modes of migrantisation, including the “migrant in the family” and “migrant in formal care” outcomes. In the literature, the emergence of each mode is explained by a country-specific intersection of regimes of care, migration and employment. However, analyses of the concrete mechanisms through which such intersections produce differential outcomes are still missing. In this chapter, we identify and explain the mechanisms that resulted in the emergence of “migrant in the family” and “migrant in formal care” migrantisation in Germany.

This contribution reconstructs the policy shift from a Bismarckian “low road” to a “higher road” of long-term care (LTC) policy in Germany. We argue that this policy change is deeply intertwined with migration to uphold and transform LTC policy. Cash benefits did not just stabilise family care, but are increasingly used to establish a “migrant-in-the-family” model. Moreover, while the marketisation of care services led to an expansion of commercial services, this process increasingly depended on migrant carers. Policy measures to improve working conditions in formal care were only initiated when ever-growing demands could not be met by migrant workers. At the same time live-in arrangements are only cautiously regulated. Reflecting the familialistic legacy, provision of care by women (paid/unpaid, formal/informal, professional/semi-professional) has become more stratified.