The Essential Employment in the Care Sector

Every person has needed care at some point, and most likely will need it again throughout life. From childhood to old age, in specific situations or over extended periods, there are moments or life stages when a person is unable to care for themselves in order to live a full life in the society they inhabit. This may be due to an inability to feed themselves, bathe, move, or interact with others, or because—even while retaining some autonomy—they require support to do so.

In Spain, this support has traditionally been provided by the family within the household; particularly by women—partners, mothers, daughters, or daughters-in-law. In fact, 85% of those who care for dependent elderly people at home are women, whether family members or domestic workers (Moreno, 2020). The association of caregiving with the feminine sphere—within the home and family environment—has historically led to its lack of recognition, professionalization, and social and labor valuation.

The care crisis in developed countries reveals the imbalance between the growing need for attention and the capacity to provide care, which is partially resolved by the labor of migrant women in what is known as global care chains. This system perpetuates the unequal distribution of caregiving responsibilities, which disproportionately fall on women.

This scenario makes it essential for the State to provide the necessary resources to guarantee every person’s right to be cared for, in line with the European Care Strategy (2022), based on the European Pillar of Social Rights (principle 18 on long-term care). At the same time, it is urgent to redistribute and rebalance caregiving tasks, moving toward genuine shared responsibility.

Because caregiving requires time, effort, and resources. It is, therefore, work. And as such, it must be made visible, valued, and dignified, as emphasized by feminist economics.

Defining Employment in the Care Sector

Direct care work (bathing, dressing, feeding…) may involve exclusively attending to a single person within a household. But indirect care can also be provided (cleaning the house, washing clothes, cooking…), performing tasks that benefit all household members. This second category is typically carried out by domestic workers, who perform essential tasks for people’s well-being—also referred to as care or domestic work. The Survey on occupational health in domestic and care work indicates that nearly 70% of domestic workers perform care tasks for elderly people and/or those in dependent situations.

One of the key elements for defining employment in the sector is the inclusion of indirect care work carried out by domestic workers.

Another challenge concerns the location where the work takes place, as it may occur in the home (of the dependent person or caregiver) and may be provided by professionals or informally (i.e., without certified qualifications or even by people in irregular migration situations).

Care work can also be provided in nursing homes or day centers, with varying degrees of specialization and managed by public or private entities. These spaces include occupations directly linked to the care sector (medicine, nursing, physical therapy, psychology, social work, occupational therapy, social education, cultural animation…) along with other support occupations essential to the functioning of the centers (maintenance, security, transportation, or administration and management of the center itself).

This diversity of profiles highlights the interdisciplinary nature of long-term care, which spans numerous occupational fields—from the healthcare sector to the social sector.

Precarity in Care Employment

Various studies agree that care sector employment in Spain is characterized by:

• extremely high feminization: about 85% of people employed in the sector are women;
• a high proportion of migrants: 22% of people employed in domestic service and elderly care come from other countries, especially from Latin America and the Global South. Furthermore, they tend to be concentrated in the most precarious jobs;
• high levels of irregular employment: between 30% and 36% of care work is undeclared (people not registered with Social Security);
• precarious conditions observed in the following dimensions:
  
  • regarding working time, there are long shifts, atypical schedules (night shifts, weekends), and underemployment due to insufficient hours: a high proportion of workers hold involuntary part-time jobs, with very short and intermittent schedules, leading to insufficient wages and the need to combine multiple jobs (moonlighting);
  • low wages: which can be up to 20% lower in the care sector compared to other sectors;
  • high exposure to occupational risks: 83% of domestic and care workers report having or having had health issues related to their job; 80% report mental health problems; and 40% report having had a work-related accident. These risks include biological (exposure to infectious microorganisms), chemical (use of disinfectants), physical and ergonomic (mobilization of dependent persons), and psychosocial risks (including violence, harassment, and emotional overload).

These features, which reveal the sector’s precarity, are not exclusive to the Spanish labor market. According to the Long-term care report from the European Commission, in Europe, the vast majority of those working in long-term care are women (88%), with 20% born outside the country and up to one-third in irregular situations.

In a context of population aging and after the experience of the pandemic (which revealed the essential nature of care work), now is the time to transform the sector—by promoting, valuing, and guaranteeing decent working conditions. The modernization of the Welfare State depends on recognizing care employment as a strategic pillar essential for building an inclusive, sustainable, and equitable society.

Referencias:

Domínguez Rodríguez, Antía; Lamas, Sarah; Pérez Caramés, Antía (2024). Encuesta sobre salud laboral en el empleo de hogar y los cuidados. Informe de resultados, Universidade da Coruña y Plataforma por un Empleo de Hogar y Cuidados con Plenos Derechos de Madrid

Eurofound (2025). Undeclared care work in the EU: Policy approaches to a complex socioeconomic challenge, Eurofound research paper, Publications Office of the European Union, Luxembourg.

Moreno Colom, Sara (2020). El desafío de género en los cuidados de la vejez. ¿Riesgo u oportunidad social?, VIII Informe sobre exclusión y desarrollo social en España.

OIT (2024). El trabajo decente y la economía del cuidado, Ginebra: Oficina Internacional del Trabajo

Servicio Público de Empleo Estatal – SEPE (2024). El Empleo en España en el sector de los cuidados de larga duración, Informe del Observatorio de las Ocupaciones.

Social Protection Committee (SPC) y European Commission (DG EMPL) (2021). Long-term care report. Trends, challenges and opportunities in an ageing society