Slovakian care taker Alena Konecna helps an 89-year-old bedridden woman in Leoben.
Every two weeks, Alena Konecna packs her bags to leave her own mother and daughter at home in Slovakia and travel some 400 kilometres (250 miles) across the border into Austria to take care of someone else's mother.
She's one of more than 65,000 people -- mostly women from Slovakia and Romania -- who form the backbone of Austria's domestic care sector.
For two weeks at a time, Konecna stays with the 89-year-old bedridden woman to cook and care for her.
"Without care workers from abroad, the 24-hour care system would break down... No one (in Austria) wants to do it," says Klaus Katzianka, who runs the agency that found Konecna her current job and who himself needs round-the-clock care due to a disability.
But the arrangement may be coming under strain.
Demographic time bomb
Konecna started to work as a caregiver more than two years ago in the town of Leoben, nestled amid mountains in the Austrian countryside, which reminds her of her home in Banska Bystrica in Slovakia.
Previously the single mother worked in a factory in the car industry.
Fed up with the long shifts and inspired by her mother's erstwhile career as a nurse, in 2015 she took a three-month course in first aid and care skills, including some practical experience in nursing homes.
She also took a one-month German course, allowing her to watch TV with her employer and read newspapers to her.
Care workers can earn roughly double as much in Austria than in Slovakia, although Konecna says it's hard to leave behind her daughter, now 19.
"My daughter was often sick when I was away. And I have missed things like my daughter's birthday," she says, adding she would prefer working in Slovakia if wages were better there.
Slovakian care taker Alena Konecna, accompanied by her friend Michal, leaves her home for another two-weeks.
Besides being separated from their families, there are other problems in how the sector works across Europe.
A study by the Johannes Gutenberg University in Mainz found inadequate training, extreme working hours and salaries below the legal minimum wage.
In Romania, more than 150 women were hospitalised at Socola Psychiatric Hospital in the country's northeast last year alone, their mental health having suffered after caring for the elderly abroad -- what has become known as the "Italy syndrome".
"I had the misfortune to work all the time for elderly people suffering from Alzheimer's so I spent most of my time between four walls, under constant pressure," says one former hospital patient, a 58-year-old mother of two who worked in Italy from 2002 until 2014.
"I devoted the most beautiful years of my life to elderly Italians."
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