Long-term care poses challenges for ageing societies.

UM – 06/2021

Europe's societies are getting older, which means that people are frequently becoming more dependent on long-term care services. Their needs are being met in very different ways: through the coexistence of professional and informal care, at home or in a residential facility, using benefits in kind, cash benefits or even combinations of both.

With advice and support

The EU wants to help its Member States through providing information, developing indicators, making resources available through the social fund and not least, by supporting those who provide a high level of informal care. This will be accompanied through monitoring via the European Semester. 

Long-term care is a patchwork quilt

Member States in Europe find themselves in very different positions when it comes to long-term care. The task of the Social Protection Committee (SPC), an advisory body to EPSCO, and the EC's Directorate-General for Social Affairs and Labour of pooling their findings was accordingly challenging. The recently published Care Report 2021 provides a comprehensive analysis of the common challenges in long-term care for older people as well as in-depth studies of the situations in the specific countries, where long-term care is a policy (for country reports, see here).

The report's recommendations are inevitably varied and are as follows: 


  • collect comparable data about the access, coverage, needs and provision of long-term care and develop appropriate indicators,
  • improve the quality of care in terms of financing, organisation, standards, technical support and, especially, the care workforce,
  • ensure an adequate supply of care workers against a background of difficult working conditions, low wages, high levels of informal care and increasing mobility and migration and
  • ensure sustainable financing. This is not the case in many countries. Often not being a policy in its own right, long-term care is organised at different levels and is financed from various sources. The possibilities of prevention and technical progress should be exploited just for this reason.

Further structural development is needed

Although reforms had been undertaken in various Member States in recent years, they only ever targeted specific aspects of the systems. A number of ad hoc measures were also implemented during the pandemic. However, structural changes mainly failed to materialise.

Less care at zero cost

The authors of the 2021 Care Report also point out that long-term care has a distinct gender dimension. Women dominate the informal care sector, in particular. Unpaid care by mostly female family members cannot be expected in the long term. Continued growth in female participation in the labour markets will increase the pressure on expanding professional care.