Adequate social protection for long-term care needs in an ageing society

Report jointly prepared by the Social Protection Committee and the European Commission

The European Union (EU) is facing unprecedented demographic changes. Europeans are living longer and healthier lives, although large gaps in health remain between different social groups, countries as well as regions.. Life expectancy is increasing at the rate of 2-3 months every year. This is a very positive trend. However, an ageing population, combined with lower birth rates, changing family structures and migration, creates a number of challenges. As the big generations of baby-boomers are swelling the ranks of the retired the working age population will increasingly be formed by the smaller cohorts of baby-busters. In the light of these challenges it is important, both at EU and national level, to review and adapt at national level existing policies, including long-term care services for frail older people. With the further ageing of the big cohorts a major challenge will be to meet the needs of a fast-growing number of older people at risk of suffering from frailty and physical and mental disability while keeping cost affordable and avoiding to endanger the stability of public finances. Even as some of these older people will come to need residential care, many others – if given the right support in time – can continue to live fairly independently at home and enjoy a good quality of life. Responding to these challenges also offers opportunities. Meeting the needs of a growing population of older people, and supporting what is often referred to as the "Silver Economy", could potentially create many more jobs in the long-term care sector and much greater demand for a wide range of older-age-related goods and services, including assistive technology. Long-Term Care (LTC) encompasses a range of services and support for people who are dependent over a long period of time on help with their daily living. This need is usually the result of disability caused by frailty and various health problems and therefore may affect people of all ages. But the great majority of the recipients of long-term care are older people. Increasingly long-term care in the EU will be facing three major, related and simultaneous challenges. The first is a huge increase in need. Over the next five decades the number of Europeans aged over 80 and at risk of needing LTC is expected to treble. The second is the threat to the supply of long term carers from the decline in the number of people of working age, and from social changes which make it less likely in the future that families will provide the informal, home-based care on which the great majority of older people now rely. The third is the pressure that rapid growth in demand, and the expectations of the ―baby boom‖ generation, will place on care quality, enforcement of care standards and on public expenditure. There is a real risk that current arrangements for long-term care across the EU will be overwhelmed by this three-fold challenge and a major gap between needs and available services will develop. This report examines what can be done to help Member States reduce the risk that such a gap emerges and ensure that adequate provisions for long-term care needs can be organised in a sustainable way even at the height of population ageing.