< Executive summary >
Demographic change and ageing populations in European Union countries will impact many aspects of the economy and have a direct effect on long-term care (LTC) systems. Demand for LTC already exceeds supply in many EU countries, leading to the ‘care gap’. This gap is expected to widen, threatening quality of life for the elderly, exacerbating gender disparities and imposing significant economic costs.
The root causes of the gap include demographic shifts, inadequate public investment, workforce shortages and a heavy reliance on informal caregiving. Women stand to lose the most if no steps are taken to prepare LTC systems for the coming surge in demand because care, both formal and informal, is predominantly provided by women.
The care gap can be reduced by either increasing the supply of care or by reducing the demand for care. We assess LTC reforms in five EU countries and explain how these can affect the care gap by influencing demand and supply. Governments should:
1. Recognise LTC as a priority. Governments should increase public spending on LTC and make LTC a central policy priority linked to broader goals, including gender equality and economic growth.
2. Expand funding mechanisms. Governments can introduce new means of financing, such as mandatory LTC insurance and pre-funding mechanisms. Most importantly, benefits should target those with the greatest needs, to promote equity and adequacy.
3. Support the workforce more. The LTC sector should be made more attractive by raising wages, improving working conditions and expanding training programmes to attract and retain workers.
4. Develop prevention strategies. EU funds could be directed to research into treatments targeting age-related diseases such as dementia. National governments could invest in public health campaigns and preventive care to reduce future demand.
5. Use the newest technologies. EU countries should invest in robotics and assistive technologies to improve productivity and to reduce physical strain on caregivers.
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Title : Prepare Now—Europe Must Get Ready for the Coming Long-Term Care Surge
Publication : Bruegel, 2025 January (14 pages)
URL : https://www.bruegel.org/sites/default/files/2025-01/PB%2002%202025.pdf