On the International Day of Care and Support, Eurodiaconia calls for the full implementation of the European Care Strategy including planned reforms listed in several recently published country reports.
As Europe’s population continues to age, the demand for long-term care services is increasing significantly, yet the supply of care workforce has stagnated over the past decade. The number of people aged 65 or over is projected to increase by 41% over the next 30 years, (from 92.1 million in 2020 to 130.2million in 2050), while the number of people aged 80 or over is projected to increase even more, by 88% (from 26.06 million in 2020 to 49.9 million in 2050).
Old-age dependency ration is therefore projected to increase significantly from 32 in 2020 to 52 in 2050-an increase of more than 62%. Although many older people are living healthier lives, with ageing the need for LTC services becomes more likely, especially for the oldest. Among those aged 65 or over, 47.8% have disabilities, thus increasing the demand for support¹.
Moreover, Eurodiaconia members continue to see an increase in the number of elderly persons with dementia amidst a shrinking number of family and informal carers due to changes in family and societal patterns- more women who in the past bore the burden of unpaid care work are participating more in the labour market.
Our members continue to face massive challenges in recruiting and retaining qualified workforce in the long-term care sector. This is partially due to chronic underfunding, difficult working conditions, relatively low salaries, lack of clear career development path. In addition to this, public funding continues to decrease.
Currently across Europe, publicly funded long-term care systems still leave almost half of older people with care needs at risk of poverty, particularly those with severe care needs and low income. Out-of-pocket costs represent, on average, 70% of an older person’s median income across the OECD countries². Reason why our member in Germany Evangelische Heimstiftung recently relaunched its political initiative “Pro-Pflegereform” campaigning for a reform long-term care insurance. Launched in 2017, the initiative brings together almost 200 supporting organisations, associations, care entrepreneurs and experts to formulate concrete proposals for a reform in LTC insurance.
Similarly, in Italy, our member Diaconia Valdese report users do not receive enough money from authorities to pay for the services they need. Public allowances have not improved since 2013, making it almost impossible for some persons at risk of poverty to afford the care they need.
On this International Day of Care and Support, we call for the full implementation of the Council Recommendation on access to high-quality long-term care. This involves governments across Europe providing adequate funding to ensure high quality and affordable LTC services to all people who need them. We need public authorities to improve the implementation of public procurement by awarding contracts on the basis of quality criteria rather than of price only by setting an adequate duration of contracts(a minimum of three or four years) and including a mechanism to adjust the funding related to potentially faster rising costs due to external circumstances. Governments need to invest in adequate resourcing and support of informal and family carers, such as information about their rights, subsidies, counselling and training, group back up, quality respite services, adequate protection such as medical insurance and reimbursement of cost incurred.
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[1] European Commission and Social Protection Committee(2021), Joint Report. 2021 Long-term care report, Trends, challenges and opportunities in an ageing society.
[2] OECD (2024) Is Care Affordable for Older People?, OECD Health Policy Studies, OECD Publishing, Paris.