"Everyone has the right to affordable long-term care services of good quality, in particular home-care and community-based services".
Long-Term Care in the EU
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Everyone has the right to affordable long-term care services of good quality, in particular home-care and community-based services.
This is Principle 18 of the European Pillar of Social Rights and it reflects one of the most important social challenges facing Europe: how to ensure care, dignity and autonomy in ageing societies.
Long-term care is primarily a national responsibility, but the EU supports Member States through policy coordination, recommendations, monitoring, funding and exchange of good practices. The key EU framework is the European Care Strategy — COM(2022) 440 final, presented by the Commission in September 2022.
The Strategy aims to ensure quality, affordable and accessible care services across the European Union and to improve the situation of both care receivers and carers, whether professional or informal. It covers care throughout the life course, with a specific focus on early childhood education and care and long-term care.
The COVID-19 pandemic exposed structural weaknesses in long-term care systems, including insufficient availability of services, staff shortages, difficult working conditions, lack of resilience and the heavy reliance on informal carers. These challenges are becoming more urgent because demographic ageing will increase demand for care in the coming decades.
This is Principle 18 of the European Pillar of Social Rights and it reflects one of the most important social challenges facing Europe: how to ensure care, dignity and autonomy in ageing societies.
Long-term care is primarily a national responsibility, but the EU supports Member States through policy coordination, recommendations, monitoring, funding and exchange of good practices. The key EU framework is the European Care Strategy — COM(2022) 440 final, presented by the Commission in September 2022.
The Strategy aims to ensure quality, affordable and accessible care services across the European Union and to improve the situation of both care receivers and carers, whether professional or informal. It covers care throughout the life course, with a specific focus on early childhood education and care and long-term care.
The COVID-19 pandemic exposed structural weaknesses in long-term care systems, including insufficient availability of services, staff shortages, difficult working conditions, lack of resilience and the heavy reliance on informal carers. These challenges are becoming more urgent because demographic ageing will increase demand for care in the coming decades.
The expansion of care services is crucial to meet current and future needs for care, and it should go hand in hand with improving their quality, affordability, and accessibility. Quality encompasses not only infrastructure and services, but also the interactions and human relations between carers and the people receiving care. Early childhood education and care services must be of high quality, inclusive, and non-segregated to bring full benefits to all children. Quality long-term care promotes the well-being, dignity and fundamental rights of care recipients, including by preventing and alleviating isolation, loneliness, and their physical and psychological impacts.
Improving the affordability of care services leads to fairer access to care, as high costs are one of the most significant barriers for many people. Making care services accessible means enabling and providing the means to the people who need care (and their families) to actually make use of the services available. This may require adapting the facilities to enable physical access for care receivers and caregivers with disabilities. Rural and remote areas and regions with low population density are particularly affected by the lack or shortage of available care services, both early childhood education and care as well as long-term care, due to long distances or limited public transport options.
Improving the affordability of care services leads to fairer access to care, as high costs are one of the most significant barriers for many people. Making care services accessible means enabling and providing the means to the people who need care (and their families) to actually make use of the services available. This may require adapting the facilities to enable physical access for care receivers and caregivers with disabilities. Rural and remote areas and regions with low population density are particularly affected by the lack or shortage of available care services, both early childhood education and care as well as long-term care, due to long distances or limited public transport options.
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The 2021 Long-Term Care Report
The 2021 Long-Term Care Report, prepared by the European Commission and the Social Protection Committee, remains an important analytical reference for understanding the structural challenges of long-term care in the EU.
It provides a comparative overview of national long-term care systems and examines issues related to access, affordability, quality, workforce shortages, financing and informal care.
However, the report should now be read together with the European Care Strategy and the Council Recommendation of 8 December 2022 on access to affordable high-quality long-term care — 2022/C 476/01.
The EU policy debate has moved from diagnosis to implementation. The central question is no longer only how to identify the weaknesses of long-term care systems, but how Member States will expand affordable, accessible and high-quality services in practice.
The report showed that many people in need of care face difficulties in accessing long-term care because of cost, lack of available services, territorial disparities or insufficient support.
The 2021 Long-Term Care Report, prepared by the European Commission and the Social Protection Committee, remains an important analytical reference for understanding the structural challenges of long-term care in the EU.
It provides a comparative overview of national long-term care systems and examines issues related to access, affordability, quality, workforce shortages, financing and informal care.
However, the report should now be read together with the European Care Strategy and the Council Recommendation of 8 December 2022 on access to affordable high-quality long-term care — 2022/C 476/01.
The EU policy debate has moved from diagnosis to implementation. The central question is no longer only how to identify the weaknesses of long-term care systems, but how Member States will expand affordable, accessible and high-quality services in practice.
The report showed that many people in need of care face difficulties in accessing long-term care because of cost, lack of available services, territorial disparities or insufficient support.
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These barriers are particularly serious for people with low income, older people living alone, persons with disabilities and people living in rural or remote areas.
It also highlighted the importance of informal care. Family members, relatives and friends provide a large share of long-term care in Europe, often with limited support.
This can have significant consequences for carers’ health, employment, income and social life. Women are particularly affected, because they are more likely to provide unpaid care and to reduce working hours or leave employment because of care responsibilities.
The report therefore remains useful as background analysis, but it should no longer be presented as a preparatory step towards a future EU initiative. That initiative has already been adopted. The current focus should be on implementation of the European Care Strategy and the 2022 Council Recommendation, especially through reforms that strengthen home-care and community-based services, improve working conditions in the care sector, support informal carers and ensure sustainable financing.
The European Care Strategy and long-term care
The European Care Strategy — COM(2022) 440 final provides the main EU policy framework for improving care systems across the life course. For long-term care, its objective is to help Member States make care services more available, affordable, accessible and of higher quality, while also improving the situation of both care receivers and carers.
The Strategy was presented by the European Commission in September 2022 and was followed by the Council Recommendation of 8 December 2022 on access to affordable high-quality long-term care — 2022/C 476/01. This Recommendation invites Member States to strengthen access to long-term care for all people who need it, with particular attention to affordability, quality, availability of services and territorial disparities.
A central element of the EU approach is the promotion of home-care and community-based services. These forms of care can help people remain in their own homes and communities for as long as possible, support autonomy and independent living, and reduce unnecessary institutionalisation. However, they require adequate funding, trained workers, coordination between health and social services, accessible housing, digital tools and support for families and informal carers.
The Strategy also recognises that long-term care depends on the people who provide it. Care workers need better working conditions, training, occupational safety and health, and more attractive career paths. Informal carers also need stronger recognition and support, including respite care, counselling, training, flexible working arrangements and access to social protection where appropriate.
Long-term care reform is therefore not only a social protection issue. It is also linked to ageing, disability, gender equality, labour-market participation, healthcare, local services and public finance. The European Care Strategy sets the policy direction, but implementation depends on national and local reforms that can expand services, improve quality, support carers and make long-term care financially sustainable.
It also highlighted the importance of informal care. Family members, relatives and friends provide a large share of long-term care in Europe, often with limited support.
This can have significant consequences for carers’ health, employment, income and social life. Women are particularly affected, because they are more likely to provide unpaid care and to reduce working hours or leave employment because of care responsibilities.
The report therefore remains useful as background analysis, but it should no longer be presented as a preparatory step towards a future EU initiative. That initiative has already been adopted. The current focus should be on implementation of the European Care Strategy and the 2022 Council Recommendation, especially through reforms that strengthen home-care and community-based services, improve working conditions in the care sector, support informal carers and ensure sustainable financing.
The European Care Strategy and long-term care
The European Care Strategy — COM(2022) 440 final provides the main EU policy framework for improving care systems across the life course. For long-term care, its objective is to help Member States make care services more available, affordable, accessible and of higher quality, while also improving the situation of both care receivers and carers.
The Strategy was presented by the European Commission in September 2022 and was followed by the Council Recommendation of 8 December 2022 on access to affordable high-quality long-term care — 2022/C 476/01. This Recommendation invites Member States to strengthen access to long-term care for all people who need it, with particular attention to affordability, quality, availability of services and territorial disparities.
A central element of the EU approach is the promotion of home-care and community-based services. These forms of care can help people remain in their own homes and communities for as long as possible, support autonomy and independent living, and reduce unnecessary institutionalisation. However, they require adequate funding, trained workers, coordination between health and social services, accessible housing, digital tools and support for families and informal carers.
The Strategy also recognises that long-term care depends on the people who provide it. Care workers need better working conditions, training, occupational safety and health, and more attractive career paths. Informal carers also need stronger recognition and support, including respite care, counselling, training, flexible working arrangements and access to social protection where appropriate.
Long-term care reform is therefore not only a social protection issue. It is also linked to ageing, disability, gender equality, labour-market participation, healthcare, local services and public finance. The European Care Strategy sets the policy direction, but implementation depends on national and local reforms that can expand services, improve quality, support carers and make long-term care financially sustainable.
The 2021 Long-Term Care Report
The 2021 Long-Term Care Report, prepared by the European Commission and the Social Protection Committee, remains an important analytical reference. It provides a broad overview of long-term care systems in the EU and identifies key challenges related to access, affordability, quality, workforce, financing and informal care.
The report showed that long-term care systems were already under pressure before the pandemic. Many people in need of care faced difficulties in accessing services because of cost, lack of availability, territorial disparities or insufficient support. It also highlighted the hidden costs of informal care, which often fall disproportionately on women and can reduce their labour-market participation, income and pension rights.
The report remains useful as background analysis, but it should now be read together with the European Care Strategy and the 2022 Council Recommendation. The policy debate has moved from diagnosis to implementation: the central question is how Member States will reform and finance long-term care systems in practice.
The 2021 Long-Term Care Report, prepared by the European Commission and the Social Protection Committee, remains an important analytical reference. It provides a broad overview of long-term care systems in the EU and identifies key challenges related to access, affordability, quality, workforce, financing and informal care.
The report showed that long-term care systems were already under pressure before the pandemic. Many people in need of care faced difficulties in accessing services because of cost, lack of availability, territorial disparities or insufficient support. It also highlighted the hidden costs of informal care, which often fall disproportionately on women and can reduce their labour-market participation, income and pension rights.
The report remains useful as background analysis, but it should now be read together with the European Care Strategy and the 2022 Council Recommendation. The policy debate has moved from diagnosis to implementation: the central question is how Member States will reform and finance long-term care systems in practice.
Member States and long-term care reforms
Member States have started or planned reforms to improve long-term care systems, but the pace and scope of reforms vary widely. The main reform areas concern access, affordability, quality, workforce conditions, support for informal carers and better coordination between health and social services.
The Council Recommendation asks Member States to take action to improve access to affordable, high-quality long-term care and to address the adequacy of social protection for long-term care. It also calls for better support for formal and informal carers and stronger governance of long-term care systems.
Reforms often focus on home-care services, residential care, carers’ allowances, respite care, training, quality monitoring and workforce shortages. In many countries, the challenge is not only to expand services, but also to make them financially accessible, geographically available and adapted to the needs of people with disabilities, older people and people living in rural or remote areas.
Long-term care reform is also linked to gender equality. Women represent a large share of both professional care workers and informal carers. Poor working conditions in the care sector and insufficient public care services can limit women’s participation in paid employment and increase the gender gap in income and pensions.
Member States have started or planned reforms to improve long-term care systems, but the pace and scope of reforms vary widely. The main reform areas concern access, affordability, quality, workforce conditions, support for informal carers and better coordination between health and social services.
The Council Recommendation asks Member States to take action to improve access to affordable, high-quality long-term care and to address the adequacy of social protection for long-term care. It also calls for better support for formal and informal carers and stronger governance of long-term care systems.
Reforms often focus on home-care services, residential care, carers’ allowances, respite care, training, quality monitoring and workforce shortages. In many countries, the challenge is not only to expand services, but also to make them financially accessible, geographically available and adapted to the needs of people with disabilities, older people and people living in rural or remote areas.
Long-term care reform is also linked to gender equality. Women represent a large share of both professional care workers and informal carers. Poor working conditions in the care sector and insufficient public care services can limit women’s participation in paid employment and increase the gender gap in income and pensions.
Care workers and informal carers
A sustainable long-term care system depends on the people who provide care. Professional care workers often face low wages, physically and emotionally demanding work, part-time or unstable contracts and limited career progression. These conditions make it harder to recruit and retain workers in a sector where demand is expected to grow.
The European Care Strategy and the Council Recommendation therefore emphasise better working conditions, training, skills development, occupational safety and health, and professionalisation of the long-term care workforce. Improving job quality in care is not only a labour-market issue; it is also a condition for better care quality.
Informal carers also need stronger support. Many family members, relatives or friends provide long-term care without pay or with limited compensation. This can affect their health, income, employment and social life. Public policy should therefore support informal carers through respite care, training, counselling, flexible working arrangements, social protection and better recognition of their role.
A sustainable long-term care system depends on the people who provide care. Professional care workers often face low wages, physically and emotionally demanding work, part-time or unstable contracts and limited career progression. These conditions make it harder to recruit and retain workers in a sector where demand is expected to grow.
The European Care Strategy and the Council Recommendation therefore emphasise better working conditions, training, skills development, occupational safety and health, and professionalisation of the long-term care workforce. Improving job quality in care is not only a labour-market issue; it is also a condition for better care quality.
Informal carers also need stronger support. Many family members, relatives or friends provide long-term care without pay or with limited compensation. This can affect their health, income, employment and social life. Public policy should therefore support informal carers through respite care, training, counselling, flexible working arrangements, social protection and better recognition of their role.
Important to know
Long-term care is becoming a strategic issue for the European social model. It connects ageing, disability, gender equality, labour-market participation, healthcare, social services, local governance and public finance.
The EU does not harmonise national long-term care systems, but the European Care Strategy and the Council Recommendation create a common direction: care should be affordable, accessible, available and of good quality; care workers should have better working conditions; informal carers should receive more support; and home-care and community-based care should become stronger alternatives to institutional care.
The main challenge is implementation. Member States need to expand services, improve quality, recruit and retain care workers, support informal carers and secure sustainable financing. Without these reforms, demographic ageing will increase inequalities in access to care and place growing pressure on families, especially women.
Long-term care is becoming a strategic issue for the European social model. It connects ageing, disability, gender equality, labour-market participation, healthcare, social services, local governance and public finance.
The EU does not harmonise national long-term care systems, but the European Care Strategy and the Council Recommendation create a common direction: care should be affordable, accessible, available and of good quality; care workers should have better working conditions; informal carers should receive more support; and home-care and community-based care should become stronger alternatives to institutional care.
The main challenge is implementation. Member States need to expand services, improve quality, recruit and retain care workers, support informal carers and secure sustainable financing. Without these reforms, demographic ageing will increase inequalities in access to care and place growing pressure on families, especially women.
eBriefing PaaS · EU Long-Term Care & Care Strategy
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The service can support policy monitoring, institutional analysis, stakeholder briefings, programme design and regulatory intelligence, including an assessment of how the European framework on long-term care, care services and welfare-state adaptation may evolve over time.
