Help Wanted?

Providing and Paying for Long-Term Care

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This book examines the challenges countries are facing with regard to providing and paying for long-term care. With populations ageing and the need for long-term care growing rapidly, this book looks at such issues as: future demographic trends, policies to support family carers, long-term care workers, financing arrangements, long-term care insurance, and getting better value for money in long-term care. 


“WHO recognizes that long-term care represents a major challenge for all countries in the world, with important implications for economic development and for the health and well-being of older people. This well-documented book provides a comparative analysis of the common challenges and diverse solutions OECD countries are adopting to respond to the growing demand for long-term care services, and particularly its implications for financing and labour markets.  It provides much needed evidence to guide policy makers and individuals.”

-Dr John Beard, Director, Department of Ageing and Life Course,

World Health Organization


“This carefully researched book offers invaluable data and insights into the organization and financing of long-term care in OECD countries.  The book is an indispensable resource for anyone interested in international long-term care”.

-Dr. Joshua M. Wiener, Distinguished Fellow and Program Director

of RTI’s Aging, Disability, and Long-Term Care Program, United States

English Also available in: French

Sizing Up the Challenge Ahead

Future Demographic Trends and Long-term Care Costs

Pressures on long-term care (LTC) systems are expected to grow in the future, for at least four reasons. First, although the speed at which populations are ageing varies considerably across countries, and despite uncertainties about future trends in disability among the population, demographic transformations will increase demand for LTC services in all societies. Second, changing societal models – such as declining family size, changes in residential patterns of people with disabilities and rising female participation in the formal labour market – are likely to contribute to a decline in the availability of family carers, leading to an increase in the need for paid care. Third, as societies become wealthier, individuals demand better quality and more responsive social-care systems. People want care systems that are patient-oriented and that can supply well co-ordinated care services. Fourth, technological change enhances possibilities for long-term care services at home but may require a different organisation of care. These factors will create upward pressure on the demand for long-term care services. They will raise pressure for improving the provision of care services and their performance, and, therefore, their cost. This chapter presents demographic forecasts for OECD countries, and projections on family carers in selected OECD countries and long-term care costs.

English Also available in: French

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