Long-life societies confronting the challenge of long-term care
1According to the World Health Organisation, long-term care (LTC) is a system of actions carried out by informal caregivers (family, friends or neighbours) or professionals (health, social or other), or both, in order to ensure that a person who is unable to perform basic daily life activities can independently maintain the best possible quality of life in accordance with their individual preferences and with the highest possible degree of autonomy, participation, self-fulfilment and human dignity. Respect for human rights must always be present.
2Scientific advances in health and technology as well as improvements in the lifestyles of Europe’s population have increased life expectancy to unprecedented levels and this poses a major challenge not only in health and social care, but also in areas such as caregiving, housing, the economy and, above all, public policy.
3COVID-19 has greatly impacted the most vulnerable people and has placed the issue of care for the elderly and dependent persons at the heart of public debate. Particularly in relation to the respect that should be given to the rights and wishes of all elderly people, including those in their last moments of life and those living with some form of severe cognitive or physical impairment and/or high levels of dependency. Integrating public policies from various sectors around common objectives is extremely necessary but at the same time very complex. The need for coordination among the different systems has become clear during the COVID-19 pandemic, given that ineffective health and social care coordination leads to increased health care pressure, neglect and excess deaths.
4Health and social systems are a necessary part of the welfare state and are at the heart of the protection model. Adopting a socio-health care coordination model provides clear opportunities when it comes to caring for people: on the one hand, a comprehensive and integrative approach to people in which care services revolve around them and not the other way around and, on the other hand, the optimisation of public and private resources in order to assist people requiring long-term care.
5Home care involves support services for people in a situation of dependency who wish to continue living at home. Ageing in one’s place is a preference that has constantly been highlighted in scientific literature for all ageing people, including those in need of long-term care.
6There are various resources and services for the prevention and care of situations of dependency and the promotion of personal autonomy in the catalogue of services of the Law on the Promotion of Personal Autonomy and Care for People in a Situation of Dependency (Art. 15): telecare service, home help service, day/night centre service and residential care service. With the exception of residential care, the other services are focused on improving the quality of life of non-institutionalised people, thereby helping to extend the period of life at home.
In the world:
There are nearly 703 million people over the age of 65 in the world and this number is expected to rise to over 997 million by 2050.
Life expectancy is increasing in the world and this can be seen in the table displaying data from 2012 and 2019 as well as forecasts for 2050. Clear differences by sex, with women having a higher life expectancy, can also be noted. These differences indicated almost 5 years of life expectancy at birth in the year 2019. In the case of people who are already 60 years old, their life expectancy in 2019 was 15-18 years longer and 20-24 years longer in 2020.
In the case of Spain, there were 9,183,000 people over the age of 65 in 2019 and this figure is expected to increase to 11,575,000 by 2030. If the dependency ratio (ratio between dependent and active population) in 2019 was 32.2, this number is expected to be 43.2 by 2030.