Investing in long-term care benefits everyone: experts

Societies that invest in long-term care see benefits for individuals, families, health systems, economies and societies as a whole, according to new global evidence.

A group of researchers, including experts from the World Health Organization/Europe and the European Observatory on Health Systems and Policies, published new evidence and analysis showing how societies that invest in long-term care — assisted living communities, skilled nursing facilities, community care centers, home health, health centers and hospitals — can unlock economic potential while generating returns for families and health systems.

“The Care Dividend: Why and How Countries Should Invest in Long-Term Care,”  a 408-page book, makes the case for “ambitious investment” in long-term care systems and services. Investments in the long-term care workforce, innovation, working conditions and competitiveness in the care sector have the potential to trigger “flourishing” care economies, the authors said.

“As populations across the WHO European Region continue to age, often with disease and disability, the need for re-thinking and strengthening care ecosystems has never been more pressing,” Stefania Ilinca, PhD, technical officer for Long-Term Care at WHO/Europe and a co-author, said in a news release. “With this new body of research, we hope to tackle some of the negative and misleading myths holding back decisive policy action and make the case for the transformative potential of long-term care investments.”

Pushing back on the negative conversations surrounding population aging and unsustainable pressures on public resources, the authors show how countries can promote greater economic resilience, reduce inequality and strengthen community by investing in high quality long-term care services.

“The evidence overwhelmingly demonstrates how access to comprehensive, publicly financed long-term care benefits not only care recipients, but also economies, health systems, households and societies overall,” Jonathan Cylus, PhD, head of the London hub of the European Observatory on Health Systems and Policies, said in a statement. “Long-term care has received far too little policy attention in most countries.”

Among the researchers key findings was that adequate access to long-term care services prevents unnecessary hospital admissions, ensures appropriate care and keeps health systems efficient, affordable and sustainable. 

In addition, they said, a well-functioning long-term care system can be a powerful driver of economic growth through job creation and reduced costs for families. And, as the US senior living industry has repeatedly professed, long-term care provides socialization.

A call to action

​​Estimates of the number of people needing long-term care vary according to ​how need is defined, the authors said. But if the definition is confined to functional disabilities in ​the activities of daily living tasks, ​then ​it is estimated that ​2.5 million people aged 65 or more years in the United States need such care. If instrumental ADLs are included in the definition, then the US population needing long-term care increases to 5 million to 5.4 million, they said.

Among the “practical” recommendations in the book for policymakers is to meet long-term care needs, support and protect family caregivers, implement innovative finance strategies, support multisectoral collaboration and incorporate technology. 

“The call to action is clear — government leadership is needed to align resources with the needs of an aging population,” Sarah Louise Barber, WHO Centre for Health Development in Japan director, said in a statement. “By unifying policy, funding and innovation, decision-makers can create a sustainable future in which older adults receive high quality, sustainable care — and families and communities thrive, rather than buckle, under the pressures of demographic change.”

“The Care Dividend” reinforces the principles outlined in the WHO/Europe toolkit, released last fall, that provided a structured approach to help policymakers transform long-term care systems and policies to meet the needs of current and future generations. 

The authors concluded that the longer countries delay meaningful reforms in long-term care, the greater the challenges will eventually be for society.