Learning to care
In 1950, less than 1% of the global population was over 80. By 2050, the share of those aged 80 and over is expected to reach nearly 10% across OECD countries. The trouble is, while people are living longer, they are not always able to look after themselves. Relying on family help can be difficult, not just financially, but also because, as people live longer, their children may also be ageing and facing challenges of their own. That is why public authorities are starting to focus on the issue of long-term care and the provision of services for elderly people with reduced functional capacities.
Help Wanted? Providing and Paying for Long- Term Care is the result of a two-year project conducted by the OECD in 2009 and 2010, covering 29 OECD countries. The report reveals that almost all OECD countries surveyed encourage home-based long-term care as the preferred method for most recipients, despite the fact that most countries pay more for institutional care than homebased care. Switzerland, for instance, devotes 1.8% of its GDP to institutional care, but only 0.3% to home-based care. Only four countries buck this trend: Denmark, Austria, New Zealand and Poland.
There are obstacles to the implementation of home-based care, such as a limited number of providers (whether by firms or families that are willing or able to help out) and a lack of incentives. Governments have tried to counteract these problems in various ways. Norway, for instance, encourages competition between private home-care providers by issuing vouchers: employers provide their employees with these vouchers, which maythen be used to buy formal care in lieu of a part of the employee’s income.
The development of new technologies could improve the productivity and efficiency of long-term care workers, but this area demands more attention. Better interaction between long-term care and the wider healthcare systems could also improve efficiency. Many OECD countries have tried to do this by integrating care services within their healthcare systems, but it remains to be seen whether this can generate the highest health gain per dollar. To make more progress, the authors recommend information sharing, evidence-based guidelines and care planning programmes. More generally, they suggest that societies need to change their perspective on long-term care. Caring for the elderly is a learning process, and one which concerns every one of us.
©OECD Observer No 285 Q2 2011
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