Policy Brief on Towards Community Long-term Care  Stefanie Bluth 23 February 2010, Budapest, Hungary

Policy brief: elements Table of Contents Main argument Graphic overview

Population is ageing: Age-group with care needs will increase Introduction Population is ageing: Age-group with care needs will increase Age-group able to provide care will decrease

Old-Age Dependency Ratio Old-Age Dependency Ratio (OAD): number of older persons/persons in working age key indicator of sustainability of public long-term care policies. indirectly, provides information on fiscal base to finance benefits

Old-Age Dependency Ratio

GGP: Source of personal care of 50-79 year-olds in need of care Help with personal care received over the 12 months before the survey. 50-79 year-old persons in need of personal care = 100%.

Rational of this brief Introduction to various informal and institutional care facilities Preference of informal care to institutional care (lower costs) Institutional care steps in when informal care cannot be provided

Preference of different care options and possibilities to choose The share of long-term care beneficiaries much lower than home care one In Nordic countries the highest proportions of persons receiving long-term institutional care Knowledge about different types of long-term care as the precondition for being able to choose

Informal long-term care Knowing about the needs of caregivers may lead to a decrease in the use of residential institutions and thus to a reduction of costs Who cares? Informal care met by migration What needs do the caregivers have?

Who cares? Mainly children and partners/spouses Female caregivers provide approximately two thirds of informal care Women tend to stay home to provide care for a relative Men postpone their retirement in order to earn more money to cover financially long-term care

Informal care met by migration Many families meet the care needs of older dependents by hiring migrant care workers This has implications on: Receiving countries Sending countries Good-practice: Italy: Long-term informal care and immigration Austria: Long-term informal care provided by caregivers from the CEE region

What needs do caregivers have? Employment of informal caregivers: better self-esteem and do not feel isolated Different models of financial support for informal care: in-kind benefits and cash benefits

Financing of Informal care In-kind (mainly relevant for institutional care) Cash-benefits: Through the tax envelope or insurances Means-tested or regulated Hybrid models

Institutional long-term care Informal caregivers and patients could prefer that care tasks are performed by institutions Social support Health services for out-patient Part-time care centre Residential care homes

Social support Good practice: Social support reliefs in-formal caregivers for some hours Social support at home Social networks and interactions have proven to impact the health and well-being Organization of events for older people Reduced prices for activities or public transport Good practice: Slovakia: Training Courses by Samaritan Israel: Warm Homes

Health services for out-patients Many people may choose to spent most of time within their own home The intensity of the care can be easily adapted Emergency device like safety alarms dispatcher worn by the older person Good-practice: Czech Republic: Distress Care Areíon

Part-time care centre Part-time care centres offer the opportunity for relatives to reconcile care and work duties Two types: Day-care centres Night-care centres

Residential care homes For frail people For mentally frail people For people with severe care needs (nursing departments) Good-practice: Germany: Flagship project dementia France: Le plan Alzheimer 2008-2012

Quality and choice of community long-term care Availability Access Affordability Quality: Security Training Ratio of care personnel

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