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

2. Policy brief: elements
Table of Contents
Main argument
Graphic overview

3. 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

4. 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

5. Old-Age Dependency Ratio

6. 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 year-old persons in need of personal care = 100%.

7. 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

8. 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

9. 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?

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

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

20. Thank you very much for listening…