1. Long Term Care in Europe
MISSOC NETWORK MEETING Budapest, 19 & 20 May 2011
Long Term Care in Europe
John Ditch

2. Long Term Care in Europe
Right Questions and Wrong Answers? or
Wrong Questions and Right Answers?
20 Submissions (but 3 were ‘nil responses’)
Focus on LTC for Older People

3. Long Term Care in Europe
Distinguishing Terms:
Long Term Care
Community Care
Residential Care
Formal Care
Informal Care

4. Long Term Care in Europe
Trends in Long Term Care
The key drivers: demography, expectations, female roles
The key constraints: expenditure & staffing
Balance between formal and informal care; public, private and voluntary sectors; national or local government
Legal basis
Funding principles and practice

5. Long Term Care in Europe

6. Long Term Care in Europe

7. Long Term Care in Europe
EU over-sight & principles
Promoting access
Improving quality
Ensuring sustainability

8. Long Term Care in Europe
ACCESS
Rights to LTC not same as access to LTC
Lack of insurance cover
Lack of provision
Poor geographical coverage
High cost
Waiting times and assessment complexity

9. Long Term Care in Europe
QUALITY (1)
Quality standards vary between/within countries
Poor nursing
Patient/resident abuse
Inadequate accommodation
Lack of privacy/dignity

10. Long Term Care in Europe
QUALITY (2)
Inspection regimes and methodologies
Infrastructure: buildings, rooms, facilities, staffing levels…
Care in practice: clear information, assessment procedures, diet, staff training
Outcomes: pressure sores, infections, drug use, falls, mortality rate

11. Long Term Care in Europe
SUSTAINABILITY (1)
Financial:
Public Social Insurance (DE, LU, ES)
Public taxation (Nordic, LT)
Public means tested (UK, CY, IRE)
Mixed (FR, BE, EL)

12. Long Term Care in Europe
SUSTAINABILITY (2)
Organisational:
Coordination of services
Alignment of tiers of responsibility
Promote health/active lifestyles
diet, smoking, alcohol
life skills
Training of staff and support for carers

13. Long Term Care in Europe

14. Long Term Care in Europe

15. Long Term Care in Europe
CONCLUSION
Demographic imperative
Sustainability challenge
Quality standards
Balance between public and private