Strengthening social infrastructure in long-term care for older people: coordinated action and local empowerment in Europe

Accelerated population aging, changing socio-economic patterns and more recently the COVID-19 pandemic are increasingly challenging the sustainability of traditional care models in Europe and beyond, bringing long-term care system development to the forefront of the policy agenda. Despite the increasing recognition, investment in long-term care remains chronically low in most European countries even as recent studies reveal large and growing service capacity gaps and a social infrastructure investment gap that is more than twice as large as that observed for healthcare. In this chapter we provide an overview of the slow development of both tangible (long-term care service availability, support for informal caregiving) and intangible (workforce availability and training, data infrastructure) assets for community-based long-term care in Europe. We conclude by recommending a pathway to long-term care development that emphasizes the empowerment of local communities and governing bodies to design and implement programs for social infrastructure development.