Long-term care, organisation and financing

Long-term care is provided for individuals – particularly older people – who have lost self-care capacity because of chronic illness or disability, to improve personal functioning and quality of life. Most long-term care today is provided by unpaid family caregivers, but state-provided and other services are growing in importance. There is increasing emphasis on providing care in community settings in preference to nursing homes or hospital. Financing of long-term care relies heavily on collective prepayment and out-of-pocket arrangements, with funding shifting increasingly onto service users and families. Self-directed support systems are being introduced in some countries. The future affordability of long-term care is a major challenge across the world.