Long-term care settings for older people

This report, prepared by the European Social Policy Analysis Network (ESPAN), presents a comparative overview of the settings providing formal long‑term care (LTC) for older people in 38 European countries: the 27 EU Member States, nine (potential) candidate countries, as well as Iceland and Norway. Drawing on national reports produced by the 38 ESPAN country teams, it maps the range of formal LTC settings for people aged 65+, covering residential care, home care and community‑based care, as well as hybrid and innovative models. For the Member States, the report also presents a selection of key comparative indicators, context information and policy levers included in the EU Monitoring Framework for the Council Recommendation on access to affordable high‑quality LTC (covering expenditure, affordability and availability of LTC services, the LTC workforce and informal care).

The report describes and assesses residential, home and community‑based settings, including their organisational characteristics and regulatory frameworks, and reviews recent and ongoing reforms in this area. It discusses how the current configuration of LTC settings affects older people’s effective freedom of choice and the “person‑centredness” of care pathways, identifying key structural obstacles such as fragmented governance, uneven financing and insufficient data. It concludes with policy pointers for improving availability and delivery of LTC services going forward.