Help Wanted?

What will be the effects of growing need for long-term care?Chapters 1 and 2 examine the growing demand for long-term care in the context of ageing societies, discuss demographic projections and their implications for long-term care labour markets and expenditureIn 1950, less than 1% of the global population was aged over 80 years.By 2050, the share of those aged 80 years and over is expected to increase from 4% in 2010 to nearly 10% across OECD countries.This population ageing is being accompanied by family ties becoming looser.The need for community involvement in the care for frail and disabled seniors is growing and will do so ever more rapidly in OECD countries.This will challenge long-term care (LTC) services and systems.The pool of potential family carers is likely to shrink because more women are working, and social policies no longer support early retirement.Currently, between 1 and 2% of the total workforce is employed in providing long-term care.For many countries, this share will more than double by 2050.Government and private market spending on LTC is as much as 1.5% of GDP on average across the OECD, and will double or even triple between now and 2050.There is a history in many countries of LTC policies being developed in a piecemeal manner, responding to immediate political or financial problems, rather than being constructed in a sustainable, transparent manner.The future of LTC is more demand, more spending, more workers, and above all, higher expectations that the final few years of life must have as much meaning, purpose and personal well-being as possible.Facing up to this challenge requires a comprehensive vision of long-term care.Muddling through is not good enough.This study examines not only policies for informal (family and friends) carers, but also policies on the formal provision of LTC services and its financing. Why should family carers be supported? And how?Chapters 3 and 4 discuss the role of family carers, the impact of caring on carers' mental health, poverty and labour market participation, as well as policies to support family carers Family carers are the backbone of any long-term care system.Across the OECD, more than one in ten adults aged over 50 years provides (usually unpaid) help with personal care to people with functional limitations.Close to two-thirds of such carers are women.Support• Move towards forward-looking financing policies, involving better pooling of financing across generations, broadening of financing sources, and elements of pre-funding.Japan, the Netherlands, Belgium and Luxembourg complement payroll contributions with alternative revenues sources.In Germany, retirees are required to contribute premia to social LTC funds, based on their pension.Innovative voluntary funding schemes based on automatic enrolment with opting-out options are being implemented in the United States.• Facilitate the development of financial instruments to pay for the board and lodging cost of LTC in institutions.This cost can be twice or three times as large as personal-care and nursing costs taken together.Home ownership can provide means to help users mobilise cash to pay for such cost, for example via bonds/equity release schemes, public measures to defer payments, and private-sector products, such as reverse-mortgage schemes and combinations of life and LTC insurance policies.