National Data
Data date of extract 08/2024
🇦🇹 Austria
| Demographic | In 2021 just over 2/3 of the population were of working age (between 15 and 64,
66.2%), while around 19% were over 64, i.e. of retirement age.
Link/Source: Census 2021 Austria (statistik.at) |
| In the period 2019-2050, the share of people aged 65+ in Austria is
expected to grow from 18.8% to 27.2% (compared to a rise from 20% to 28.5% for the EU-28)
Link/Source: https://eurocarers.org/country-profiles/austria/ |
|
| In the period 2019-2050, the share of people aged 85+ is expected to
more than double, from 2.5% to 5.8%
Link/Source: https://eurocarers.org/country-profiles/austria/ |
|
| The proportion of over-65s will increase from 20% in 2024 to 23% in 2030, 27% in 2040, and 28% in 2050. In 2060 and 2070, it is forecast to be around 29%. The proportion of women over 65 is higher at 22% in 2024 and 30% in 2070. While the 65 to 74 age group will see the strongest growth in this decade, it will then be the older age groups that will see the biggest increase.
Link/Source: European Commission (2024) Implementation report on the Council Recommendation on access to affordable high-quality long-term care: Austria |
| Employment in care work | The proportion of part-time employed people aged 15 to 64 among employees
working
in the “Health and Welfare” sector is well above average for both women (63.4%) and men
(31.7%).
Link/Source: Census 2021 Austria (statistik. at) |
| By 2030, roughly 76,000 more professional care workers would be
necessary to meet the needs of care receivers in Austria – 42,000 solely due to the retirement
of care workers.
Link/Source: abstract_hanzl_momentum_kongress.pdf (momentum-kongress.org) |
|
| According to SHARE/OECD data, the estimated number of informal carers
in Austria amounts to more than 800.000
people (about 7% of the total population)
Link/Source: Austria – Eurocarers |
|
| Informal care remains the main form of care
provision in Austria, with an estimated 7% of people aged 18 years or over who care for one or
more disabled or infirm family member, neighbour or friend, of any age, more than twice a week.
This trend persists despite the substantial expansion of institutional care services over the
last two decades.
Link/Source: Austria – Eurocarers | Eurofound, EQLS 2020 |
|
| 22% of women report have had to reduce working time or give up their
jobs entirely due to care responsibilities, compared to 3% of men.
Link/Source: Centre.org |
| Quality of care | 33% of individuals believe they are unlikely to receive appropriate help
when
needed, with a significantly higher level of mistrust among women (38%) compared to men
(21.5%).
Link/Source: Centre.org |
| Self-employed live-in carers in Austria are often placed through placement agencies. In order to promote quality assurance in 24-hour-care, the Austrian quality certificate for agencies recruiting personnel for 24-hour-care (Ă–QZ-24) was developed in 2019 with the aim of strengthening the situation of people with care needs and their families and contributing to a sustainable increase in care and support. The certification is voluntary and offers those agencies that fulfil higher standards than the legal requirements the opportunity to prove this to an independent certification body. Currently, 42 of around 930 registered agencies (agencies with an active business licence) are certified. The 42 certified agencies provide around 11,200 live-in carers. In total, around 58,000 live-in carers in Austria have an active business licence.
Link/Source: European Commission (2024). Implementation report on the Council Recommendation on access to affordable high-quality long-term care: Austria |
| Policy and regulation | In Austria, there is currently no clearly defined and integrated quality
framework, covering the different sectors of LTC. The ’15a agreement’ on LTC between the Federal
Republic and the federal provinces only defines rather general quality criteria and leaves
considerable room for interpretation. On the sub-national level, the federal provinces enacted
more detailed regulation to promote the quality of LTC services. The main instruments are the
federal provinces’ legislations concerning the minimum income schemes, nursing home acts (five
federal provinces) or nursing home decrees (four federal provinces), and specific directives on
the organisation and implementation of different LTC services.
Link/Source: European Commission’s 2021 LTC report country profiles |
| Technology Adoption | There are a large number of pilot projects throughout Austria, such as “Workvision Home Nursing” in Salzburg with a new approach to handing over patients to social services, the “Salve App” in Vorarlberg, which enables standardisation of requests for a permanent or short-term care place through an IT application, or fall sensors in retirement and nursing homes.
Link/Source: European Commission (2024). Implementation report on the Council Recommendation on access to affordable high-quality long-term care: Austria |
🇧🇬 Bulgaria
| Demographic | By the end of 2022, the number of persons aged 65 and over is 1,515,383,
or 23.5%
of the country’s population. Compared to 2021, the share of the population aged 65 and over
increases by 0.1 percentage points
Link/Source: Population and Demographic Processes in 2022 (nsi.bg) |
| In the period 2020-2060, the share of people aged 80+ in the
Bulgarian population is expected almost to double. Over the same period, the old age dependency
ratio was defined as the ratio of the number of older people at an age when they are generally
economically inactive (aged 65 years and over) compared with the number of people of working age
(15-64 years), will rise from 34.3% to 56.1%
Link/Source: Bulgaria – Eurocarers |
|
| In 2027, the share of the population aged 65+ in the total population will amount to 24.5%, and at the end of the forecast period in 2034, this share will reach 27.6%. This demographic trend is also typical for other EU Member States.
Link/Source: European Commission (2024) Implementation report of the Council Recommendation on access to affordable high quality long-term care: Bulgaria |
| Employment care work | In 2016, the number of LTC workers providing informal care at home was 1 per 100 individuals aged 65 and over, 87.7% of whom were women.
Link/Source: Bulgaria – Eurocarers |
| Informal carers represent 8% of the population (people aged 18 years or over who care for one or more disabled or infirm family member, neighbour, or friend, of any age, more than twice a week).
Link/Source: Eurofound, EQLS 2020 |
|
| In Bulgaria, there is no established information system for collecting data on professional carers providing long-term care, and even less information about the number of people providing informal care. But there is little doubt that informal carers in families provide the overwhelming bulk of LTC.
Link/Source: Bulgaria – Eurocarers |
| Quality of the Long Term Care services | Social services are regulated by the Social Services Act (SSA). The
SSA establishes a new Agency for the Quality of Social Services at the Ministry of Labour and
Social Policy. The new structure will monitor how municipalities and private providers are delivering social services and spending state funds. Its objective is to verify compliance with the rights of users of social services, monitor national performance and license all private
social services providers. It will create common standards for providers but, at the same time,
will give them the freedom to develop their own practices and relationships between
professionals, children and parents, since the system was previously highly restricted by
methodological guidelines.
Link/Source: European Commission’s 2021 LTC report country profiles |
| Policy and regulation | The action plan for the implementation of the National Strategy for
Long-Term Care for the period 2018-2021 established in 2018, aims to address some of the
challenges identified in the strategic document for LTC in Bulgaria, such as the development of
quality standards for social services for older people and people with disabilities. However,
implementation of these measures is yet to be seen and evaluated. There is ongoing
implementation of the ‘New Standards for Social Services’ project; an important activity
involving the development of quality standards with objective and measurable criteria and
indicators and a monitoring and control system of the services.
Link/Source: European Commission’s 2021 LTC report country profiles |
| The action plan for the implementation of the National
Strategy for Long-Term Care for the period 2018-2021 established in 2018, aims to address some
of the challenges identified in the strategic document for LTC in Bulgaria, such as the
development of quality standards for social services for older people and people with
disabilities. However, implementation of these measures is yet to be seen and evaluated.
Link/Source: European Commission’s 2021 LTC report country profiles |
|
| The SSA also places a strong emphasis on achieving and maintaining the quality of social services by establishing a special body mandated to monitor and support all social service providers – the Agency for the Quality of Social Services (AQSS). The Agency is the main institution at the national level tasked with monitoring the quality of social services, as well as providing methodological support to social service providers, which in turn are also responsible for monitoring, evaluating, and reporting on the services they provide.
Link/Source: European Commission (2024) Implementation report of the Council Recommendation on access to affordable high quality long-term care: Bulgaria |
| Training and skills | Since January 2019, the Personal
Assistance
Act assistants (which can be family members of the
disabled person, part of the extended family circle, or those outside) can receive training from
the municipalities, but it is not mandatory.
Link/Source: Bulgaria – Eurocarers |
| The SSA introduced entirely free support and training services for
family members who provide informal care at home for people with permanent disabilities and for
people with disabilities over the working age who are unable to look after themselves.
Link/Source: Bulgaria – Eurocarers |
🇨🇿 Czech Republic
| Demographic | The proportion of population aged 65 and over 20.5% AND is projected
to
increase to 30.4% by 2060.
Link/Source: Czech Republic – Eurocarers |
| In the period 2016 to 2070, the old-age dependency ratio i.e. the
share of the population aged 65 and above as a % of the population aged 20-64 is projected to
rise from 30.1% (EU-28: 32.2%) to 54.8% (EU-28: 56.4%) i.e. 24.7 pps. Most of this increase is
driven by the old-age dependency ratio (people aged 80 and above relative to those aged
15-64).
Link/Source: Czech Republic – Eurocarers |
|
| The number of recipients of the care allowance increased from 260,000
in 2007 to almost 350,000 in 2016.
Link/Source: Czech Republic – Eurocarers |
|
| It reaches its peak in 2024; the old-age dependency ratio, comparing older people (65+) with active population (20–64), almost doubles over the projection horizon, reaching almost 52% in 2070 with a peak in 2059 amounting to 56%. Share of population 80+ over 65+ raises from 21.0% to 43.5%.
Link/Source: Ministry of Finance of the Czech Republic (2024). 2024 Ageing Report: Czech Republic – Country Fiche |
| Employment care | Informal carers represent 9% of the population (people aged 18 years or
over who
care for one or more disabled or infirm family member, neighbour or friend, of any age, more
than twice a week).
Link/Source: Eurofound, EQLS 2020 |
| Social care is mainly provided by informal carers and professional
social services. Professional carers of social services can be registered or
unregistered.
Link/Source: Czech Republic – Eurocarers |
| Training and skills | Â As of April 2020, there were a total of 318 registered respite care
services/providers in the Czech Republic. Among these, 230 were specifically aimed at older
individuals aged 65 and over. There is a notable absence of education and counselling for
informal carers.
Link/Source: Czech Republic – Eurocarers |
| Certified educational seminars (funded by the Continued
Education Fund) were organized in regions and towns for informal carers and professionals
working in social services, municipal administration, and labor offices.
Link/Source: Czech Republic – Eurocarers |
| Quality | The system of quality assessment of health services in the Czech Republic is complex and includes various aspects of legislation, competence and control. The evaluation of the quality of health services in the Czech Republic is based on a comprehensive legislative framework and involves the cooperation of various entities such as the Ministry of Health, health insurance companies, the State Institute for Drug Control and health service providers themselves. Accreditation, audits, quality indicators and an incident reporting system are key tools of control, which together contribute to ensuring a high level of quality and safety in the health services provided.
Link/Source: Ministry of Finance of the Czech Republic (2024). 2024 Ageing Report: Czech Republic – Country Fiche |
| Technology Adoption | Launched in September 2022, Direct people’s “INTELLIGENT REMOTE MONITORING” project, aimed at improving medication adherence in the elderly. The second part of the project was the development of a “Digital Caregiver” – a voicebot that uses AI technology to provide regular telephone reminders to take medication, have empathetic conversations and provide feedback on the patient’s condition. Testing with real users has shown that a voicebot is more effective than traditional reminder methods and more natural for the elderly who are already used to using the phone. Several channels were used to recruit testers, such as outreach, social networks, personal referrals, and physicians. It turns out that in the case of a new solution, especially when technology is involved, a personal recommendation is best. A total of 13 elderly persons with various health problems participated in the test.
Link/Source: Ministry of Finance of the Czech Republic (2024). 2024 Ageing Report: Czech Republic – Country Fiche |
🇬🇷 Greece
| Demographic | In the period 2019-2050 the share of people aged 65+ in the Greek
population is
expected to grow from 22% to 33.8% (EU-28: 20%-28.5%), with most of the growth happening before
2032. At the same time, the share of people 85+ will more than double from 3.3% to 7% (EU-28:
2.7%-6.1%).
Link/Source: Greece – Eurocarers |
| The percentage of 65+ compared to the population of 15-64-year-olds
will rise from 34.1% (EU-28: 30.5%) to 67.1% (EU-28: 55.3%).
Link/Source: Greece – Eurocarers |
|
| Number of older people aged 65+: 2,390,550 (out of whom 1,209,126 were aged 75+ / 23 % of the total population).
Link/Source: European Social Network (ESN) (2024). Social Services Index: Greece |
|
| Number of older people facing severe limitations: 244,457 / 10 % of the total population.
Link/Source: European Social Network (ESN) (2024). Social Services Index: Greece |
| Employment care work | In 2019, there were on average five LTC workers per 100 people aged
65 or older in 28 OECD Member countries, ranging from 13 workers per 100 older people in Norway
to less than one per 100 older people in Greece, Poland and Portugal.
Link/Source: OECD (2019) Health at a Glance 2019: OECD Indicators |
| Informal carers represent 10% of the population (people aged 18 years
or over who care for one or more disabled or infirm family member, neighbour or friend, of any
age, more than twice a week).
Link/Source: Eurofound, EQLS 2020 |
| Policy and regulation | Social insurance funds provide disability pensions and allowances. Other
(non-contributory) disability benefits (in cash and in kind) are provided by social welfare
institutions to persons who are in need of care because of a specific chronic illness or
incapacity. According to 2011 administrative data (referred to in OECD 2013), about 60% of
disability benefit recipients (either insurance or assistance-based) were above 50 years of
age.
Link/Source: Greece – Eurocarers |
| There is no national or sub-national definition of LTC quality in
Greece neither in the context of the healthcare sector nor of the social sector. This is
congruent to the fact that the system is strongly based on informal LTC and, consequently,
formal services play rather a residual role in the provision of LTC in Greece. Along with the
absence of a definition of LTC quality, there is also a lack of a general LTC quality framework
that would apply to all types of support (residential or home care) and to all kinds of
providers (public or private, for-profit/ not-for-profit); neither is there a general healthcare
and social services quality framework that applies to LTC.
Link/Source: European Commission’s 2021 LTC report country profiles |
|
| Articles 24-55 in part III of the Law 4808/2021, published on the
19th June 2021 and which is the transposition of the EU Directive on Work-Life Balance defines
for the first time the concept of informal carer as “an employee who provides personal care or
support to a relative or person who resides in the same household as the employee and who is in
need of significant care or support for a serious medical reason.”
Link/Source: Greece – Eurocarers |
| Education and training | The only support services available to informal carers are those provided
by a few
NGOs, operating mainly in Athens and other big cities and offering – among other things –
information, practical advice, psychological/emotional support and training.
Link/Source: Greece – Eurocarers |
| 44% of the formal caregivers have a tertiary or higher education in Greece, as opposed to 25% in most European Countries.
Link/Source: European Commission (2024). Implementation report of the Council Recommendation on access to affordable high quality long-term care: Greece |
🇪🇸 Spain
| Demographic | In the period 2013-2060 the share of people aged 80+ in the Spanish
population is
expected to grow from 5.5% to 14.9% (EU-28: 5.1%-11.8%)
Link/Source: https://eurocarers.org/country-profiles/spain/ |
| There are 1,424,322 people supported by the Individual Care Programme (PIA). 22 % (427,301 people) have a resolution with a high dependency degree III, and 30 % (593,931) with a medium dependency degree II.
Link/Source: European Social Network (ESN) (2024). Social Services Index: Spain. |
| Employment care work | Spain has one of the highest prevalence of informal carers, with 13% of
people
aged 18 years or over who care for one or more disabled or infirm family member, neighbour or
friend, of any age, more than twice a week.
Link/Source: Eurofound EQLS 2020 |
| Spanish legislation on the Promotion of Personal Autonomy and
Attention to people in a situation of dependency (Law 39/2006), recognises the status of a carer
(informal carer) as a person who, exceptionally, provides care to a spouse or relative by
consanguinity, affinity or adoption, up to the third degree of kinship, for at least a year.
Both the carer and care recipient should live under the same roof.
Link/Source: https://eurocarers.org/country-profiles/spain/ |
| Demographic | In the period 2013-2060 the share of people aged 80+ in the Spanish
population is
expected to grow from 5.5% to 14.9% (EU-28: 5.1%-11.8%)
Link/Source: https://eurocarers.org/country-profiles/spain/ |
| There are 1,424,322 people supported by the Individual Care Programme (PIA). 22 % (427,301 people) have a resolution with a high dependency degree III, and 30 % (593,931) with a medium dependency degree II.
Link/Source: European Social Network (ESN) (2024). Social Services Index: Spain. |
| Education and training | Persons covered by the non-professional carers’ agreement can participate in the offer of the vocational training subsystem for employment in the same way as other unemployed and employed workers. Moreover, anyone, whether or not they provide care, can take regulated studies, as there is a wide range of courses on offer in the different autonomous communities, not only in the morning or afternoon, but also through distance learning, and in the case of vocational training, in the dual system. Some strategies, such as the Strategy on Neurodegenerative Diseases, include in their objectives the provision of support for caregivers, reporting and training on the disease and its care. Â |
| Quality | For the change in the model of care and support to become a reality, real cultural change is required, involving a significant investment in the training of professional carers across the sector. Training in these new models of person-centred care, based on rights and in the community, in the ethical practice of care, or in aspects as specific as restraint-free care, which requires not only the gradual withdrawal of restraints, but also learning new strategies of respectful support for people. To this end, the Accreditation and Quality Agreement is already committed to these new competencies and to continuous training, based on the conviction that improving the skills and competencies of these professionals will improve the quality of life of the people receiving care and support. |
🇫🇷 France
| Demographic | In the period 2019-2050 the share of 65+ people in the French population
is
expected to grow from 20% to 26.6% (compared to an increase from 20% to 28.5% in the
EU-28)
Link/Source: France – Eurocarers |
| It is estimated there would be 8,3 million informal carers in
France (12.9% of the population), among whom 4,3 million provided regular care at home to a
person over 60 years old
Link/Source: France – Eurocarers |
|
| France would have 4 million older people with loss of autonomy by 2050, accounting for 16.4% of seniors. People over 65 will make up 30% of the French population by 2050, while those under 20 will represent 20%
Link/Source: European Commission (2024). Implementation report of the Council Recommendation on access to affordable high quality long-term care: France |
|
| Almost 10% of people over 75 years old, and one in three individuals over 90 years old live in a residential nursing home.
Link/Source: European Observatory on Health Systems and Policies (2024). France: Health system summary. |
| Employment care work | Women represent 57% of informal carers of older people in the country.
The
proportion of female carers even increases to 74%, along with the level of dependency of the
cared-for person
Link/Source: France – Eurocarers |
| The rate of informal carers is high compared to other countries:
approximately 26% of people aged 18 years or over care for one or more disabled or infirm family
member, neighbour or friend, of any age, more than twice a week.
Link/Source: Eurofound EQLS 2020 |
|
| It is estimated that between 8 and 11 million individuals provide
informal care for a relative who needs care because of age, disability or a chronic or disabling
illness in France
Link/Source: European Observatory on Health Systems and Policies (2023) France. Health system Review |
|
| Since 2023, the government has been working to establish a Comprehensive Extended National Collective Bargaining Agreement (CCNUE) for the entire social and medico-social associative sector. This initiative aims to create a uniform regulatory framework for all actors in this field. The goal is to raise salaries across the sector, whether employees are covered by a collective bargaining agreement or not (coverage rate is 80%), through a single extended collective agreement. Therefore, there is ongoing national social dialogue to improve working conditions for sector professionals, in accordance with point 7.a) of the recommendation.
Link/Source: European Commission (2024). Implementation report of the Council Recommendation on access to affordable high quality long-term care: France |
| Quality of the social care system | Data on care quality are lacking in the primary and long-term care settings
Link/Source: European Observatory on Health Systems and Policies (2023) France. Health system Review |
| Policy and regulation | The dependent elderly is also entitled to receive the Allocation
Personnalisée
d’Autonomie – APA (Personalised Autonomy Benefit), which is a universal benefit for people over
60 that came into force in 2002.
Link/Source: France – Eurocarers |
| The national Strategy to support informal carers includes an action
plan to reinforce and diversify the offer of respite care services, which is accompanied by an
additional budget of €100 million for the period 2020-2022.
Link/Source: France – Eurocarers |
Disclaimer
“Not all LTC is provided by paid professionals, and it is important to reflect that informal carers are also part of the LTC workforce. Informal carers are defined as any person who provides – usually – unpaid care to someone with a chronic illness, disability or other long-lasting health or care need, outside a professional or formal framework. This typically includes family members, partners/spouses, friends and neighbours. Informal carers are sometimes referred to as family carers, or unpaid carers, depending on the context.”