Understanding Gaps in the Provision of Long‐Term Care for Older People Across Europe

ABSTRACT Since the 1990s, European welfare states have expanded long‐term care (LTC) support for older people, yet gaps in social security and unmet needs persist. This study identifies key gaps in LTC provision and examines how differences in policy design contribute to them. It applies a typology of LTC policies that considers the balance between support for formal and semi‐formal care systematically assessing regulations of access to support and the extent of support. Moreover, cultural and infrastructural influences on care gaps are examined. The study compares 10 European welfare states with social‐democratic, conservative, liberal, Mediterranean and post‐socialist welfare traditions. The analysis is based on legal policy documents, expert reports and comparative policy databases, as well as national and international statistics. Findings indicate that cross‐national differences in care gaps largely stem from institutional policy structures. However, cultural perceptions of appropriate forms of LTC and infrastructural factors, such as policy implementation and the availability and quality of formal care, also play a crucial role in shaping cross‐national differences.

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Publication Details

Journal
Social Policy and Administration
Published
2025-11-21
DOI
https://doi.org/10.1111/spol.70029
Primary Topic
Intergenerational Family Dynamics and Caregiving
Type
article
Field-Weighted Citation Impact
0.00

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article

Understanding Gaps in the Provision of Long‐Term Care for Older People Across Europe

Christopher Grages
Social Policy and Administration
Intergenerational Family Dynamics and Caregiving
article

Understanding Gaps in the Provision of Long‐Term Care for Older People Across Europe

Christopher Grages
article en

Abstract

ABSTRACT Since the 1990s, European welfare states have expanded long‐term care (LTC) support for older people, yet gaps in social security and unmet needs persist. This study identifies key gaps in LTC provision and examines how differences in policy design contribute to them. It applies a typology of LTC policies that considers the balance between support for formal and semi‐formal care systematically assessing regulations of access to support and the extent of support. Moreover, cultural and infrastructural influences on care gaps are examined. The study compares 10 European welfare states with social‐democratic, conservative, liberal, Mediterranean and post‐socialist welfare traditions. The analysis is based on legal policy documents, expert reports and comparative policy databases, as well as national and international statistics. Findings indicate that cross‐national differences in care gaps largely stem from institutional policy structures. However, cultural perceptions of appropriate forms of LTC and infrastructural factors, such as policy implementation and the availability and quality of formal care, also play a crucial role in shaping cross‐national differences.

Social Policy and Administration
University of Bremen (DE)
European Commission
Openalex Percentile: Top 55%
Intergenerational Family Dynamics and Caregiving
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