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  • 8 - Sharing the burden: the impact of long-term care on the financial situation of families in Europe

  • Edited by Jonathan Cylus, European Observatory on Health Systems and Policies, George Wharton, London School of Economics and Political Science, Ludovico Carrino, University of Trieste, Stefania Ilinca, World Health Organization, Manfred Huber, World Health Organization, Sarah Louise Barber, World Health Organization
  • Book:
    The Care Dividend
    Published online:
    21 March 2025
    Print publication:
    03 April 2025, pp 266-298
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  • Summary

    This chapter considers the costs of long-term care for service users and their families, and the policies that are necessary for adequate financial protection. The main focus is on home care services due to the substantial gap in evidence regarding their affordability. Given the widespread preference for home-based care, particularly in Europe where the majority of long-term care users reside at home, understanding the financial implications of these services is crucial. While decisions about home care primarily prioritize users’ wellbeing, financial considerations also shape care arrangements. Overall, common protective mechanisms such as caps on out-of-pocket payments income-based and means tests seem unable to successfully protect long-term care users from experiencing catastrophic spending.