Expanding Long-Term Care and Proactive Longevity Planning
The global demographic shift toward an aging population presents both challenges and opportunities for governments, industries, and communities worldwide. According to the World Bank’s recent report Unlocking the Power of Healthy Longevity, expanding and diversifying long-term care (LTC) options for older adults is essential to ensuring their wellbeing and maintaining economic productivity, particularly in low- and middle-income countries (LMICs).
The Growing Need for Long-Term Care
Even as gains in healthy longevity improve life expectancy and quality of life, many older adults will eventually experience functional limitations requiring some form of LTC. Long-Term Care (LTC) refers to a range of services and support systems designed to meet the health, personal, and social needs of individuals who are unable to fully perform everyday activities over an extended period. These individuals typically include older adults, people with chronic illnesses, and those with disabilities or functional limitations.
The primary goal of LTC is to ensure the dignity, wellbeing, and quality of life of care recipients by addressing both their medical and non-medical needs.
Traditionally, informal family care—often provided by women—has been the cornerstone of care for older adults in many cultures. However, changing family structures, urban migration, and increasing workforce participation among women are making informal care models unsustainable as the sole solution.
As the World Bank report highlights: “Traditional models of informal care in extended families cannot be the only option. Formal care systems that complement these models are limited and fragmented in most LMICs, creating challenges for both caregivers and older adults.”
Why Diversifying LTC Options is Essential
Expanding the portfolio of LTC options is critical for three reasons:
- Wellbeing and Dignity of Older Adults: Affordable and decent LTC options are vital to preserving the dignity and quality of life for many older adults. Informal care alone cannot meet the growing need.
- Empowering Informal Caregivers: Developing formal LTC systems can alleviate the burden on informal caregivers, enabling many—especially women—to pursue paid employment, education, or community service. This enhances their wellbeing and human capital.
- Economic Opportunity: Building professional LTC systems creates jobs, particularly for women, and fosters growth in the emerging “silver economy,” which is becoming a vital industry in aging societies.
Proactive Longevity Planning
While LTC is critical, Ron van Bloois of the Senior Housing and Healthcare Association (SHHA) underscores the importance of proactive solutions that support healthy aging and longevity: “As the SHHA, we see a need for LTC actions, but we also advocate for proactive solutions that support healthy aging and longevity—such as senior living. While long-term care remains critical, addressing care needs earlier—by building appropriate infrastructure and support systems—can reduce reliance on intensive care solutions and create significant societal and economic benefits.”
Proactive longevity planning includes several impactful strategies:
- Integrated Retirement Communities (IRC): Senior housing models, such as IRCs and co-living spaces, empower older adults to live independently longer. These environments promote social interaction, wellness, and safety while reducing reliance on long-term care.
- Healthier Aging through Supportive Environments: Providing appropriate housing, healthcare, and community support at certain life stages fosters well-being, delays the onset of chronic conditions, and enhances quality of life.
Economic and Social Benefits
Proactive longevity planning offers clear advantages for both society and the economy:
- Savings for Healthcare Systems:
Housing-with-care models reduce healthcare costs by an estimated 38%, according to SHHA data. If 250,000 Europeans aged 65+ were to live in such settings by 2030, the potential savings could reach €5.6 billion. - Addressing Housing Shortages:
By integrating senior housing solutions, communities can free up significant housing stock for younger generations. For instance, in the UK alone, housing-with-care models could free up 562,000 bedrooms by 2030. - Reducing Pressure on Caregivers:
Proactive solutions reduce the reliance on informal caregivers—primarily women—who often balance caregiving with employment. This alleviates caregiver burden and promotes gender equality in the labor market.
Policy Recommendations for Building Sustainable LTC Systems
The World Bank outlines four key policy directions for LMICs to promote context-appropriate, affordable, and compassionate LTC solutions:
- Adopt a Balanced Mix of Care Offerings:
A mixed care system that includes day care centers, home-based services, and tele-assistance can address diverse needs while promoting aging in place. Examples include Myanmar’s innovative loan program for home adaptations, which supports the construction of accessory dwelling units for older relatives. Nonprofit organizations and community-based initiatives also play a significant role in filling gaps in care provision. - Engage the Private Sector and Strengthen Governance:
The private sector has been a key player in building LTC systems globally, often through government-supported incentives like tax breaks and construction subsidies. However, robust regulatory frameworks are needed to ensure quality and prevent issues like profiteering, which have been observed in some privatized nursing homes.
The report emphasizes, “Strengthening government stewardship and regulatory capacity is essential to set ground rules and ensure service quality, particularly in LMICs where oversight is often lacking.”
- Systematize LTC Financing:
Organized LTC financing is critical to reducing access gaps, inequalities, and out-of-pocket expenses. Countries are encouraged to adopt broad-based social insurance models to fund LTC systems. Subsidies or vouchers for low-income individuals can also promote aging in place by enabling access to home- and community-based care. - Build the LTC Workforce and Support Family Caregivers:
Skilled human resources are a bottleneck for LTC services in many countries. Investing in caregiver training and offering support services—such as respite care and counseling—can improve care quality while reducing caregiver stress.
Expanding the Scope of Longevity Planning
Combining formal LTC systems with proactive strategies, such as those advocated by the SHHA, creates a more holistic approach to healthy aging. This dual focus can help societies adapt to the demographic realities of aging populations and ensure a better quality of life for older adults.
As Ron van Bloois concludes: “By fostering healthier aging environments and building the right infrastructure early, we can reduce reliance on intensive care while promoting dignity, independence, and economic sustainability for all generations.”
Proactive planning, innovative housing solutions, and better support for aging in place will be critical to unlocking the full potential of longevity and creating healthier, more resilient aging societies worldwide.