The demands for and costs of long-term care provision in the EU will rise significantly by 2050, according to a new report presented by the European Commission. Meanwhile, the vast majority of Europeans (almost nine out of ten) favour home- or community-based care over care in an institutional setting.

The projected growth in demand for long-term care services presents a major challenge for national governments. But the report also shows that Member States are striving to guarantee access for all to quality care by providing adequate resources to meet this demand. The report was discussed at a conference on intergenerational solidarity organised by the Slovenian EU Presidency on 28-29 April in Brdo, Slovenia.

The Commission's report – 'Long-term Care in the European Union' – analyses the main challenges Member States face in the field of long-term care, their strategies for tackling them and presents possible solutions. It draws on the national reports submitted as part of the EU's system of common objectives, assessment and reporting for social protection and inclusion – the 'Open Method of Coordination'. It identifies the main challenges for national governments as:

• Ensuring access for all to long-term care services.
• Securing financing for long-term care through an adequate mix of public and private sources of finance and potential changes in the financing mechanisms.
• Improving coordination between social and medical services, often involved in the provision of long-term care services.
• Promoting home or community-based care rather than institutional care to help dependent people remain in their own homes for as long as possible.
• Improving the recruitment and working conditions of formal carers and supporting informal carers.

According to a Eurobarometer report carried out in 2007, most Europeans expect to need long-term care at some point in their lives (with an EU average of 13% seeing this as inevitable, 32% likely and 29% unlikely but possible). However, 86% of Europeans would prefer to be cared for in their own homes or that of a relative should they become dependent, as opposed to only 8% preferring an institution.

It is important to note that, within the European Union, different definitions of long-term care coexist. The OECD has defined long-term care as "a cross-cutting policy issue that brings together a range of services for persons who are dependent on help with basic activities of daily living (ADLs) over an extended period of time."  Elements of long-term care include:

• rehabilitation,
• basic medical services,
• home nursing,
• ocial care,
• housing and services,

such as

• transport,
• meals,
• occupational and empowerment activities,

thus also including help with Instrumental activities of daily living (IADLs). Long-term.