28 June 2017

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Kate Roberts
Social Policy Section

Introduction

Aged care, as it is known in Australia, is usually called ‘long-term care’ or ‘social care’ in other countries.[1] It is organised, funded and delivered in many different ways. Not all countries provide public support, and levels of social protection (public coverage of care costs) vary widely. There is also significant international variation in the terms used for different types of care, and these can even vary within the same country. This quick guide provides:

• English terms that may be used to describe aged care in other countries[2]
• a basic indication of funding arrangements, lead government agencies and primary legislation in selected countries, and
• links to further information.

This guide focuses on formal, government-approved care for older people. It does not cover informal care (such as care provided by relatives) or retirement villages. For a guide to aged care in Australia, see Aged Care: a quick guide.

What is long-term care and social care?

The Organisation for Economic Co-operation and Development (OECD) defines long-term care as ‘care for people needing support in many facets of living over a prolonged period of time’. This includes what we know as aged care, but in some countries can also include other types of care, such as care for adults with a disability. However, older people are the primary recipients of long-term care.

Social care is a term used predominately in the United Kingdom to describe formal care for all people who require support with daily living. This includes older people, but can also include people with a disability and children at risk of harm.

As in Australia, long-term care and social care includes assistance with ‘instrumental activities of daily living’ (such as cleaning and shopping); ‘activities of daily living’ or ‘personal care’ (such as eating, showering, dressing, and toileting); and usually also includes medical care. It can be delivered in the home, in short-term settings (such as respite facilities) or in permanent residential care homes. Consumer preferences for home-based care and greater choice and control are increasing in other countries as well as Australia.

How is it funded?

The systems that OECD countries have adopted to fund aged care fall broadly into four categories, as described by Raphael Wittenberg, Associate Professorial Research Fellow at the University of Oxford:

‘social insurance, as in Germany;

taxation and means-tested user charges, such as in the United States and the United Kingdom (except Scotland);

taxation without means-tested charges, as in Austria, Denmark and Scotland; and

social insurance and taxation, such as in Japan.’

The Australian system would best be described as ‘taxation and means-tested user charges’.

International resources

The OECD has published several reports on long-term care systems and services, with a focus on care for older people. These include reports on public funding for care, dementia, quality of care, informal carers and workforce challenges.

The World Health Organization website includes information about long-term care systems and ageing.

Alzheimer Europe represents Alzheimer’s associations from 34 countries. The Alzheimer Europe website includes comprehensive information about National Dementia Strategies in European countries and country comparisons of approaches to supporting people with dementia and their carers.

The International Federation on Ageing (IFA) is a non-government organisation (NGO) which includes government, NGO, academic, industry and individual members from 70 countries. The IFA website includes publications on a range of aged care-related issues.

The Parliamentary Library’s collection includes resources that provide international perspectives on aged care, comparing approaches to issues such as funding models, reforms, regulation and human rights.

Overview of aged care in selected countries

The following table provides brief details of aged care in selected OECD countries (plus Singapore). The countries were chosen on the basis of available information in English; relevance to Australia (for example, countries with similar systems of government); and to provide a range of examples of aged care systems.

This information is indicative only and subject to change. Where available, links to government information should be consulted for recent developments. Australia is included for comparative purposes.

[1].     Or is part of long-term care/social care systems that also provide for other target groups, such as people with a disability.

[2].     A few terms in other languages have been included, where the original-language term is commonly used within information otherwise in English.

For copyright reasons some linked items are only available to members of Parliament.

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