In its report entitled "Growing Old with Dignity" Caritas Europa warns that the EU's long-term care system is insufficient In its report entitled "Growing Old with Dignity" Caritas Europa warns that the EU's long-term care system is insufficient 

Caritas: EU not keeping up with needs of ageing population

The number of people in need of care in the ageing European continent is projected to rise by the millions in the next 30 years. Caritas Europa’s latest report highlights the fact that EU countries are not keeping up with the trend and proposes solutions.

By Linda Bordoni

“Population ageing is the defining global trend of our time,” said Shannon Pfohman, Policy and Advocacy Director for Caritas Europa, noting that the demand for long-term care is soaring, and public spending is not keeping pace with the demand.

Speaking to Vatican Radio just after the launch of the Caritas Europa report “Growing Old with Dignity, the Challenges of Long-Term Care in Europe”, she explained that demographic trends are not reflected by public investment, meaning that more and more people find themselves in need.

Listen to the interview with Shannon Pfohman

Phoman explained that the Caritas Europa report on long-term care in Europe was based on the experiences of Caritas member organizations in at least 13 countries who were asked to complete a questionnaire with over 100 “very detailed” questions in order “to have very rich data collection from their realities in providing long-term care services.”

Essentially, she continued, findings are in line with general key trends and demographic changes pertaining to long-term care across an increasingly aged Europe, where “the demand for long-term care is soaring and public spending is unfortunately not keeping pace with the demand.”

“Public spending is not keeping pace with the demand.”

“The fact that more people will be needing care than can possibly be provided to them and respond to this need is already an indication of what's to come as we move forward,” she said.

A Caritas member involved in caring for the elderly
A Caritas member involved in caring for the elderly

Request for action

Pfohman explained that one of Caritas Europa’s key tasks involves liaising with European institutions including the European Commission, the European Parliament and currently with the future Spanish presidency of the Council of the EU as well as all relevant policymakers.

The organization, she added, also does advocacy on the EU Care Strategy and the Council's Recommendation on long-term care.

“We've already been feeding into these legislative files and will continue to do so.”

“The crux of the issue now is really what will the member states do at the national level, because it's now in their hands to follow up on the Council Recommendation and decide if, and how, they will reform their long-term care systems,” she said.

Caritas’ Recommendations

Caritas Europa, Pfohman said, has identified 15 diverse key Recommendations.

Some, she said build on “already existing legislative files such as implementing the Minimum Wage Directive, ensuring the proper implementation of the Work-life Balance Directive, but also introducing a legally binding framework directive on minimum income.”

These, she explained, are general recommendations that aim to support the social protection system.

She also reflected on the need for governments to borrow funds, not only to invest money, but to fund current spending that could be directed towards much-needed long-term care.

“We're asking for investments in public and or social capital stock to provide for future benefits and be financed by debt and thus excluded from the balanced budget rules.”

“Number one,” Pfohman insisted, “is the need to invest in long-term care systems and to reform them.”

One of Caritas Europa's mandates is to ensure the long-term care system is accessed by those most in need
One of Caritas Europa's mandates is to ensure the long-term care system is accessed by those most in need

Growing old with dignity

Another priority, she continued, is the need to apply and prioritize a person-centred approach in the provision of long-term care that ensures quality care and dignified care work, thus Caritas is asking for a “Care Guarantee” which guarantees the right to long-term care for everyone regardless of their financial situation.

She said one of the most important findings from the research shows that increasingly more elderly people, who are of low income, “cannot cover their costs for care at all.”

Many of them, she said, are in rural areas “where there are not even the care systems in place or the personnel to support them. And so it's a very worrying situation.”

When it comes to the need to revise and reform the long-term care system, she said this could extend from institutionalized facilities, or community-based centres to allowing for more home care and enabling live-in care. It could also include hospice and palliative care, depending on the different types of needs.

Pfohman also highlighted how, according to the Council Recommendation, one request is to focus more on community-based care, moving away from institutionalized care “unless it's the only option.”

Working with dignity

So many realities are involved in the issue, that Caritas, Pfohman said, has a two-pronged approach: “On the one hand, we're advocating on behalf of the care recipients, those receiving care, as well as on behalf of the care workers, those providing the care services.”

Many care workers emigrate to rich countries where their skills are in demand, so one of the big concerns of many of Eastern European members, she said, is that there are not enough personnel in their countries “because as soon as they train them and get them skilled up to be a care worker, they migrate to richer Western European countries like Austria, Germany, or Switzerland.

Thus, she said, the topic of mobility and migration are addressed in the report.

Caritas she said, urges for “more upward social convergence between the EU member states and also within them, because there are inequalities within Europe and also with the non-EU member states, as well as between the urban and rural divide.” 

A Caritas member offers care to an elderly person
A Caritas member offers care to an elderly person

Migration and mobility

This, Pfohman observed, often leads to the fact that the legitimate desire to improve one’s working conditions results in a labour market gap in many countries in this job sector.

One of the solutions that Caritas is working on in this regard, she explained, is not to stop migration, “because of course we believe in the importance of mobility” and in the right of every person to be able to migrate and start their lives again somewhere else if they'd like,” but at the same time, “we observe that a lot of people are migrating out of necessity because they can't afford to cover their costs within their own countries.”

Most of them,  she noted, would prefer to stay in their own country, and so what Caritas is doing is fostering more circular migration through exchange programs.

The example of Caritas Romania

Pfohman upheld the example of Caritas Romania that's been working to train the care workers to ensure that they have all the skills and can deliver quality care to a high standard. “Then they go to Switzerland, for example, for several months, but intending to return to Romania. While they're in Switzerland, they earn enough money to be able to save some money for their living expenses in Romania when they return. And then they can continue to work in the care sector in Romania.”

This mechanism, she said, not only provides a positive situation for the families who are not divided, it allows them to earn some extra money and ensures that the labour market situation in Romania remains somewhat balanced.

Protecting the rights of the carers

With so many potentially vulnerable people who work as carers within the system, Caritas, Pfhoman said, has a very clear stand when it comes to dignified work.

“That is a common thread throughout this publication as well, because so many of the care workers who are employed in this sector are not being valued the way they should be,” she said.

It is a questionable reality, she added that often people do not hesitate to offer good money to someone, for example, who is working in a bank, but doesn’t seem to have the same approach when it comes to paying the person who is looking after an elderly relative.

“[ Why would we rather have somebody caring for our elderly parents but not pay them dignified wages? Yet we want them to treat our parents with dignity and with quality care services...]”

At Caritas, she added, they are working to try and ensure quality standards for the kind of care work that it delivers, as well as being attentive to the kind of bilateral agreements and partnerships set up with third countries in which carers are recruited like Sri Lanka, Vietnam, the Philippines and other developing nations.

During the launch of the Caritas report, she said, “Somebody from the European Commission guaranteed that the idea is not to recruit them to exploit them, but to recruit them and ensure that their rights are protected.”

This is a question, she said that Caritas will continue to monitor, but it doesn't address the main issue, and that is that the care systems need to be reformed.

Integral development

Shannon Pfohman concluded by highlighting the difference between social and health care and the need for a more integrated approach “because right now there are different responsibilities, different ministries, even within the European Commission, different Director-Generals who are responsible for the delivery of long-term care.” 

This she explained, results in an approach that is not coordinated and makes for a fragmented scenario in which often there is no clarity even when it comes to whom to speak to, what rights are involved, and which protections are needed “both for the care receiver as well as the care worker.”

In line with Pope Francis’ call, Caritas Europa, Pfohman insisted, strives for integral human development... Always!

Protecting the rights both of care receivers and care givers
Protecting the rights both of care receivers and care givers

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03 July 2023, 17:24