Abstract
The rapid ageing of populations around the world and the associated shift in the burden
of disease from infectious to chronic conditions are creating complex challenges for
national governments. Addressing the needs of these older populations in a sustainable
and equitable way, will be a fundamental pillar of socioeconomic development in the
21st Century.
The World Health Organization (WHO) Global strategy and action plan on ageing and health, which was adopted by all the Organization’s 194 Member states in 2016, provides
a clear framework for global action. One critical priority is to establish sustainable
and equitable long-term care systems in every country. WHO defines long-term care
as “the activities undertaken by others to ensure that people with, or at risk of,
a significant ongoing loss of intrinsic capacity can maintain a level of functional
ability consistent with their basic rights, fundamental freedoms and human dignity”.
These activities include both social care and health care, as well as contributions
from other sectors, such as education or transport. And these activities need to be
effectively coordinated if they are to efficiently, equitably and sustainably meet
the needs of older people. This requires the stewardship of governments to ensure
that: care is accessible and affordable; the rights of older people to lives of meaning
and dignity are upheld regardless of their physical or mental capacity; services are
oriented around the individual’s specific needs; caregivers are supported; the workforce
(both paid and unpaid) are treated fairly; and older people’s intrinsic capacity is
maintained for as long as possible.
WHO has proposed three inter-related strategies to establish and sustain long-term
care systems. System infrastructure needs to be developed and continually improved.
The capacity of the workforce needs to be strengthened and families and communities
must be supported. And the care and support provided needs to be more person-centred
and integrated, underpinned by minimum standards and accreditation for care providers.
This paper outlines some of the critical issues confronting governments in countries
at all levels of development if this ambitious vision is to be achieved.
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Article info
Footnotes
The authors declare no conflicts of interest.
The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated.
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© 2018 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
