Long term care: the case of the elderly

Health care for the elderly in industrialized countries has been characterized by a variety of persistent myths, nurtured by an amazing blindness for facts, and pertaining to their number, the related morbidity, the models of care, the unbearable costs and the financial situation of the elderly. Today a more optimistic perspective about the elderly is emerging emphasizing an older person with a remarkable physical and mental fitness and living in satisfying housing and income conditions. There is a less alarming prognosis about the increase of the elderly population and the share of elderly in the increase of health care budgets seems to be incremental. A wide spectrum of models of care has unfolded over Europe and the plausible explanations for the differences relate to the North-South gradient, the cultural patterns, the history of the health care system and the level of economic development. Europe is focusing on community care: in northern Europe to substitute for institutional care and in southern Europe as a response to changing family patterns. There is a danger of overshooting with policies for the aged, but more than special attention is to be given to the vulnerable risk groups which are the octogenarians, suffering from dementia and poor in housing assets.