Defining Long-Term-Care Need Levels for Older Adults: Towards a Standardized European Classification

Area of Science:

• Gerontology
• Health Economics
• Social Policy

Background:

• International comparisons of long-term care (LTC) are hindered by inconsistent definitions of care needs.
• The European Union's Aging Working Group uses competing definitions: Activities of Daily Living (ADL) and Global Activity Limitation Index (GALI).
• Increasing longevity exacerbates issues with measurement inconsistency and defining care intensity.

Purpose of the Study:

• To investigate the relationship between the ADL and GALI measures of care needs.
• To calibrate the two measures and identify their overlapping and differing aspects.
• To propose a new, unified measure for assessing long-term care needs.

Main Methods:

• Analysis of a large European sample survey where respondents answered questions related to both ADL and GALI.
• Calibration of the ADL and GALI measures based on survey data.
• Development of a new 4-scale measure combining ADL and GALI metrics.

Main Results:

• The study establishes a link between the ADL and GALI measures, allowing for their calibration.
• Identified areas of overlap and divergence between the two existing measures.
• A new 4-scale measure of care needs was developed, incorporating intensity gradation.

Conclusions:

• A consistent measure of care needs, incorporating intensity, is crucial for accurate international comparisons.
• The proposed 4-scale measure can improve long-term expenditure projections.
• This unified approach will aid policy discussions and the transfer of best practices in long-term care.