Long-Term Care Challenges and Opportunities in Latin America and the Caribbean

Caribbean (LAC) has been one of the fastest in the world with the share of the population age 65 and older increasing from 5 percent in 1990 to 9 percent in 2019. And the trend will continue as that share is projected to double by 2050.1 With age, levels of functional ability may become impaired due to a variety of internal and external factors. Ultimately this can reduce autonomy, compromise an individual’s ability to meet dayto-day needs, and limit a person’s capacity to learn, grow, make decisions, build and maintain relationships, and contribute to society.2 Already there are approximately 8 million older people in LAC who need to receive long-term care and support (also known as “long-term care”) to perform at least one basic activity of daily living. This translates to 12 percent of the population age 60 and over, and 27 percent of the population over age 80, who need assistance with activities such as bathing or showering, eating, or moving around a room. By 2050, the number of older people with severe long-term care needs in LAC is projected to grow to 27 million, representing more than 3 percent of the total population and approximately 14 percent of people aged 60 and above in the region.3 As the population ages and more people require long-term services and supports, the promotion of healthy aging is essential for maximizing individual autonomy and preventing the long-term care systems from being overwhelmed. The United Nations Decade of Healthy Ageing (2021-2030) is based on the premise that every person should have access to environments and opportunities that enable their right to live a long and healthy life. The initiative seeks to promote access to quality and timely long-term care services with the double objective of meeting current support needs and reducing the intensity of future needs through the preservation and recovery of older persons’ functional capacities.4 The majority of long-term care in LAC is provided by family members — mostly women — who receive limited support from governments.i Along with being unfair to women, the situation is also unsustainable due to reductions in family size, increased participation of women in the formal job market, and the growing recognition of unpaid care provision as a key source of gender inequity.5,6 Governments can enhance access to affordable, quality services through the development of national care and support systems for older people experiencing or at risk of developing long-term care needs as well as for their unpaid caregivers.5