You can’t always get what you want: can European care systems respond to the expectations and preferences of their citizens?

Presenter: Stefania Ilinca (European Centre for Social Welfare Policy and Research)

Abstract for the International workshop on COVID-19 and Long-Term Care systems: What have we learnt and what policies do we need to strengthen LTC systems?, 6 and 7th December 2021

Video of the presentation (see 17:15):

Stefania Ilinca: LTC-COVID Webinar 6 – 7 December 2021


Background: Following the devastating effects of the Covid-19 pandemic on long-term care systems, many European countries are embarking on ambitious reforms. To create better, more resilient care systems, it is essential that inclusive and participatory approaches are built into all reform efforts, and that service and system design reflect the needs, preferences and expectations of older people, their families and communities. 

Methods: Primary data has been collected by the InCARE project team through a European-wide, general population online survey on attitudes, experiences and expectations on long-term care, modelled after the Eurobarometer on health and long-term care (2007). We report preliminary results from over 2000 responses collected in 32 European countries. 

Results: We find that the vast majority of respondents both expect and prefer to be cared for in their homes, closely reflecting results obtained almost 15 years earlier. What has changed in the intervening years is a marked increase in both preferences and expectations towards care provided by formal providers and care professionals, in the detriment of informally provided care. Whereas one in two respondents in 2007 expressed a preference for informally provided care in their homes, the majority of respondents in 2021 reported preferring care provided by professional services or a mix of formal and informal care. While the share of individuals who prefer to be cared for in a residential setting has not changed over the same period (approximately one in 10), many more Europeans expect in 2021 they will have to rely on this type of care. 

Discussion: Our results are a strong indication that European citizens neither expect nor do they wish to rely on families and informal support should they need care. Therefore, policy debates on shaping the long-term care systems of the future should focus on developing solutions for expanding the availability of high quality, affordable long-term care services in particular in home- and community-based settings.  


S.Ilinca & C. Simmons – European Centre for Social Welfare Policy and Research, Vienna 

M. Salcher-Konrad & A.Comas-Herrera – Care Policy and Evaluation Centre, London School of Economics and Political Science

The InCARE project team

For more information:

The survey is still open and can be completed here:

InCARE project website: 

Publication – Promoting social innovation in long-term care: 

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