Comparison

Abstract

The risk of long-term care dependency is on the increase not only in all countries included in this comparative study but far beyond. Even countries that face severe financial problems have to find solutions how to deal with long term care. This is not surprising, as the demographic challenges posed by a rapidly ageing population are common throughout Europe. This does not mean that old age per se automatically leads to long-term care dependency. In fact, many of today’s 80-year-olds are significantly more agile than their parents and grandparents when they were 60 or 70 years of age. Undisputed, however, is the fact that as a person grows older, he or she is more likely to require the help of others. Increasing longevity also means an increase in the duration of help services needed. What is more, medical progress now enables life-prolonging measures that would, some years ago, not have been a given or even imaginable. The issue here is not whether these measures are indeed always beneficial to the actual life quality of the person involved. Discontinuation of life support measures is very problematic in ethical and legal terms, even in cases where the person involved has opted for it (e.g. in the context of a living will). It becomes even more difficult in cases where there are no indications of what the actual wish of a patient might be once the latter can no longer make a clear statement. A discontinuation of life support measures might all too easily spark the suspicion that (unnecessary) costs for complex and expensive long-term care services might be saved.