Policy Briefing | European Parliament

The way forward: Innovation by coordination and integration
Brussels, 28 November 2013

Good practices in long term care for older people in Europe presented at the European Parliament

What are the good practices in long term care for older people in Europe? The EU FP7 project INTERLINKS developed a systematic framework illustrated by most innovative practice examples from 13 Member States (see also: 

On 28 November 2013 representatives of INTERLINKS from Vilans (The Netherlands), the European Centre for Social Welfare Policy and Research (Austria), the University of Kent (UK), IRDES (France) as well as colleagues from the University Applied Studies of Fulda (DE) and Hospice Austria presented selected examples during a Policy Briefing event to members of the European Parliament in Brussels. The event was hosted by the MEP Heinz K. Becker, chair of the Interest group Carers at the European Parliament.

Partners in the INTERLINKS-project developed a framework for defining and analysing the elements of emerging long-term care systems and provided a way of comparing the different approaches across Europe. Using this framework helps practitioners and policy-makers to compare their own country to other experiences. The INTERLINKS framework is also useful to monitor individual countries’ stages of development. Almost 100 examples of good practice were collected during the project, for instance to illustrate ways to assess and monitor the quality of care, to stimulate preventative approaches and rehabilitation, and to support informal carers.

Following a short introduction about the background and findings of INTERLINKS, selected examples were showcased at the European Parliament following the ideal-typed Mrs. L.T. Care (Lilly) alongside her fictitious pathway through long-term care. Lilly is 81 years old and lives in an old farm at the countryside with her husband, who is partly blind. Both are confronted with six difficult situations during the final stages of Lily’s life. The collected examples from the different European countries show a possible solution for each problem.

The case of Lilly

Lilly made a nasty fall and ended up in hospital. She can only walk short distances at home, so taking care of herself is difficult. Lilly’s husband can support her only partially due to his near blindness. The nearest neighbours are living at a distance of 3 kilometres and their daughter lives too far away to take up on a considerable part of the daily care. 

Moving to a rehabilitation centre is not an option, because Lilly cannot leave her partner alone at home. What would be a solution for their situation? And why is this particular solution suitable for their situation? (click on titles for videos)

Lilly was diagnosed for Alzheimer’s in an early stage while she was in hospital. This situation worries both Lilly and her husband. What will happen to Lilly and how do other couples deal with this? Talking to people in similar situations would help them a lot. But where could they meet those people? And what will the information do to them?

Lilly tends to wander around the farm. Sometimes she wanders a great distance from the house and cannot find her way back home. This situation worries her husband and her daughter a lot. But they want Lilly to be able to move freely around the house. Limiting her freedom is not an option. Are their any technical applications to provide in their needs?

Lilly’s partner is getting more and more exhausted. Lilly is up every night, because she thinks she has to give a piano lesson, keeping him awake. He does not want to complain to Lilly and their daughter but he cannot go on like this! He can seldom leave the house and does not want to go far away for help. Who can help him?

Despite them being vulnerable, both Lilly and her partner want to remain as independent and active as possible. Although it means they have to leave the farm they both lived at for 46 years. They are looking for a way of living that can facilitate freedom of choice and access to additional external services including medical, social or voluntary services. Such a place is appealing to them. Where can they find it?

Despite the excellent care, Lilly’s condition deteriorates. She is suffering from an ammonia and needs to be admitted to a hospital. Lily does not want to go to a hospital, last time she went there she got very confused. What should they do now?

Lilly receives some bad news at the hospital. She is diagnosed with lung cancer. Her physical condition deteriorates even more and she’s in a lot of pain. The question of dying comes into the picture. Lilly absolutely does not want to die in the hospital. Can somebody fulfil Lilly’s last wishes?

Comments and statements by most important stakeholders complemented this presentation. Waltraud Klasnic who is the Austrian Member of the European Economic and Social Committee underlined the importance of end-of-life care in the context of long-term care systems. In her function as President of Hospice Austria she also outlined latest positive developments in this direction in Austria.

Sven Matzke represented the European Commission, DG Employment, Unit for Active Ageing, Pensions, Healthcare, and recalled the current challenges for long-term care in Europe as well as salient activities of the Commission to support Member States in improving their policy responses.

Last, but not least, Frank Goodwin as President of EUROCARERS, the European Association working for Carers, made a strong point for involving carers as the unrewarded backbone of long-term care provision across Europe in policy development and in the design of any intervention in long-term care.

Participants in the event appreciated in particular the mix of scientific research, practical relevance and the orientation towards policy development by which this event was characterised.

MEP Heinz K. Becker underlined that, although long-term care is not a matter of EU legislation, Member States need to be confronted with relevant European experiences to which they must reply: "They have no chance to escape!"