Policies for supporting caregivers of older adults with long-term care needs in EU countries: a systematic review

欧盟国家支持长期照护老年人照护者的政策:系统性综述

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Abstract

In the context of population ageing, increasing long-term care needs and constraints on welfare spending, informal caregivers assume a pivotal role as providers of long-term care. This systematic review synthesises reported data on the diverse support policies implemented across the European Union (EU) to assist them. Findings from 35 studies and reports published between 2011 and 2025 suggest that, despite similar demographic challenges, policies diverge significantly, with some EU countries to have established mechanisms beyond financial assistance to support carers, while others, particularly those located in Eastern and Southern EU, to offer less comprehensive support. While the frameworks of defamilialisation (Nordic), supported familialism (Continental), and familialism by default (Southern and Eastern Europe) provide a useful analytical lens to our findings, the review also identifies significant heterogeneities within welfare regimes and even within countries, often driven by decentralisation and regional disparities. Across all models, financial support via cash-for-care schemes and in-kind respite care are the most common instruments, though their generosity and comprehensiveness vary substantially. In contrast, policies such as training, counselling, and flexible work guarantees are less developed, with their availability and access, however, varying significantly across the EU. Furthermore, the review identifies critical gaps in the geographical coverage of existing literature, with certain Southern and Eastern EU countries being particularly understudied. The synthesised evidence provides key implications for policymaking, thoroughly mapping the implementation of diverse social care policies as reported in the international literature.

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