EU Care Strategy – Europe must show it cares about older women!


photo by Nevenka Vidmar

The European Commission announced the release of a European Care Strategy for this autumn. This echoes a long-held demand by AGE, other civil society organisations and members of the European Parliament to define a policy for long-term care in the EU. Demographic change and the pandemic have placed a high burden on women, especially older women. The Strategy is a chance to finally value and support their essential contribution to society.

Ageing policies on the shoulders of – female – giants

Older women and their contribution continue to be undervalued, in particular in the context of care yet this is an area where they are very much involved.

  • An estimated 80% of long-term care is provided by unpaid informal carers, a majority (59%) performed by women, especially in some EU countries.

  • more than 85% of care in many Eastern Member States1 is provided only by informal carers.

  • 70% of informal carers are 45+.

  • Informal carers are more frequently at risk of poverty and social exclusion, report worse mental and physical health, and are more frequently socially isolated than other persons.

  • Women provide more intense care than men, spending on average 17 hours per week on informal care compared to 14 hours for men.

  • More than 30% of female informal carers in Spain provide more than 40 hours of care per week, followed by Ireland, Bulgaria, Poland and Greece, where between 20 and 25% provide such high numbers of hours.

These findings, which stem from the 2016 Quality of Life Survey, do not take into account the impact of the pandemic, where care services have been reduced or entirely shut down – particularly home care services, which are the ones supporting informal carers.

But also the perspective of persons in need for care and support has an important implication for women. Differences in life expectancy and the prevalence of chronic disease mean that mainly older women tend to have more needs for long-term care and support: indeed, women live 3.5 years longer than men on average, and spend 12.7 years with a chronic health condition or disability, compared to 9.2 years for men. About one in three persons in need for care and support in the EU is not able to access formal care. Older women have on average lower incomes than men – the gender gaps in pension is of 27% – while the care needs of persons with lower incomes are highest. About 37% of women over 65 report needs for long-term care, versus 23% of men 65+. This means that women’s needs for support for their autonomy and independence in old age are largely unmet, despite the promises of the EU Charter of Fundamental Rights and the EU Pillar of Social Rights.

Finally, the formal long-term care workforce is predominantly female. Media reports, but also the high rates of staff turnover and workforce shortages show that the sector is not valued enough to provide adequate working conditions and provide for sustainable workplaces. Increasing the quality of care comes with improving working conditions, improving the status of underpaid and undervalued women workers.

Towards gender equality with the EU Care Strategy

The EU Care Strategy is an opportunity to tackle these challenges. The European Commission has just launched a call for evidence to collect the voices of civil society about what to include in the future Care Strategy. From the point of view of AGE, it should take a rights-based approach, a point we outline in our recent policy brief. To support gender equality across the life span, it should in particular contain the following points:

  • A social protection guarantee, framing long-term care as a universal right provided to all those who need it, no matter their sex, ethnicity, age, “perceivedrace, income, degree of disability etc.
  • Access to all forms of care in a person-centred way: people should be free to choose the care they want or need, including the degree, home care, community-based care, residential care etc.
  • Quality of care should be guaranteed by standards that measure the outcome of care based on the degree of independence and quality of life it provides
  • Informal care should be a personal choice, not an obligation: formal care services and especially home care services should be affordable and available everywhere, so that informal carers are free to choose to provide care
  • Specific support to informal carers: informal carers should have a right to take remunerated leave from work, including flexible, beyond the current minimum standard of four days per year and worker. Informal care provision should be valued by social protection coverage, such as provision of pension credits to informal carers. Informal carers need support services, such as training, counselling, exchange with peers, access to respite care and day-care services and must be integrated as full partners in a long-term care setting, rather than bystanders.
  • Prevention must be supported: through the strengthening of age-friendly environments, that are accessible to all and that foster everyone’s full participation in societies
  • Investment is badly needed to address all of these issues. While many EU funds (RRF, ESF+, Cohesion Fund, …) allow investing in this sector, too little is done to steer the wheel of our long-term care systems towards such a rights-based approach. European Economic Governance, which has been reduced during the pandemic and possibly the medium-term due to the General Escape Clause, must be reformed and adapted to meet this challenge.

Given the context of demographic change, needs are bound to increase in the coming decades. At a period where geopolitical upheavals draw the attention of policymakers towards defence, security and solidarity with refugees, we should not forget that demographic change is a fundamental trend that will shape the ageing experience of all, and particularly of women.

Improving the situation of older women today and tomorrow requires that we trigger this change now.

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