Long-term care

Also called: LTC, Long-Term Care Insurance · Topic: Human Capital: Education, Health and Demographic Dividend · NCERT: Beyond NCERT

Meaning

Long-term care (LTC) is help given over a long period to people who cannot manage daily life on their own because of old age, long illness or disability. It covers activities of daily living, the basic tasks of self-care such as eating, bathing, dressing and moving around. Some nursing support may also be part of it. Care can be given at home, in the community or in a care home. It can be paid for by the family, by public funds or by social insurance, a compulsory scheme where people pay in regularly and draw benefits when they need care. Japan's Long-Term Care Insurance is the best-known example of this model. LTC matters more as a country ages, because the oldest people, many of them widowed women, often live with frailty for years and need daily help rather than a hospital stay.

Example

A 82-year-old widow in Kerala lives alone after a stroke. She needs someone to help her bathe, eat and walk every day for years. That help is long-term care. India's Ayushman Vay Vandana card (launched 2024 for everyone aged 70 and above) would pay for her hospital treatment, but not for this daily help.

Don't confuse with

• Health insurance (hospital cover): it pays for treatment during a hospital stay, such as cataract surgery or angioplasty. Long-term care is ongoing help with daily living, often at home, with no hospital admission.
• Curative medicine: this is treatment that aims to cure an illness. Long-term care supports people whose condition will not be cured, so they can live with dignity.

Recent developments

• SHATAYU launched (22 May 2026): The Ministry of Social Justice and Empowerment started SHATAYU, a free national online directory that connects families with trained, vetted elderly caregivers in their own district. Families can book full-time or hourly help, including dementia and palliative care. By 13 Nov 2026 it listed 30,151 caregivers. This is India's first organised way to find paid long-term care help. It only helps families find a caregiver, though. The family still pays the caregiver directly.
• OECD study on care workers' pay (2020): An OECD study of 11 countries found that long-term care workers earned a median of EUR 9 an hour, against EUR 14 for hospital workers. They also stayed in their jobs about two years less than workers overall. This shows why it is hard to find and keep long-term care workers, even in rich countries.
• OECD review of Japan (2024): Japan has had compulsory long-term care insurance since 2000. Even so, the OECD found that Japan still has too few caregivers. Families still give much of the care, and Japan may need more foreign caregivers. The lesson is that insurance can solve who pays for care, but not who gives it.

Read more

• Human Capital: Education, Health and Demographic Dividend