On the road to accessible, affordable, high-quality long-term care? The emergence and framing of elder care policy in the European Union

Demographic aging has been recognised as a global challenge decades ago, with International Organisations (IOs) such as the European Union (EU) and the United Nations (UN) playing an important discursive role. Yet, it seems that the issue of long-term care (LTC), which is predominantly a social risk affecting older persons, has largely been overshadowed by other discussions, e.g. on pensions and labour markets. While the last years have seen a surge in the topic of (elder) care in the EU – for instance with the European Care Strategy and the Council Recommendation on LTC – little is known about the earlier supranational discourses and proposals which have led up to recent policies. When did LTC for the elderly first become a policy issue in the EU? Which ideas where promulgated and how did they evolve over time? How does the European debate relate to global discourses and ideas on LTC? The present article examines these questions by analysing EU and UN policy documents (up to 2005). First, we construct timelines of major documents and events for each IO, starting with the earliest appearance (1950s and 1980s, respectively). Interestingly, LTC appears in different parallel domains such as policies for older persons, social protection, or women’s rights. Second, we qualitatively code the content of the documents, identifying problems, values, responsibilities, LTC services and target groups. We trace and compare, for instance, the role of social vs. economic challenges associated with LTC and the responsibility attached to different actors such as states, markets, and families. The analysis sheds light on the (dis)continuity of ideas used in EU LTC policy today such as the principle of "accessible, affordable and high-quality" LTC. With the focus on LTC, the article aims to contribute a hardly researched, but increasingly important, puzzle piece of "Social Europe".