In OECD countries, life expectancy at age 65 has increased significantly for both men and women during the past 50 years. Some of the factors explaining the gains in life expectancy at age 65 include advances in medical care combined with greater access to health care, healthier lifestyles and improved living conditions before and after people reach age 65.

Most OECD countries conduct regular health surveys which allow respondents to report on different aspects of their health. A question that is often found among such surveys relates to self-perceived health status, and is usually similar to: “How is your health in general?”. Although these questions are subjective, indicators of perceived general health have been found to be a good predictor of people’s future health care use and mortality (see Miilunpalo et al., 1997). However, cross-country differences in perceived health status may be difficult to interpret. This is because survey questions may differ slightly, and cultural factors can affect responses.

Dementia describes a variety of brain disorders which progressively lead to brain damage, and cause a gradual deterioration of the individual’s functional capacity and social relations. Alzheimer’s disease is the most common form of dementia, representing about 60% to 80% of cases. Currently, there is no treatment that can halt dementia, but pharmaceutical drugs and other interventions can slow the progression of the disease.

The number of people receiving long-term care (LTC) in OECD countries is rising, mainly due to population ageing and the growing number of elderly dependent persons, as well as the development of new programmes and services in several countries. In response to most people’s preference to receive LTC services at home, an important trend in many OECD countries over the past decade has been the implementation of different types of programmes to support home-based care.

Informal carers are the backbone of long-term care systems in all OECD countries, although there are substantial variations across countries on the relative importance of informal care giving by family members compared with the use of more formal long-term care providers. Because of the informal nature of care provided by family members, it is not easy to get comparable data on the number of informal carers across countries, nor on the amount of time that they devote to care giving. The data presented in this section come from national or international health surveys, and refer to people aged 50 years and over who report providing care and assistance to a family member for activities of daily living (ADL).

The number of beds in long-term care (LTC) institutions and in LTC departments in hospitals provides a measure of the resources available for delivering LTC services to individuals outside of their home. Long-term care institutions refer to nursing and residential care facilities which provide accommodation and long-term care as a package. They include specially designed institutions or hospitallike settings where the predominant service component is long-term care for people with moderate to severe functional restrictions.

Long-term care (LTC) expenditure has risen over the past few decades in most OECD countries and is expected to rise further in the coming years due mainly to population ageing and a growing number of people requiring health and social services on an ongoing basis. LTC cuts across the domains of both health and social care. The component of LTC that is considered under the health boundary for international comparisons comprises continuous episodes of care with a dominant characteristic related to medical or personal care (i.e. support for basic activities of daily living such as eating, dressing and washing). In contrast, spending on LTC services or programmes associated with helping people with disabilities to live as independently as possible (i.e. support for residential services or help with instrumental activities of dailing living, such as preparing meals or managing personal finances) are considered outside the scope of medical or personal care and represent the social component of LTC spending.