Access to affordable long-term care remains a persistent challenge. On top of the physical, emotional and financial cost of informal caring provided in the home and in the community, the rising costs of institutional care and professional services often exceed what families can afford. In the United States, the cost of nursing home care can surpass $100,000 per year, while similar trends are evident in other high-income countries.72 Natural supply-and-demand dynamics will likely push costs higher around the world, as the supply of care workers reduces and demand for long- term care increases. Meanwhile, low- and middle- income countries often lack robust long-term care infrastructure, leaving many to depend on informal family care networks.73 This gap highlights a global need for equitable and accessible care solutions to alleviate both financial strain and emotional stress. Lack of support exacerbates challenges for carers. Despite the critical role of carers, many lack access to essential resources such as respite care, carer training, childcare assistance or mental health support. These gaps lead to carer burnout and negatively affect the health of both carers and care recipients. The absence of accessible support also perpetuates inequalities, with women disproportionately bearing the burden of unpaid care responsibilities. Additionally, the absence of age-friendly (or disability-friendly) environments can hinder the ability of older adults to live independently, increasing their reliance on carers. By promoting age-friendly communities that enhance accessibility and social engagement, the demand for external support can be reduced and the overall carer experience improved. Policy gaps leave many carers without adequate financial and systemic support. Globally, policies often fail to recognize or support the economic contributions of informal carers, who provide the majority of care. Programmes such as Japan’s Long-Term Care Insurance System and Germany’s Care Allowance Programme offer valuable lessons in integrating public funding and carer compensation, but such systems remain the exception rather than the norm. Policy-makers must address the financial, physical and emotional costs of providing care through comprehensive reforms that include incentives, subsidies, childcare support and workplace protections for carers. Informal carers around the world FIGURE 8 Spain 7,000,000 carersUK 13,600,000 carers Germany 4,927,000 carersFinland 350,000 carers Ireland 500,000 carersDenmark 750,000 carersCanada 7,800,000 carers France 8,300,000 carers Japan 6,280,000 carers Taiwan, China 1,400,000 carers Australia 2,650,000 carersUSA 56,400,000 carersIndia 138,328,000 carers Italy 7,500,000 carers Israel 1,214,000 carers New Zealand 430,000 carersSweden 1,300,000 carers Hong Kong SAR, China 376,000 carers Source: International Alliance of Carer Organizations. (2021). Global state of caring. https://internationalcarers.org/wp-content/uploads/2021/07/IACO-Global- State-of-Caring-July-13.pdf Future-Proofing the Longevity Economy: Innovations and Key Trends 33

Future Proofing the Longevity Economy 2025