All OECD countries offer some degree of formal LTC to assist people in need of care in their daily activities. Care is provided by LTC workers, who are defined as paid staff – typically nurses and personal carers – providing care and/or assistance to people limited in their daily activities at home or in institutions, excluding hospitals. The demand for LTC workers will keep rising in the years to come due to population ageing and changing patterns of informal care.
Despite this increasing demand, the average number of LTC workers remained stable at 5 per 100 people aged 65 and over between 2013 and 2023, among the 31 OECD countries for which data were available, ranging from a high of 13.0 in Norway to a low of 0.2 in Greece (Figure 10.18). Korea, Türkiye and Spain each saw an increase of more than 1 LTC worker per 100 people aged 65 and over from 2013 to 2023. Conversely, notable reductions in the number of LTC workers per 100 people aged 65 and over were observed in the United States, Denmark, Estonia and Belgium.
The LTC sector is constantly facing difficulties in attracting talent and meeting growing demand due to poor working conditions – including low wages, high physical and mental risks, non-standard employment contracts and low recognition (OECD, 2023[1]). Non-standard employment is common in the LTC sector (Figure 10.19). In 31 OECD countries that reported data, more than one in three LTC workers, on average, were in part-time employment, with significantly higher shares working in part-time arrangements in Australia (91%), the Netherlands (74%) and Korea (69%). Moreover, one in six LTC workers across 28 OECD countries worked on a fixed-term contract basis. This was particularly common in Australia and Portugal, as well as accession countries Bulgaria and Croatia, where again more than a third of the LTC workforce works under fixed-term contracts.
Amid labour shortages, the importance of migrant workers is rising in the LTC sector. Across 26 European OECD countries, the share of foreign-born LTC workers increased from 14% in 2014 to 21% in 2024 (Figure 10.20). Four out of ten LTC workers in Luxembourg, Sweden, Ireland and Switzerland were foreign-born, whereas very few workers were foreign-born in many Central and Eastern European countries. Moreover, the LTC workforce had a higher share of foreign-born workers than the overall workforce in two‑thirds of the countries – particularly among countries with a higher share of foreign-born workers.
Educational and training requirements are particularly low for personal care workers. For example, there is no qualification requirement for LTC workers in Greece, Iceland, the United Kingdom and the United States (Llena-Nozal, Barszczewski and Rauet-Tejeda, 2025[2]) A mismatch between education and skills needed – such as specific geriatric training, health monitoring and co‑ordinating care – can negatively affect the quality of care delivered. Beyond low salaries and employment instability, limited access to training and education and career prospects might lower the attractiveness of the LTC profession (OECD, 2020[3]).
