Long-term care providers: The roles, rights, and needs of paid and unpaid caregivers. Policy brief 2

Long-term care (LTC) refers to a wide range of personal, health-related, and social support activities provided to individuals experiencing significant declines in intrinsic capacity, enabling them to maintain functional ability and live with dignity. In the Americas, LTC is primarily delivered by paid and unpaid caregivers – most of whom are women – under conditions that are often invisible, undervalued, and unsupported. Unpaid caregivers, who represent around 80% of all those providing care, continue to be largely unrecognized, untrained, and without adequate support. 

Paid caregivers also work under difficult conditions. The majority earn minimum wage or less and lack access to social protection and professional development. Training is limited or absent in most countries, and the absence of certification pathways hinders improvements in care quality and worker retention. In 2020, the Region of the Americas faced a shortage of nearly 5 million care workers to meet the needs of older people with severe functional decline, even before considering the contributions of unpaid labor. 

Investing in the recognition, training, and support of caregivers is essential to ensure the delivery of equitable, person-centered, and rights-based care. Expanding formal provision helps improve care quality, stabilize the workforce, and prevent avoidable hospitalizations, while also reducing the excessive burden carried by women. 

Developed by the Pan American Health Organization and the International Labour Organization, this technical brief highlights the urgent need to support LTC providers. It calls for coordinated, multisectoral action to professionalize care work, ensure fair working conditions, and strengthen formal care provision throughout the Region, at the same time that unpaid care is valued and supported.