(source: https://www.pexels.com/photo/joyful-adult-daughter-greeting-happy-surprised-senior-mother-in-garden-3768131/ )

It is predicted that, by 2050, the largest share of Europeans will be aged between 60 and 64, which could put a strain on the current mainframe of elderly care homes [1]. By 2030, the bed stock of European nursing homes will become insufficient. The most notable lack of nursing home beds is estimated to be 320 thousand beds in Germany and 250 thousand beds in Belgium. Although European residential care will have to address these issues, to this day, elderly care in Europe relies heavily on informal care [1].

Depending on the country, nursing or care homes conditions may vary. According to the National Healthcare System of the UK, their nursing homes provide accommodation, personal care (hygiene, dressing, medication compliance, toilet facilities, and even activities, such as day trips). Additionally, there will always be 1 or more qualified nurses on duty to provide nursing care. Some nursing homes offer services for people that may need more care and support. For example, people with a complex medical condition that needs help from a specialised nurse – such as someone who is fed through a tube, or someone suffering from dementia [2].

The same institution made the argument that a person with dementia requires care and support directly proportional to the severity of its symptoms. Thus, moving the patient to a care home could better address their needs, offering around-the-clock support from professional staff, a safe environment and social interaction with other residents. This represents a traditional solution to informal caregiving by family members [3].

Regarding the main obstacle in accessing care homes (i.e. their costs), a country-specific analysis is required, as prices vary deeply between states. To expand, Romania’s nursing homes cost an average of 5100 RON (~1025 euro) per month [4], while in Spain, they are between €2500 and €3000 [5]. A similar position is occupied by Germany, averaging €2783 per month [6], which is exceeded by the prices in the UK, estimated at around £800 per week (~€3800/month) [2].

As mentioned above, patients with dementia usually require more care than other seniors, the cost of which increases substantially. An example of successful solutions for dementia patients is the Hogeweyk Dementia Village, located in the Netherlands, the first of its kind globally. The village has a unique concept: the deinstitutionalization of care by the emancipation and inclusion in society of people suffering from dementia. The 152 residents of the village of Hogeweyk live as normally as possible and benefit from specialised medical care; facilities such as a supermarket, restaurant, cafe and cinema; but also the company of other people with similar afflictions [7]. The village, whose inhabitants all occupy private rooms, has operated at full or near-full capacity since it opened in 2009. The cost of care is nearly $8,000 (~€7400) a month, but the Dutch government subsidies residents to varying degrees [8].

At the other end of the spectrum, the ‘Horror Asylums’ of Romania captured the public’s attention in July 2023, when 3 nursing homes situated near the capital were deemed unfit to offer care to elderly people with disabilities. The National Authority for the Protection of the Rights of People with Disabilities concluded that the aforementioned facilities performed heinous illicit activities, by defying minimal wellbeing standards. Among others, they reported deficits regarding housing (elderly people were kept in extremely precarious conditions), feeding (patients suffered from starvation), bodily autonomy (seniors were held captive against their will), which were accompanied by physical abuse (beatings as a form of coercion), and financial abuse (the patients' funds were held by their caregivers) [9].

Given the reasons presented above (lack of financial resources, limited number of beds in care facilities, inhumane conditions), the EU needs alternatives for traditional ways of elderly care. This represents the scope of the CAREPATH Project, which will be achieved by developing a personalised health and home monitoring system for seniors suffering from dementia and multimorbidities. The system will empower seniors to lead more autonomous and full lives, by providing continuous health assistance and a holistic approach that connects the patient to their informal caregiver and a team of medical professionals catering to their individual needs.