Newsletter 02
Summer 2025 - Issue 2

HIGHLIGHTS  |  Expanding the LeTs-Care outreach activities

In this Issue you will find insights on:

  • LeTs-Care at the Transforming Care Conference 2025. We share some reflections on the LeTs-Care researchers’ participation in the international conference held in Helsinki on 25-27 June 2025, with active contributions through paper presentations and the coordination of the Symposium “Talking about Rights in LTC: A Polysemic Pool of Terms and Ideas”, fostering dialogue across research perspectives.
  • Forthcoming Policy Lab in Brussels. Looking ahead to the launch of our first Policy Lab on 25 September 2025, a dedicated space for structured exchange with EU-level stakeholders and policy-makers in the field of long-term care.

CONNECTING KNOWLEDGE AND PRACTICE. REFLECTIONS ON LETS-CARE DISSEMINATION EFFORTS

If a project remains confined within its own boundaries – in terms of participation, circulation of knowledge and integration of external inputs and feedback – its capacity to generate meaningful change and act as a transformative force for its stakeholders is greatly affected.

We, as LeTs-Care partners, are well aware of this risk and are committed to making their findings visible and shareable and encouraging dialogue. We actively engage with stakeholders who are recognised experts and credible voices in the field.

Currently, our efforts are focused on two complementary lines of action: the academic dissemination, through participation in national and international events with an active role as contributors, and the policy-oriented dissemination, entailing exchanges with influential players in the LTC-related policy areas.

In this Summer Issue of our newsletter, we aim to take a closer look at these two strands. We reflect on recent activities and achievements and share our perspectives and intentions for future events and engagements.

BEYOND BUZZWORDS: EXPLORING THE MEANINGS OF LONG-TERM CARE

[Lisa Waldenburger, Bernhard Weicht, University of Innsbruck, Austria]

At the 2025 Transforming Care Conference in Helsinki, the theme “Social and Human Rights in Care” was addressed through keynotes, symposia and individual sessions that emphasised critical issues: the right to quality care, access to good care, assessing the quality of care or equal rights in care. While those transnational debates used similar terminology on LTC needs, quality or rights, one fundamental question often remained unasked: What do we actually mean by these concepts?

Terms such as “needs”, “quality” or “sustainability” are often treated as self-evident and universal. But are they? The LeTs-Care project challenges this assumption by investigating these concepts through the lens of “meanings”. This approach moves beyond just asking what the problems in long-term care are; it asks how they are framed, constructed, and understood in different national and institutional contexts. After all, what “quality care” means in one country may look very different in another, shaped by unique histories, political systems and cultural expectations.

Our research shows that these meanings are not fixed definitions but dynamic, context-dependent constructs. Different national policy texts use concepts like “care”, “needs” or “quality” in similar ways but their meanings are embedded in specific social and institutional frameworks. When we want to discuss care challenges in different societal contexts, we need to understand how those terms, concepts and ideas shape the way problems are identified, how policies are designed, and what solutions are considered possible. Additionally, through our policy reviews, interviews with stakeholders and a structured analysis of key LTC dimensions (i.e., Needs, Care and Quality of Care, Care Work and Quality of Care Work, Sustainability and Inequalities), the LeTs-Care project exposed a striking insight: there is often a mismatch between formal definitions of LTC and how stakeholders actually describe and frame care. By focusing on meanings, we move beyond technical fixes and static comparisons. This perspective reveals how LTC is shaped by historical legacies, institutional logics, and political negotiations. It also highlights the need for a shared vocabulary in national and international workshops to navigate these complexities. Ultimately, this approach offers a fresh foundation for more reflexive, context-sensitive policy development, that aligns with the EU Care Strategy while addressing the diverse realities of care across Europe.

REFLECTIONS FROM THE TRANSFORMING CARE CONFERENCE: INEQUALITIES IN LTC HIGH ON THE RESEARCH AGENDA, YET DIVERGENT IN MEANING

[Alexandra Lopes, University of Porto, Portugal]

At the recently held Transforming Care Conference, there was the opportunity to present findings from the LeTs-Care project on the varying meanings of inequalities in LTC. The topic of inequalities emerged as a central concern across the entire event, reflecting its growing importance in academic and policy discussions. In total, 25 presentations across six parallel sessions directly addressed issues of inequality in LTC, alongside two dedicated symposia. These were the ones where the term “inequality” was explicitly mentioned. Several others have addressed it in a more implicit manner. This strong presence signals not only the relevance but the urgency of tackling the topic.

Yet, the convergence on the theme of inequalities belies a striking diversity in how it is understood and approached. Presentations ranged from analyses of classic socioeconomic inequalities to examinations of gendered dimensions, labour market dynamics, and financial barriers to care. Some researchers focused on inequalities in access and outcomes, others on the ways systems themselves reproduce disparities. Most have approached inequalities as consequences of LTC system design or as barriers to access and quality, rather than exploring them from the perspective of equality as a guiding principle.

In the LeTs-Care presentation, we reflected on how meanings of inequalities in LTC are shaped by national contexts and the positionalities of different stakeholders. Drawing from ongoing work in the project, we argued that these meanings influence how LTC problems are identified and how policy reforms are framed. What counts as an “inequality”, who is seen as affected, and what responses are considered appropriate vary not only between countries but also among stakeholders, from policymakers and providers to researchers. Interestingly, this multiplicity of meanings was evident even among academic peers at the Transforming Care Conference. Scholars from different national traditions and disciplines framed the topic in diverse ways, echoing the project’s central claim that meanings are deeply contextual. Recognising and mapping these meanings is essential if we are to understand how LTC challenges are conceived, and how potential solutions are imagined and legitimised.

The conference underscored how vital it is for projects like LeTs-Care to move beyond shared terminology and uncover the nuances beneath. Only then can we begin to build bridges across contexts and move toward more inclusive, equitable, and context-sensitive LTC systems.

WHAT DO WE MEAN WHEN WE TALK ABOUT “LTC NEEDS”?

[Virginija Poškutė, ISM, Lithuania]

The demand for LTC services for older persons is increasing in all EU countries and, according to the European Commission, it is expected to further grow. There are many academic and policy level discussions on challenges in responding to current and future LTC needs.

But what do we mean by “needs” when we discuss about them?

LTC is a relative newcomer to the European social policy field. At the EU level the right to care was established for the first time within the European Pillar of Social Rights, which stated that “everyone has the right to affordable long-term care services of good quality, in particular homecare and community-based services”. The European Care Strategy (2022) further stressed the necessity to “ensure quality, affordable and accessible care services across the European Union and improve the situation for both care receivers and the people caring for them, professionally or informally”.

However, despite the acknowledgement of the right to care, the needs of older people for LTC services are not clearly defined in the EU documents. There is no single internationally accepted definition of what constitutes LTC needs of older people either. There is a general tendency to define the needs in terms of activities, tasks, services that need to be provided and only in rare occasions there is an attempt to identify the needs as such. Such a lack of consensus however is a commonplace in the broader context of LTC, as even long-term care itself is defined slightly differently in documents of international organisations.

Looking at the legal and policy documents in the LeTs-Care countries one realises that LTC needs are not defined in the same way, or to be more precise, they fail to define the needs explicitly.

Furthermore, different national LTC stakeholders mean different things or include different dimensions of needs when talking about LTC needs. For example, below are several quotes from the interviews with LTC stakeholders from LeTs-Care countries:

“[…] who is it that defines the need? So (…) it has for a long time been the Service law” (DK_7)

“Each person’s needs are unique. You can’t put that down to a formula” (DK_1)

 “Interventions required at specific critical moments, whenever they arise (they may be needed continuously or at specific times). […] specialised services directly related to the care of certain acute health and assistance situations. Then […] long-term care also involves a relational aspect. This means trying to maintain, for example, social connections, proximity, cultural, recreational, and other activities that greatly influence the well-being of the person and also their health status in a broader sense” (IT_5)

“There is a care that is directly linked to the issue of health, […], then there are also needs that are more human, personal” (IT_8) 

 “The boundary is always clear: there are social needs, there are socio-health needs, and there are health needs” (IT_9) 

“There are in fact many different needs here: health, yes, social, material and even a certain quality of lifestyle, even though they’re getting on in life. So, I think this is a huge challenge” (PT_1)

“They’re not just health, they’re social, they’re material, so it’s a continuum of needs that leads us to design an appropriate response to each person’s needs. It’s people who are at the centre of needs and at the centre of the system. […] We’re biopsychosocial, not just bio, aren’t we?” (PT_2).-

“In addition to socio-health support, in addition to home care, in addition to telecare, in addition to the basics that we all understand could be of interest to a person who needs care, we also understand it as everything that the person may need on a social level, on a convivial level, on a family level” (ES_1)

“We, older people, want to live as long as possible in our environment, at home, in our house, in our neighbourhood, surrounded by our loved ones, our neighbours, and that we can choose the care we each need at the time we need it” (ES_03)

 

As all the countries face similar challenges regarding LTC and implications to the social contract between generations, i.e. the increasing demand for the services and its impact on economy and labour markets, defining LTC needs is of utmost importance in developing sustainable LTC and ensuring access to services for those in need.

UNPACKING “QUALITY” IN CARE: BEYOND SIMPLE EQUATIONS

[Barbara Da Roit, Ca’ Foscari University of Venice, Italy; Siënna Hernandez and Sabya van Elswijk, University of Amsterdam, The Netherlands]

The interplay between the quality of care and the quality of care work is often assumed to be straightforward. Researchers, professionals, and policymakers frequently suggest these two aspects are inextricably linked. However, the past year of research by the LeTs-Care team challenges this very assumption, revealing a far more nuanced reality.

Defining “quality”

A primary challenge lies in the ambiguous definitions of “quality of care” and “quality of care work.” What constitutes “good care”? Is it defined by professionalism, specialization, integration, or perhaps the ability to provide care in a home setting, irrespective of who delivers it? Similarly, what makes for “good care work”? Does it entail safety, security, intellectual stimulation, fair compensation, or autonomy for caregivers?

Our evidence, gathered across seven diverse countries, indicates that the implicit meanings of these terms vary significantly, not only between countries but often within them. This inherent ambiguity makes any simple equation problematic from the outset.

A problematic equation

Beyond definitional complexities, the notion that “good care equals good care work” remains deeply problematic. Consider a highly professionalized caregiving workforce with advanced skills in addressing physical, cognitive, and psychological needs, coupled with opportunities for autonomous decision-making and flexible work arrangements. While this might effectively meet some needs of care receivers, such as safety, does it equally uphold their autonomy and self-determination?

Furthermore, if “good care” is fundamentally about adapting to the unique needs of each individual, can we truly expect extremely flexible schedules for care workers to be an inherent part of “good work”?

A political and policy process

There is no singular, technical, or straightforward solution to these complex issues. Both the definition of quality and the relationship between care and care work involve fundamental preferences, difficult choices, and significant consequences. The answers depend on what we collectively believe care receivers and providers need and deserve, and what priorities we choose to set.

Regrettably, robust public and policy discussions on these critical issues are often limited in many countries and further complicated at the EU level. Open and evidence-informed dialogue is crucial to navigate these complexities and make sense of “high-quality” care systems.

WHAT DOES IT MEAN TO HAVE “SUSTAINABLE LTC”?

[Roberta Perna, Spanish National Research Council (IPP-CSIC), Spain]

Since the 1990s, EU Member States have pursued reforms to make LTC systems more “sustainable”, also in response to rising international concerns. Yet, as highlighted by LeTs-Care’s presentation at the TTC, the meaning(s) of “sustainability” remain(s) ambiguous.

In some countries, the concept largely relates to the fiscal capacity to respond to LTC demands within structurally limited and fragmented public budgets. In others, it concerns how LTC systems are configured to stay responsive and efficient amid demographic and social changes. A third, cross-country meaning refers to the sustainability of LTC work: low wages, poor working conditions, and a lack of professional recognition make it difficult to recruit and retain care workers in the short and long-term.

These different meanings often coexist, but not without tension. Investing in quality care jobs is expected to make LTC work more sustainable, but also to raise costs, thus affecting the financial sustainability and affordability of LTC. Expanding home-based and community care may reduce institutional reliance and increase responsiveness to the demands of people in situation of dependency, yet it may also increase pressure on families and local systems, thus turning into a less sustainable system for carers.

If “sustainability in LTC” means different things to different actors, can it still offer clear guidance for reform? How should priorities be set between fiscal discipline, affordability, quality, and equity? Who should decide what “sustainable LTC” looks like?

THE LETS-CARE POLICY LAB SERIES

The first event, titled “CARE PROFESSIONS IN LONG-TERM CARE. DIMENSIONS AND CHALLENGES FOR POLICY AND PRACTICE” is scheduled for September 25th, 2025 in Brussels, from 9:00 to 13:00

The LeTs-Care Policy Labs are dedicated spaces for structured exchange with EU-level stakeholders and policy-makers in the field of long-term care.

These events are organised by REVES (the European Network of Regions and Cities for the Social Economy), with the support of all the LeTs-Care partners. They aim to promote the transfer of research findings to practice and policy, helping create connections, encourage reflection on research evidence, and foster mutual learning.

On 25 September 2025, in Brussels, starting at 9:00 until 13:00, the first LeTs-Care Policy Lab will bring together stakeholders from across the EU to reflect on one of the most pressing challenges in long-term care today: how to build and sustain a resilient care workforce. We will:

  • Present and validate the project’s preliminary results on the specific LTC policy and practice challenges through structured dialogue with policymakers, practitioners and civil society stakeholders.
  • Facilitate multi-level, cross-sectoral exchange to enrich project findings with diverse institutional, regional and grassroots perspectives.
  • Refine key challenges in the specific LTC area, deepening the understanding of systemic and practical challenges across formal and informal care domains and combining lived experience and expert knowledge to develop actionable insights and inputs for national/regional policy work.

The Policy Lab’s programme and further information are available on the LeTs-Care website. Please, click on this direct link: https://www.lets-care-hub.eu/project-events/

 

 

Onsite attendance is warmly encouraged! 

Arrangements for online participation will be set up, depending on requests.

 

The LeTs-Care dissemination appointments

Follow us in key conferences in Europe!

  • ESPANET Annual Conference 2025 | University of Milan (Italy), 27-29 August, 2025
    Participants from the LeTs-Care Consortium: Virginija Poškutė, Rūta Kazlauskaitė (ISM)
    Contribution: “Unpacking the Meaning of Long-Term Care Needs: A Cross-Country Comparison” (The presentation will be in the section: Care Configurations: Welfare reform to address contemporary care challenges)
  • Medical Anthropology Europe Conference | University of Vienna (Austria), 16-19 September, 2025
    Participants from the LeTs-Care Consortium: Kristine Krause, Jeannette Pols, Sabya van Elswijk (University of Amsterdam – UvA). The UvA team is hosting three panels
  • RC33 – 11th International Conference on Social Science Methodology  | University of Naples (Italy), 22-25 September, 2025
    Participants from the LeTs-Care Consortium:
    • Lisa Waldenburger, Bernhard Weicht (University of Innsbruck)
      Contribution: “Investigating Expertise: Navigating the Complexities of Analyzing Expert Interviews”
    • Pamela Pasian, Barbara Da Roit (Università di Venezia Ca’ Foscari)
      Contribution: “Sensing a nursing home. Reflections on emotions in a muti-sited ethnographic study of long-term care facilities”

 

Please, download the abstracts [CLICK HERE!]