Caribbean families absorb rising costs for aging parents

Households in the Caribbean are increasingly absorbing the financial burden of caring for elderly relatives because public systems lack the coordination and funding needed to meet demand. A joint policy brief released Wednesday by the Pan American Health Organization and the Inter-American Development Bank identifies this gap as a growing economic strain on working families.

The report projects that by 2050, approximately 306 million people in the Americas will be aged 60 or older. That figure represents more than one in four residents in the region. The brief states that current service models are too fragmented to handle this demographic shift without placing significant costs on private households.

Mary Lou Valdez, deputy director at PAHO, framed the issue as a market investment rather than a simple budget line. “Investing in long-term care is not simply an expenditure,” Valdez said. “It is an investment in healthier people, stronger families, and more resilient societies.” She noted that such investments can also help close access gaps and support the health workforce.

Despite growing political attention, formal public funding remains rare. Of the 35 Member States in the PAHO region, only 15 reported having a formal, publicly funded long-term care system. Additionally, only seven of the 27 countries surveyed reported legal recognition of informal caregivers and a statutory entitlement to support for them.

The economic weight of unpaid family labor is substantial. The brief estimates that the value of informal long-term care represents between 0.8% and 4.9% of annual gross domestic product. When health and social services operate independently, families often fill the resulting gaps by paying directly for services or providing unpaid care.

The report highlights Uruguay as a model for integrating these services. Established in 2015, the country’s National Integrated Care System brings together ministries, local governments, and civil society under a single governance structure. The system uses standardized assessments to determine eligibility, links public financing and co-payments to income, and mandates training and certification for care workers.

PAHO is promoting this integrated approach through its Regional Policy on Long-Term Care for 2025 to 2034. The policy aims to improve coordination and financing through primary health care and community-based services. PAHO and the IDB will discuss these strategies during a high-level dialogue on Oct. 29.