We're all going to live longer. But what are the real implications of that for demand for long term care? The latest edition of Eurohealth suggests demand wlll soar. We summarise the arguments.

The number of 65 year olds in the UK is set to rise 49% to 13.7m between 2010 and 2030. But forecasts suggest that the number of elderly disabled will rise 89% to 1.9m. That is because more of them will be older, and the older you are, the more co-morbidities you have.

The hope is that as healthcare improves, so diseases will become less disabling.  But even if you assume that arthritis, stroke, CHD and mild dementia decrease by 2% every two years after 2012 and that there is a 10% decrease in their disabling consequences, that moderate/severe dementia decreases by 2% every two years from 2016, that there is a 5% reduction in mortality from stroke, CHD and mild dementia from 2016 and a 5% reduction in disability for 65-66 year olds every two years the numbers are still pretty bad. The optimistic extrapolation suggests there will still be 1.74m elderly disabled by 2030. Assume, pessimistically that all these factors get worse rather than better and it soars to 2.05m.

That is a lot of people to look after, particularly given other shifts in demographics. Those who are single need much more long-term care than those who are married and, by 2030, and even more by 2050, the number of elderly singles is set to rise dramatically (already a third of middle aged people in Europe live alone). Perhaps the most shocking statistic is that, whilst there were 26 people in the productive cohort of 15-79 for every 80+ year old in 2000, there will be less than 8 per 80+ year oid by 2050.

There was little comfort in a long term Fnnish study of nearly 400,000. This highlighted that whereas proximity to death determines acute care costs - IE you use over a third of your total acute care costs in the last six months of your life - it is age that determines your long term care needs. US studies show that the acute care costs of someone who dies at 73 and someone who dies at 93 are almost the same (the older you are the less they spend on saving your life in hospital anyway). But the 93 year old will cost a great deal more in long-term care. When you get to over 80s the number of days the cohort spends in long term care per annum exceeds the number of days it spends in hospital.

There isn't a great deal that can be done about all this, apart from introducing better and more equitable social insurance, try to give carers a higher status and encourage family carers to do more. This latter has worked well in Sweden, where a good support network has been found to save the state an average of over EUR10,000 a year.

Meanwhile, an article on telehealth and telecare in the UK is positively downbeat. It points to huge problems in getting acute care and social care services to work together.

Predictably, enough none of this stuff as much as mentions how policymakers will handle the growth of the with profit care sector or the policy implications of this.