Strengthening the long-term care system is a global priority, and the Pan American Health Organization (PAHO) is one of many organizations around the world implementing strategic initiatives to realize this vital goal.

In a recent conversation with the Global Health Network, Dr. Patricia Morsch, a biomedical gerontologist, public health specialist and advisor at PAHO on topics such as healthy ageing, long-term care and age-friendly communities throughout the Americas, spoke on a range of subjects including the work of providing long-term care in different regions and how a life course approach could ultimately lead to a healthier older population.

Progress on the Decade of Healthy Ageing

Morsch provided context around the progress of the Decade of Healthy Ageing (2021-30) which was declared by the United Nations General Assembly in December 2020, following the World Health Organization (WHO) strategy on ageing and health (2016 to 2019).

“The Decade was a proposal [during] the World Health Assembly in 2020 to bring different perspectives based on what had been done, but also what needed to be strengthened in the following years,” said Morsch. “This brings different actors and agencies, not just WHO and PAHO; WHO leads this work, but as a regional office, PAHO supports implementation and monitoring within the different regions.” According to Morsch, PAHO’s work with member states includes taking action on everything related to a rights-based approach, as well as on combating ageism.

In May 2026, the Draft of Global Standards for Long-Term Care, part of the Decade of Healthy Aging initiative, was launched. “It is a framework for countries to strengthen their long-term care systems and it’s the big picture of different areas that we have to work on—for example, governance, financing, and workforce,” she said.

Comments on the draft will be accepted through 30 October 2026. “We expect different stakeholders to provide their comments on the various areas that we are proposing as standards, as well as [comment on] the indicator for quality long-term care proposed within each of the areas,” Morsch said. “Different sectors are leading long-term care—social protection, health, the government, the private sector. There are also different actors participating—family caregivers, people who receive care, and organizations that provide the services. Listening to all of them is very important to help shape long-term care in the different countries with different scenarios around the world. That is why the consultation is open until October—we want to hear from everybody and to have standards that would be feasible to achieve and implement.”

Strategic Planning

Long-term care strategic plans will look closely at care for older adults with Alzheimer’s and dementia, Parkinson’s disease and other neurological and/or mental health conditions; according to PAHO, “the prevalence of severe functional limitations is increasing” due to non-communicable diseases. “This is a very critical issue to consider because with the ageing population, we are also seeing a change in the epidemiological profile in the region,” Morsch said.

She continued, “When we talk about healthy ageing and adapting our systems to an ageing society, we have to enable our health systems for early identification of cognitive losses, identifying Alzheimer’s disease or other dementias. This type of care is still very specialized, so sometimes people lack access to these services, and it can take a long time to receive the support and care they need—one approach would center on early diagnosis and treatment.”

Different Approaches to Health Systems

With a focus on the future of long-term care, Morsch said, it’s also important to develop prevention strategies to allow people to live well and remain healthy for as long as possible.

“Considering healthier trajectories across the life course is critical. Understanding that the actions [we] take today could promote better cognitive health in the future,” said Morsch, adding that, in July, WHO released updated guidelines on reducing the risk of cognitive decline and dementia, indicating that 45% of risk could be prevented or delayed as the result of healthier lifelong habits.

Countries across the Americas are approaching health systems in different ways.

“Uruguay has had a care system since 2015, including services like caregiving, capacity building for family members and for professionals. They have the availability for professional care providers to offer home care, for a stipend,” she said. “On the other hand, we have countries like Chile and Brazil that just published their care policies maybe two years ago and are structuring their care system right now.”

Costa Rica has a very specific model with a focus on long-term care for older adults. “They created an evaluation [tool] and depending on the level of severity for the individual, they have different packages of long-term care,” said Morsch.

When asked how the Americas are building an ageing services workforce, Morsch said “that’s a great challenge that we have in the region,” adding roles for geriatricians often remain unfilled due to a lack of interest. “I think one approach could be increasing the visibility and benefits associated with these professions,” she said. “For that, it’s crucial we combat ageism overall in society as I think that hinders interest in working with older people.”

Changing the narrative around ageing so that working in the field would be seen as an opportunity is essential due to an ageing workforce, Morsch said. “It’s worth considering opportunities for a multi-generational workforce that can lead to a sharing of skills between the older people and the younger generations coming into the field, who may have new ideas and more technological approaches.”

Morsch values the connections made between PAHO and the Global Ageing Network. “Even though the regions of the world are unique in their needs, the infrastructures they have for health, health care, long-term care—a lot of the challenges are similar,” she said. “Building these opportunities of sharing and learning from others is very important in the global work we all do, considering the challenges we have today and the difficulties we are experiencing.”