ABSTRACT
Just two decades ago, Portugal was as poor in LTC infrastructures as some of the new member states are now. In a relatively short period of time, it managed to implement a national system of social care services that displays coverage rates close to the European Union average, although remaining as one of the least generous countries in the EU in what concerns the percentage of GDP allocated to elderly care and one of the countries with the lowest number of formal LTC workers. In its effort to build up supplies of home and residential services, Portugal has pursued its own preferred path of policy development. One could broadly describe that as a path of mixed LTC, with flexible residential care flanking home care services, and oriented toward the quasi-privatization of services provided by a powerful nonprofit sector that is financially supported by the state. Recent reforms have introduced a dual approach to LTC. Traditionally, LTC was confined to provision of help for activities of daily living without any component of health care. This is why for many years the LTC system has been designated as social care system. In the middle of the first decade of the new millennium, a new system was implemented that integrated health and social care. Set up as a network of services providing continuous care between hospital care and community-based care, it did not replace the existing social care sector and rather introduced a new branch that operates as a parallel system.
