Among industrialized countries, Canada and Sweden have well-developed (although imperfect) systems of long-term care. The USA is unique in that its long-term health care system does not protect the el¬derly against either chronic disability or impoverishment. The phenom¬enon of spending down to become eligible for government-paid long-term care is found only in the USA.
TABLE 106-3 lists the long-term care options available in various de¬veloped countries. Very few formal arrangements for long-term care exist in less developed countries. TABLE 106^ depicts variations among the rates of long-term institutionalization in several countries. The percentage of elderly needing institutional care varies from < 2% in Hungary to almost 11% in the Netherlands.
Use of nonmedical facilities (eg, a home for the aged or sheltered housing) also varies significantly. In European countries, commitment to provide nonmedical residential care and coordinated community ser¬vices contrasts greatly to what is available in much of the USA. Despite cultural and other similarities between the USA and Canada, the two