Long-term care (LTC) systems all over the world rely heavily on provision of care by unpaid carers, mostly family members without specific training in this field. In several developed countries, the share of informal care provided to the elderly is estimated to amount to about three quarters of all long-term care provided, thus forming one of the most important building blocks of national care systems. Several international developments, however, raise concerns if and how this most important type of care provision will be able to retain its role.

Carriers providing long -term care (LTC) insurance have historically invested significant resources in risk management activities designed to ensure that policies are properly priced and that premiums can remain relatively stable for consumers. An important focus of such risk management activities has been the medical underwriting process and more specifically dementia screening. Dementia-related claims continue to present the single largest claim liability to LTC carriers.