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The European voice for informal carers

Lithuania

LITHUANIA

Towards carer-friendly societies
Demographic background

Lithuania is one of the fastest-ageing EU Member States, and faces a rapid shrinking of its population.

Lithuania’s population has fallen by nearly 25% since the early 1990s. The country had a population of 2,971,900 inhabitants at the beginning of 2013, which dropped to 2,794,184 in 2019. This figure is decreasing every year, mainly due to emigration and low fertility rates. 

The percentage of the older population (65 and above) is growing and is projected to increase further. In 2018, the proportion of people aged 65+ amounted to 19.6%, against 13.9% in 2001. It is projected to reach 31.2% by 2060.

In the period 2013-2060, the share of people aged 80+ is expected to grow from 4.8% to 11.5% (EU-28: 5.1%-11.8%), with most of the growth happening before 2045.

Over the period 2013-2060, the old age dependency ratio – measured as the percentage of 65+ population in relation to the 20-64-year-old population – is expected to rise from 30% (EU-28: 29.9%) to 52% (EU-28: 55.3%).

Life expectancy in Lithuania remains lower than the EU average, despite having increased in the last years. In 2017, average life expectancy in Lithuania was 75.8 years (70.7 for males, 80.05 for females), compared to 80.9 years for the EU-28 (males -78.3, females – 83.5). Life expectancy at age 65 in 2017 was 17.4 years (males – 14.4; females – 19.4). The difference between men’s and women’s life expectancy in Lithuania is noticeably greater than the EU average.

Compared to most other EU countries, relatively few years of life after 65 of age are lived in good health. At age 65, the healthy life expectancy is around five and a half for Lithuanians, when it is around 10 years on average in the EU.

There are important regional differences in population ageing across the country. Not only is the rural population much older, but the younger age cohort in that context is considerably smaller due to external and internal migration. These circumstances indicate that there will be a rapid increase in demand for long-term care (LTC) in rural areas, combined with depleting informal care resources.

Current Long-term care provision

Overview and spending

Public expenditure on LTC services is low compared to other Member States.  Most of LTC in Lithuania is provided by informal carers: approximately 90% in 2016. This is due to deeply ingrained traditions of family care, the lack of capacity in the formal care sector and the high cost of private services.

According to the ‘State of LTC in Lithuania’ report by WHO Europe,  public expenditure on LTC in 2022 amounted to 1.1% of GDP. While this is the result of a steady increase after 2012, it remains below the EU average and is insufficient to meet estimated current and future demand. In 2016 a total of 52.3% of public LTC expenditure was financing home-based care, while 26.2% was for residential care, and the remaining 21.3% was spent in cash benefits.

Public funding covers 87% of total LTC expenditure meaning that around 13% of care costs are covered by care users and their families. Healthcare-related LTC services are financed entirely through Lithuania’ compulsory health insurance – the National Health Insurance Fund (NHIF) – while social care-related LTC services are subsidized through taxation and supported primarily by transfers from the national budget to complement locally collected taxes. While care services covered through the NHIF are not subject to co-payment, most social care services require out-of-pocket (OOP) payments, based on income (and assets for residential care) and are capped at 80% of the care user’s income. This unequal coverage of some services due to fragmentation in the source and mechanisms for financing LTC contributes to inequities and reduced access to care.

Under an assumption of no policy change, it is expected that public expenditure on LTC as a share of GDP would rise from 1% to 2% between 2016 and 2070, remaining below the EU average (EU-27: 1.6%-3.1%). The impact of a progressive shift from the informal to the formal sector of care in Lithuania would entail an estimated increase by 127% in the share of GDP devoted to public expenditure on LTC (128% on average for the EU27).

Long-term care system: how it works

There is no unified legislation on the provision of LTC, which is rolled out through various channels: social services, health care, invalidity, and sickness. The central government is responsible for programmes, strategies, as well as setting requirements and standards. Within the central government, the responsibility for LTC provision policies is divided between the Ministry of Social Security and Labour, responsible for social care, and the Ministry of Health, responsible for healthcare services. 

At the local level, municipalities prepare and implement municipal programmes aiming at social integration of disabled people, being responsible for the organisation of social services provision, the determination of local need for social services, the supervision of social services as well as the organisation and provision of primary health care (including nursing hospitals) and temporary respite services.

While standards and procedures are strictly divided between the health and social care systems, there is substantial overlap in target groups and service tasks, generating incentives for cost- and service-shifting between systems. The development of a legal framework harmonising standards and procedures across the two systems would allow local authorities to better provide integrated, person-centred LTC, attuned to individuals’ needs. It could further reduce costs and inefficiencies by eliminating duplication of work and optimising the use of resources and services across health and social care.

Analyses of the current situation point out to the need for a better integration of medical and social care through a renewed legal framework. The need for integrated social and health services will continue to grow as elderly people report having particularly low health status. The development of integrated home care services that combine social care and nursing services started only a few years ago, and few municipalities have such services. Mostly municipality social service centres provide home care services, and there are few private or non-governmental organisation services in this area. A deinstitutionalisation programme, launched in 2014, aims at moving people with disabilities and children from institutional care to home- and community-based care services. This programme is less advanced concerning people with mental health issues. 

At EU level, improving equal access to affordable and good quality healthcare and LTC is considered as an objective guiding on Cohesion Policy Funding. As of 2025, the Recovery and Resilience Fund has allocated 11 million to Lithuania for supporting LTC. The Lithuanian plan includes a reform to improve the accessibility of integrated social and healthcare services by developing and gradually implementing a sustainable LTC model. This includes an action plan for training, re-skilling and upskilling of LTC professionals and a plan for ensuring the necessary infrastructure for the provision of services at the level of municipality and region. This reform is supported by the adoption of the LTC model and the increase of human resources and infrastructure capacity for the provision of services.

Access to long-term care

The proportion of people aged 65+ receiving long-term institutional care has remained close to 1% in recent years. LTC residential services are increasingly provided by non-governmental organisations, within the framework of public tenders. The current system is not able to meet all needs. In 2014, 47% of elderly people in need of LTC were on the waiting list.

On the contrary, the share of the population aged 65+ receiving help at home has been increasing: according to national statistics on LTC for 2018 about 19,880 received social services at home. Many of the home-based services in Lithuania are provided by municipal public services, although private providers have also started delivering such services.

Carer-friendly policy environment

Recognition and definition of carers

There is neither official definition, recognition, nor specific public support for informal carers as such in Lithuania. Caring seems historically considered as a duty towards one’s parents, enshrined in the law. The Constitution of the Republic of Lithuania (1992) states that ‘the duty of children should be to respect their parents, to care for them in their old age’. Although there is a constitutional obligation, in practice this is not legally enforced.

Despite a high reliance on care provided informally in Lithuania (in 2016, 90% of LTC was provided by informal carers), reliable data are lacking on the number, demographic profile and support needs of informal carers. Survey data from 2016 place the prevalence of informal care at over 8% and estimate that more than one in three informal carers dedicate over 21 hours per week to informal care tasks, while half of informal carers provide care four or more days a week (2022). Less than 40% of carers can rely on the support of family and friends to share care responsibilities. In the absence of systematic data collection, small-scale research on informal carers’ experiences points to a high prevalence of caregiver burden and unmet support needs. Strengthening national data collection on informal care can better inform measures needed for the support and prevention of negative health and well-being outcomes among carers.

Overall, women are more likely to be informal carers: 10.4% are providing care several times a week in contrast with 5.6% of men. In 2018, 25.8% of inactive women in Lithuania were not actively seeking a job due to caring responsibilities (including for children), as compared with only 7.5% of men.

An important fact to highlight is that 47% of people currently aged 50-65 reported having children who live abroad. This poses some specific challenges for the provision of LTC in the future. On the whole, it will be more difficult to take care of older generations in Lithuania.

Cash benefits for dependent persons

Currently, there are no specific provisions aimed at informal carers. However, there exist different types of cash benefits paid directly to the ‘dependent person’ (i.e. people with disabilities, people in old age). The benefit recipient is able to choose whether to use the money for public or private LTC providers, and it seems that these benefits are also used to financially support informal carers, albeit indirectly. Cash-benefits granted to the person in need of care can amount to 75% of the minimum wage and therefore provide an additional source of income for the household, including informal carers.

Until recently, there used to be two types of special ‘compensation’, the ‘compensation for care’ and the ‘compensation for attendance’, the level of which depended upon the intensity of the need for care. As of 1 January 2024, the target compensation for individual assistance expenditure – with four decreasing needs intensity levels – consolidates previous benefits into a unitary framework, as described below:

  • Level I: for people who, due to a long-term or irreversible impairment, develop a disability rendering them unable to orient or move independently and are therefore dependent on permanent support or care from another person. This entitles beneficiaries to an amount equal to 2.6 times the target compensation base (equivalent to €429 in 2024). 
  • Level II: for people who develop a disability due to a long-term or irreversible impairment, leading to severe difficulty in orientation or movement, and therefore are in need of support or care from another person for 6 to 10 hours a day. This entitles beneficiaries to an amount equal to 1.9 times the target compensation base (equivalent to €314 in 2024). 
  • Level III: for people who develop a disability due to a long-term or irreversible impairment, leading to moderate difficulties in independence and participation in social life, and therefore are in need of support or care from another person for 4to 6 hours a day. This entitles beneficiaries to an amount equal to 1.1 times the target compensation base (equivalent to €182 in 2024). 
  • Level IV: for people who develop a disability due to a long-term or irreversible impairment, leading to minor difficulties in independence and participation in social life, and therefore are in need  of support and care from another person for no more than four hours a day. This entitles beneficiaries to an amount equal to 0.6 times the target compensation base (equivalent to €99 in 2024).

An additional ‘Social Care Benefit’ can be paid in lieu of home-help services if the home-help agency opts for this and if the client agrees. The amount of the payment is related to the cost of the home help, and is different for each person, depending on the need for services. The mechanisms for accessing this benefit have not been sufficiently developed; therefore it is rarely used.

Cash benefits are based strictly on need, whereas coverage by in-kind benefits is additionally dependent on (family) income and assets.

Social inclusion of carers, access to education and employment

Under the Health Insurance Act 1996, carers have health insurance if they provide care to someone with a high care need that has been recognised by the court.

Public help (cash benefits or services) for families who take care of disabled and elderly family members remains negligible in Lithuania. There are no specific benefits for informal carers.

Home care is in most cases only provided to dependent people living alone, and not when he/ she is living with family members.

However, cash-benefits granted to the person in need of care can amount to 75 % of the minimum wage and therefore provide an additional source of income for the household, including informal carers.

Access to respite care

The only service specifically designed for people who care for their relatives is respite care, established in 2007.

Temporary respite services are provided to informal carers, caring for the person who has been assessed as needing compensation for the cost of providing individual assistance.

During informal carer’s temporary respite, the following social services can be chosen:

  • services can be provided in the home of the cared-for person, providing daily care, which includes: organising meals, assisting with meals or personal feeding, assisting with washing, daily personal hygiene, assisting with dressing, assisting with household chores or housework, organising health care, and accompanying the cared-for person to various institutions, socialising, organising leisure activities, other assistance related to the daily care and routine of the cared-for person, taking into account his/her independence and needs;
  • services can be provided in a temporary respite facility with daily care, which includes: accommodation, provision of meals, assistance with meals or personal meals, assistance with washing, daily personal hygiene, assistance with dressing, organising and/or providing health care services, communication, organising leisure activities, organising education (for persons with disabilities up to 21 years of age), other assistance related to the daily care and routine of the cared-for person;
  • comprehensive family services (individual and group counselling, self-help groups, family counselling in a person’s home, etc.); and
  • psychological support.

The duration is determined in accordance with the need, but the total duration may not exceed 720 hours per year.

Social inclusion of carers, access to education and employment

Under the Health Insurance Act 1996, carers have access to health insurance coverage if they provide care to someone with a high care need that has been recognised by a court.

Social protection measures for informal carers were strengthened in 2022 by introducing pension and unemployment coverage for individuals providing care to people defined as requiring permanent care.

Training opportunities for informal carers and initiatives to improve access to information remain sporadic. Psychological support and access to information through municipalities are in principle available but capacity is severely limited. In addition, existing services are disjointed, placing a further burden on potential beneficiaries to identify and access them. Some small-scale initiatives, relying on European funding, are aimed at improving access to training and providing a comprehensive package of services, including psychological and emotional support. However, these remain to be scaled at national level.

Work-Life Balance

The Code of Labour establishes support for working carers, such as flexible working time, part-time work and leave for employees with disabled children.

While the standard minimum annual leave (paid) is 28 calendar days in Lithuania, single parents with a disabled child aged under 18 qualify for a minimum leave of 35 calendar days (paid). On request, up to 30 calendar days of unpaid leave are available to employees with a disabled child aged under 18. An employee may request unpaid leave to take care of a sick family member, the duration to be recommended by a health institution.

Employees with a child aged under 18 with disabilities are given an extra resting day each month (or have their weekly working time shortened by two hours) while continuing to be paid their average wage.

Work-Life Balance

The Code of Labour provides for some support for working carers, such as flexible working time, part-time work and leave for employees bringing up disabled children.

These include several special provisions for employees raising disabled children. While the standard minimum annual leave is 28 calendar days in Lithuania, single parents bringing up a disabled child aged under 18 qualify for a minimum of 35 calendar days. On request, up to 30 calendar days of unpaid leave are available to employees bringing up a disabled child aged under 18. An employee may request unpaid leave to take care of a sick family member, the duration to be recommended by a health institution.

Employees raising a child aged under 18 with disabilities are given an extra resting day each month (or have their weekly working time shortened by two hours) while continuing to be paid their average wage.

Single parents raising a disabled child under 16 years of age may be assigned to work on rest days only with their consent. A single parent raising a disabled child aged under 18 or an employee nursing a sick family member may ask to have their part-time daily working time or part-time weekly working time set in line with the recommendation of a healthcare institution. Single parents bringing up a disabled child aged under 18 may be assigned to do overtime or to work at night or be “on call” at the enterprise or at home only with their consent.

References

Last Updated on February 12, 2026

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