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For millions of Americans, long-term care presents enormous financial, logistical and emotional challenges. Private long-term care insurance is prohibitively expensive or simply unavailable, and most older Americans aren't eligible for Medicaid until they exhaust nearly all their financial resources.

Medicaid covers long-term care for the neediest, mostly in institutional settings like nursing homes, and is the single largest payer for long-term care. In the absence of broad financial protection, the majority of families must fend for themselves.

Long-term care—defined as nonmedical assistance for senior citizens with functional impairments and for disabled younger people—is a widespread concern.

About one in five people turning 65 will need long-term care for five years or more sometime in their lives. One in seven will spend at least $100,000 of their own money on long-term care needs. The U.S. system is confusing, inefficient and offers an incomplete patchwork of coverage.

A new Brookings Institution report looks to Europe for a model of how to address this complex issue. "These countries have made real headway in providing their citizens with long-term care support," says one of the report's two authors, economist Richard Frank, senior fellow at the Brookings Center on Health Policy.

"By exploring what's been done on the other side of the Atlantic, and how well it's worked, we can learn valuable lessons that we can apply to our own situation in the U.S."

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