Austria’s Long-Term Care System: Structure, Funding and the Role of the Pflegegeld

An older person in Austria may receive a nationally defined long-term care allowance while relying on services whose availability, price, organisation and delivery are shaped much more locally. A family may use the allowance to help sustain care at home, arrange mobile support through provincial or municipal systems, purchase private help, combine formal services with unpaid family care or, where needs become intensive, consider residential care or a 24-hour live-in arrangement. The financial entitlement is national; the practical care system around it is not.

This distinction is fundamental to understanding Austria’s long-term care model. The country does not operate a single unified long-term care service. Instead, federal entitlements, provincial responsibilities, municipal delivery arrangements, social assistance, health services, household expenditure, family caregiving and a mixed provider market interact around the individual. The Austria Ageing, Long-Term Care & Community Support Knowledge Hub examines how these different parts of the system connect, where they create flexibility and where fragmentation can emerge.

The central policy challenge is therefore not simply whether Austria spends enough on care or whether enough services exist. It is whether a person’s assessed need, financial entitlement, family circumstances, location, workforce availability and access to health and social support can be translated into a coherent and sustainable package of care. As population ageing accelerates, that operational question becomes more important than the formal architecture alone.

A federal entitlement inside a decentralised care system

Austria’s long-term care architecture reflects the country’s federal structure. The federal level establishes important national entitlements and legislative frameworks, while the nine Bundesländer — the federal provinces — hold substantial responsibility for the organisation and financing of formal long-term care services. Municipalities also play important roles in local provision, funding and coordination, although arrangements vary considerably between provinces.

The result is a system with two different forms of universality. Pflegegeld, the federal long-term care allowance, creates a nationally structured cash entitlement based primarily on assessed care need. Formal services, however, are delivered through decentralised systems in which eligibility processes, charging structures, provider availability and service design can differ geographically.

That difference matters operationally. A person may qualify for the same Pflegegeld level whether they live in Vienna, Tyrol or Styria, but their realistic options for mobile care, day support, short-term care, residential provision or alternative housing may not be identical. Geography therefore influences how far the national entitlement translates into practical choice.

This is one reason Austria offers a useful case study in quality, safety and governance in ageing well services. National eligibility can create consistency around one part of the system while local service structures continue to determine the person’s lived experience.

Pflegegeld is a contribution, not a complete care budget

Pflegegeld sits at the centre of Austria’s long-term care model. Established under the Bundespflegegeldgesetz, the Federal Long-Term Care Allowance Act, it is intended to contribute towards the additional costs associated with care needs and to increase the ability of people requiring support to organise care in ways that fit their circumstances.

It is important not to interpret Pflegegeld as full reimbursement for the actual cost of care. It is a flat-rate contribution linked to the intensity of assessed care need. In many cases the actual cost of care exceeds the allowance, which means the remaining burden is absorbed through public service funding, social assistance, pensions and other income, private expenditure, family care or a combination of these.

The allowance is organised into seven levels. Entry requires a continuing need for care and assistance above the statutory threshold, with higher levels reflecting increasing intensity and complexity. Assessment considers the estimated monthly time required for recognised care and support activities, while the highest levels also take account of circumstances requiring exceptional, unpredictable or continuous care.

The allowance therefore performs several functions simultaneously. It recognises care dependency, provides financial support, gives households some purchasing power and helps sustain care outside institutions. But it does not itself guarantee that an appropriate service is available, affordable or reachable in the person’s locality.

This distinction between entitlement and capacity is central to long-term care policy internationally. Cash benefits can strengthen autonomy, but only when there is a functioning care infrastructure around them. Where formal services are scarce, a cash entitlement may increase choice only in theory. Where services are available but unaffordable beyond the allowance, households still need to bridge the gap. Where family care fills the difference, the system can appear financially sustainable while transferring substantial workload into unpaid care.

Assessment creates a national gateway into the allowance

Pflegegeld assessment is based on the person’s need for care rather than their income. The process can involve assessment by a doctor or a qualified nursing professional and considers the support required with activities such as personal care, dressing, food preparation, mobility, medication-related assistance, shopping and household tasks.

The assessor’s view of the amount of care required informs the decision, but the formal determination of the Pflegegeld level sits with the responsible social insurance institution or, where contested, may ultimately be reviewed through legal processes.

This creates an important governance distinction. Clinical or nursing assessment supplies evidence, but entitlement is an administrative and legal decision. Strong systems therefore depend on consistency across assessment, documentation, decision-making and review.

For individuals and families, the quality of the assessment process matters greatly because the resulting level affects the resources available to organise support. If needs change, reassessment becomes important. If formal service providers or family carers are already involved, their records may help demonstrate what care is actually required over time.

Organisations examining similar questions of evidence quality can use the Quality Dashboard Builder to structure measures around assessment timeliness, changing needs, service access and outcome trends. It is not an Austrian regulatory tool, but the underlying principle is relevant: entitlement systems work best when individual decisions can also be understood through population-level evidence.

The provinces shape the practical service offer

While Pflegegeld provides a national cash entitlement, much of formal long-term care provision sits within provincial and municipal structures. Austria’s long-term care service statistics cover several categories of publicly supported provision, including mobile services, support with daily living, day services, residential care, short-term residential care, alternative housing arrangements and case or care management.

This decentralisation allows services to reflect local geography, demography and infrastructure. It also creates variation. Provinces differ in population density, rurality, provider markets, staffing conditions, historic service models and fiscal choices. Vienna’s service environment is different from that of sparsely populated Alpine areas, and a national policy framework cannot remove those operational differences.

For system leaders, the governance challenge is not simply to eliminate variation. Some variation is appropriate because communities are different. The stronger test is whether variation reflects legitimate local adaptation or whether it produces unjustified differences in access, waiting time, cost, continuity or outcome.

A mature assurance system therefore needs to ask:

• whether people with comparable needs can access an appropriate service within a reasonable period;
• whether home and community services are available at sufficient intensity to prevent avoidable escalation;
• whether residential capacity matches projected local demand;
• whether rural areas face persistent workforce or travel disadvantages;
• and whether local funding arrangements create barriers that are not visible within national entitlement data.

This is where quality data, performance measures and service intelligence become more important than headline expenditure alone. A system can increase spending while still leaving unresolved gaps in access or continuity.

Home and community care sits at the centre of ageing at home

Austrian long-term care policy, like many European systems, operates within a strong preference for supporting people to remain in their own homes where this is safe, sustainable and consistent with their wishes. Mobile services can include nursing, personal support, household assistance and related community-based provision, with the precise structure varying between provinces.

The attractiveness of home-based care is clear. People can retain familiar surroundings, relationships, routines and community connections. Residential capacity is also finite and comparatively expensive. But ageing at home only works when the support around the person is strong enough.

A cash benefit cannot by itself compensate for unavailable workers, excessive travel distances, limited evening provision or inadequate specialist input. Nor can a short home-care visit automatically replace the supervision and support provided by a family member for the remaining hours of the day.

This creates a recurring tension between policy aspiration and operational capacity. Ageing at home may be the preferred model, but the practical infrastructure must include workforce, transport, housing suitability, primary and community healthcare, family support, equipment, accessible information and timely escalation when needs increase.

The connection with independence and community inclusion for older people is therefore broader than the location in which care is delivered. Remaining at home is valuable when it preserves autonomy and quality of life. It becomes less positive if it relies on exhausted family carers, inaccessible housing or an unsafe gap between scheduled visits.

Operational scenario: when national entitlement meets local capacity

An 82-year-old woman living alone in a smaller Austrian municipality experiences declining mobility following repeated falls. Her daughter lives 40 kilometres away and visits several times each week. The woman already receives Pflegegeld, but her needs have increased and the family seeks more mobile support.

The practical question is not merely whether she qualifies for a higher allowance. The local service must determine whether sufficient home-care capacity exists, whether visits can be provided at the times she needs them and whether equipment, physiotherapy, medication support or housing adaptations could reduce risk. Her daughter’s contribution is also relevant, but it should not be treated as an unlimited substitute for formal support.

If the local mobile service can expand provision, the woman may remain safely at home. If staffing is constrained, the family may consider private support or increase its own input. If falls continue and overnight risk rises, the discussion may shift towards a more intensive home arrangement, 24-hour care or residential provision.

Governance becomes visible when this pattern is not treated as an isolated case. If several people in the municipality experience delayed access to mobile services, the issue should become a capacity signal for provincial and local planning. Individual unmet need is therefore both a personal risk and a piece of system intelligence.

Family caregiving remains structurally important

Austria’s long-term care system cannot be understood without recognising the scale and significance of family and informal caregiving. Pflegegeld gives households some capacity to organise care, but many people continue to depend heavily on relatives for supervision, personal support, coordination, transport, household tasks and emotional continuity.

Family care brings substantial value. Relatives often know the person’s preferences, history and changing needs better than any formal service. They may notice subtle deterioration, coordinate appointments and maintain relationships that professional care cannot replace.

At the same time, unpaid care creates risks that should not be obscured by the language of family responsibility. Intensive caregiving can reduce employment, income and pension accumulation, particularly where women carry a disproportionate share of the work. It can also affect physical and mental health, relationships and the carer’s ability to sustain support over many years.

Austria has introduced several mechanisms intended to recognise and support carers, including social insurance arrangements, financial support in defined circumstances and quality-assurance initiatives in home care. Yet the structural challenge remains: where public services are insufficient or difficult to access, family care can become the default capacity buffer for the entire system.

That is why family partnership and carer support should be treated as a core element of system sustainability rather than a peripheral welfare issue.

Austria’s distinctive 24-hour care model

One of the most internationally distinctive features of Austrian long-term care is the role of 24-Stunden-Betreuung — 24-hour care delivered in the person’s home. The model developed as a way of enabling people with substantial support needs to remain at home when ordinary mobile services and family care are no longer sufficient.

In practice, much of this support has depended on live-in personal carers, many of whom are migrant workers from Central and Eastern Europe. They commonly work in rotational arrangements, travelling between Austria and their home countries and providing extended periods of presence in the household.

This model occupies an important space between conventional home care and institutional care. It can provide continuity, supervision and flexible daily assistance in a way that short scheduled visits cannot. It may also allow people to remain in familiar homes when residential care would otherwise be the main alternative.

But the model raises significant workforce, regulatory and ethical questions. Long periods of live-in care can blur boundaries between work and rest. Self-employed arrangements can shift commercial and employment risks towards individual carers. Cross-border labour dependence makes continuity vulnerable to travel disruption, workforce shortages and changing economic conditions between countries.

The existence of financial support for eligible 24-hour care arrangements and quality-assurance home visits shows that the model is not simply an informal private market operating outside public policy. It is embedded within Austria’s broader long-term care architecture.

The longer-term question is whether this model can remain sustainable as both Austria and the countries from which carers are recruited experience demographic ageing and workforce pressure. A labour model that depends heavily on international wage differentials may become harder to maintain if alternative employment opportunities improve elsewhere.

Operational scenario: sustaining a 24-hour home arrangement

A man in his late eighties lives with dementia and increasing night-time disorientation. His wife has provided most care for several years, supported by mobile nursing and Pflegegeld. Following repeated night-time incidents, the family concludes that scheduled visits are no longer sufficient.

A 24-hour care arrangement allows him to remain at home. The live-in carer supports daily routines, meals, personal care, supervision and household activity, while healthcare tasks remain subject to the relevant professional and legal requirements. His wife is still deeply involved but is no longer the sole source of continuous supervision.

The arrangement appears stable until the rotational carer is unable to return to Austria at the expected time. The family then discovers how dependent the package is on continuity within a cross-border workforce model.

A stronger response involves more than finding an emergency replacement. The agency or household needs contingency arrangements, clarity about responsibilities, accurate information on the person’s needs, safe handover and access to professional support if the incoming worker is unfamiliar with the household.

If similar disruptions occur repeatedly, they should inform workforce and policy discussions about the resilience of the 24-hour care sector. The Digital Twin Scenario Modeller offers organisations in other systems a way to explore how workforce loss, rising demand and service-capacity changes could affect stability. The value lies in testing dependencies before they become operational failures.

Residential care remains an essential part of the system

Ageing at home is important, but not every person can or wishes to remain at home indefinitely. Austria therefore continues to rely on residential and nursing-home capacity for people whose needs cannot be safely or sustainably met through community arrangements.

Residential care financing illustrates the mixed nature of the Austrian system. Costs vary by province and facility. Residents generally contribute income and Pflegegeld towards the cost, while public social assistance can cover remaining eligible costs when personal resources are insufficient. The abolition of recourse against assets for residential care costs removed an important source of financial anxiety for families, but it also shifted greater responsibility towards public financing.

This makes residential-care capacity both a social and fiscal planning issue. Provinces must consider not only how many places are required but also the complexity of residents entering care. If people remain at home for longer, residential services may increasingly support people with higher levels of frailty, dementia, multimorbidity and nursing need.

That changes the workforce model. A residential service designed around lower levels of dependency cannot simply absorb a more complex population without changes to nursing capacity, staff competence, clinical relationships, equipment and building design.

It also reinforces the importance of workforce skills in ageing well services. Capacity measured only by the number of beds can be misleading if there are insufficient workers with the competence to support the people occupying them.

Health care and long-term care are connected but institutionally distinct

Austria has a well-established healthcare system built around social health insurance and a broad network of hospitals, physicians and other health services. Long-term care, however, is financed and organised through a different mixture of federal benefits, provincial services, municipal structures, social assistance and household contribution.

For the person receiving support, those institutional distinctions can be invisible until a transition occurs. A hospital may treat the acute medical condition, but discharge becomes difficult if adequate home support is not available. A mobile care worker may observe deterioration, but the person may require timely primary or specialist healthcare to prevent escalation. A nursing home may support extensive daily care but still depend on external medical services.

The boundary therefore creates a coordination requirement.

Good integrated practice does not require every service to sit inside one organisation. It requires clear responsibility, information exchange, timely referral and an understanding of what happens when needs move beyond one service’s remit. Similar principles underpin multidisciplinary and integrated clinical pathways elsewhere, even though Austria’s institutional structures differ significantly from those of the UK.

The transferable lesson lies less in organisational form and more in interface management. Fragmentation becomes dangerous when each part of the system performs its own function correctly but no one manages the transition between them.

Operational scenario: hospital discharge exposes the interface

An older person is admitted to hospital after pneumonia and a fall. Before admission, he lived independently with limited family support and low-level mobile care. Following treatment, he is medically stable but has lost mobility and confidence and now needs more assistance with washing, dressing, meals and transfers.

The hospital can determine that acute treatment is complete, but that does not mean the home environment is ready for discharge. The practical pathway requires communication with community services, assessment of the person’s new care needs, consideration of equipment and rehabilitation, family involvement and clarity about who will provide support during the first days at home.

If mobile capacity is available quickly, discharge may proceed safely. If it is not, the person may remain in hospital longer than clinically necessary or move temporarily into another setting. Neither outcome can be understood purely as a hospital-performance issue.

For provincial planners, repeated discharge delays linked to unavailable home care should influence service-capacity decisions. For providers, they should influence staffing and scheduling. For families, they determine whether returning home is realistic. The system therefore needs evidence that follows the pathway rather than stopping at organisational boundaries.

Workforce sustainability is becoming the central constraint

Austria’s demographic trajectory will increase demand for long-term care while tightening the supply of working-age people available to provide it. This affects almost every part of the model: mobile care, nursing homes, nursing services, 24-hour care, family support and specialist provision.

The workforce challenge is not simply a numerical shortage. It also concerns skill mix, professional roles, geographic distribution, migration, working conditions, continuity, productivity and the ability to make care work sustainable over a career.

Rural and mountainous areas face particular challenges because travel time reduces productive care time and makes small service footprints more expensive. Urban systems may have denser labour markets but face high housing costs and competition from other sectors.

International recruitment can relieve shortages but introduces new dependencies. Austria’s 24-hour care sector demonstrates this particularly clearly. Workforce sustainability therefore needs to be assessed across national borders, not only within Austrian labour statistics.

Technology may help, but it should not be treated as a substitute for human care. Digital scheduling, remote monitoring, assistive technology and better information exchange can reduce avoidable workload and allow scarce professional capacity to be used more effectively. They can also create new requirements for digital skills, cyber resilience, data governance and informed consent.

Organisations examining whether they are ready for this transition can use the Digital Transformation Readiness Assessment to test strategy, workforce adoption, information governance and technology capability. The framework is generic rather than Austria-specific, but these questions are increasingly relevant to every mature care system.

Technology has value when it strengthens the care relationship

Austria already operates within a highly developed digital society, but the application of technology to long-term care is uneven by purpose and setting. Remote monitoring, telecare, digital records, medication support, scheduling tools and assistive devices can all support ageing at home and service coordination.

The strongest use cases are not those that simply add devices. They are those that solve a defined operational problem.

A sensor may help identify unusual night-time movement. A digital care record may improve continuity between workers. Telehealth may extend specialist access. Scheduling software may reduce travel inefficiency in mobile care. Assistive technology may allow a person to complete a task independently rather than receiving additional human support.

But technology can also introduce exclusion and surveillance concerns. Older people vary in digital confidence, cognition, sensory ability, connectivity and willingness to use monitoring devices. Family members may welcome reassurance while the person receiving support may experience the same technology as intrusive.

This means person-centred technology requires consent, proportionality and ongoing review. The question is not whether the technology works technically. It is whether it improves the person’s life without unnecessarily narrowing autonomy or privacy.

Regional variation should be governed, not automatically eliminated

Decentralised systems inevitably produce variation. In Austria, differences between provinces can reflect legitimate local choices about service design, geography, provider mix and public expenditure. A highly urbanised province does not need to organise home care in exactly the same way as a predominantly rural one.

The problem arises when variation becomes inequity.

If one person can obtain timely mobile support while another with comparable needs waits because of location, the system needs to understand the reason. If residential access differs substantially between provinces, planners need to determine whether this reflects population need, supply constraints or financing structures. If one area relies disproportionately on family care because formal services are thin, that should be visible as a system dependency rather than treated as a private household matter.

This is the distinction between decentralisation and fragmentation. Decentralisation allows local adaptation. Fragmentation occurs when responsibility is distributed without sufficient shared evidence, coordination or accountability.

A stronger governance model therefore links national entitlement data, provincial service statistics, local demand, workforce capacity, complaints, waiting times, outcomes and population projections. Organisations exploring comparable questions of oversight can use the Governance Maturity Assessment to examine how responsibility, escalation, evidence and improvement fit together. Again, the tool does not assess Austrian compliance; its relevance lies in helping leaders test whether distributed responsibility is matched by distributed accountability.

Operational scenario: rural variation becomes a planning issue

A province identifies that people in several rural municipalities receive fewer hours of mobile support on average than people with comparable care needs in more densely populated areas. At first, this could be interpreted as local preference or greater reliance on family networks.

Further analysis shows a more complicated picture. Providers struggle to recruit workers, travel times between households are high and some services cannot offer the same evening or weekend coverage available in larger towns. Families are therefore absorbing more care, and some older people move into residential settings earlier than they would prefer.

The appropriate response is not necessarily to impose the urban service model on rural communities. It may involve different workforce deployment, mobile teams, technology-enabled support, stronger transport arrangements, shared provider capacity or alternative forms of housing.

The important governance step is recognising the pattern. Without comparative evidence, each household’s difficulty appears individual. Once aggregated, it becomes a structural capacity issue requiring provincial action.

This illustrates why quality monitoring systems need to combine service activity with population and outcome data. A system cannot manage inequity that it does not measure.

Financing sustainability is about more than total expenditure

Austria’s long-term care expenditure will rise as the population ages and the number of people living with complex needs increases. But financial sustainability cannot be reduced to one question about how much government spends.

The real distribution of cost extends across federal budgets, provincial and municipal expenditure, social assistance, personal income, household expenditure and unpaid family labour. Pflegegeld itself is only one component.

This creates several policy choices. Austria can increase formal service capacity, strengthen support for family carers, redesign home care, expand residential provision, increase technology use, reform workforce models or alter the balance between cash benefits and services. Each option shifts cost and responsibility differently.

For example, keeping more people at home may reduce demand for residential places, but only if sufficient home support exists. If the practical result is that families provide more unpaid care, expenditure may fall in one part of the public system while hidden social costs rise elsewhere.

Likewise, increasing Pflegegeld strengthens purchasing power but does not automatically create workers. If workforce supply is constrained, additional cash can contribute to price inflation without producing equivalent additional service capacity.

Strong financing analysis therefore needs to connect money with capacity and outcome. This is closely related to quality assurance, governance and oversight: financial inputs only become meaningful when leaders can see what capacity and outcomes those inputs produce.

Demographic change is turning long-term care into infrastructure policy

Austria’s ageing population means that long-term care can no longer be treated solely as an individual welfare programme. It is increasingly an infrastructure issue requiring long-term planning across workforce, housing, healthcare, transport, technology and community development.

The number and proportion of people aged 65 and over are projected to rise significantly over the coming decades. The most important impact for long-term care, however, comes not simply from the number of older people but from growth in the population at ages where frailty, dementia, multimorbidity and care dependency become more common.

This has several consequences.

Residential buildings designed for a different demographic may need adaptation. Municipalities may need to consider where older people live in relation to services. Home-care providers need sufficient route density and staffing. Hospitals need discharge pathways that do not depend on care capacity appearing at short notice. Workforce planning must take account of both increasing demand and retirement among existing workers.

Long-term care therefore intersects increasingly with prevention, housing and age-friendly community development. Supporting people to maintain mobility, social connection and independence can delay or reduce the intensity of care required later, even though prevention cannot remove the need for long-term support altogether.

What Austria’s model offers internationally

Austria’s model should not be presented as a template that other countries can simply reproduce. Pflegegeld developed within Austria’s own social protection system, federal arrangements, family-care traditions, provider structures and labour market. Its 24-hour care model is also shaped by Austria’s geographic position and access to a mobile Central and Eastern European workforce.

There are nevertheless several principles with wider relevance.

First, a national cash entitlement can strengthen autonomy when people have meaningful options for using it. The transferable lesson is not necessarily to create an identical allowance, but to recognise that financial support can enable choice when combined with sufficient service infrastructure.

Second, decentralised delivery requires strong visibility of variation. Local flexibility is valuable, but only if governments can distinguish legitimate adaptation from unequal access.

Third, family care should be recognised as system capacity rather than treated as an unlimited private resource. Supporting carers is therefore part of workforce and financing policy.

Fourth, workforce dependencies need to be understood across borders. Austria’s reliance on migrant live-in carers demonstrates how one country’s long-term care capacity may depend on labour-market conditions elsewhere.

Finally, formal entitlement and practical access are different things. A person can possess a recognised right or cash benefit while still experiencing difficulty finding an appropriate service. This distinction applies far beyond Austria.

The future direction: from fragmented capacity to connected planning

The next phase of Austrian long-term care policy will be shaped by whether the country can connect several reforms that are often discussed separately: workforce development, home-care capacity, family-carer support, digitalisation, residential planning, financing sustainability and health–care coordination.

Addressing one element in isolation is unlikely to be sufficient. Increasing benefits without increasing supply may not expand access. Expanding residential places without workforce planning may create nominal rather than usable capacity. Introducing digital tools without interoperability or workforce adoption may add complexity rather than remove it.

The stronger opportunity lies in treating long-term care as a connected capacity system.

That means using demographic evidence to anticipate demand, workforce intelligence to test feasibility, service data to identify geographic gaps and lived experience to determine whether formal arrangements actually work for people and families.

It also requires clearer feedback loops between individual experience and policy. Complaints, delayed service access, hospital discharge problems, family-carer strain and workforce turnover should not remain isolated operational issues. They are evidence about the design of the wider system.

Austria already has many of the component parts required for such an approach: a nationally visible entitlement, established provincial service structures, significant home and residential care provision, formal quality-assurance mechanisms and growing digital capability. The strategic task is to make those components operate increasingly as one intelligible system around the person.

Conclusion

Austria’s long-term care system is defined by the interaction between national entitlement and decentralised delivery. Pflegegeld provides a nationally structured financial contribution based on assessed care need, but the person’s practical options are shaped by provincial and municipal services, local workforce availability, household finances, family support, health-service interfaces and the availability of home, residential or 24-hour care.

That architecture creates both resilience and complexity. It allows care to be organised flexibly and locally, but it can also produce regional variation and place significant responsibility on families. The increasing importance of migrant live-in carers further demonstrates that national long-term care capacity can depend on labour markets beyond national borders.

Austria’s central strategic challenge is therefore not simply to preserve Pflegegeld or expand one category of service. It is to ensure that entitlement, workforce, service capacity, financing, technology and family support remain aligned as demographic demand grows.

The strongest future system will be one in which individual experiences of delayed access, caregiver strain, hospital transition or service instability are converted into usable governance intelligence. Formal policy matters, but implementation determines whether people experience autonomy, continuity and security in everyday life.

Austria’s experience therefore offers an important international lesson: long-term care sustainability depends not only on how responsibility is divided, but on how effectively those responsibilities reconnect around the person who needs support.