E-Care in Slovenia: How Technology Is Becoming Part of the Long-Term Care Offer

A fall detector can recognise an event within seconds. A smoke sensor can identify danger before an older person is able to telephone for help. A personal alarm can connect somebody living alone to assistance at any hour. Yet none of these technologies provides long-term care by itself. Their value depends on what happens after the signal: who receives it, whether the information is understood, who responds and whether the technology remains appropriate as the person’s circumstances change.

Slovenia has placed this distinction inside the design of its new long-term care system. E-care, or e-oskrba, is no longer simply a separate technology project sitting alongside conventional support. It is a recognised long-term care service that can complement relevant long-term care rights and can also operate as an independent entitlement for eligible people. The development is examined here as part of the Slovenia Ageing, Long-Term Care & Community Support Knowledge Hub.

This is an important shift. Slovenia’s long-term care reform is intended to support more people outside institutions while its ageing population increases demand for assistance. Technology can help extend reassurance, detect defined risks and connect people to support between scheduled visits. But it also introduces new questions about reliability, consent, privacy, digital exclusion and responsibility.

The strategic significance of e-care therefore lies less in the devices themselves than in the service architecture around them. Slovenia is testing whether digital support can become part of an entitlement-based long-term care system without allowing technology to replace human relationships, professional judgement or the practical care that people still need.

E-care now sits inside Slovenia’s long-term care architecture

The Long-Term Care Act, ZDOsk-1, establishes e-care as part of Slovenia’s long-term care framework. Its introduction needs to be understood alongside the broader reform that has progressively brought new rights into operation.

Long-term care at home became available from July 2025, while institutional long-term care and the cash benefit followed from December 2025. The system is financed principally through compulsory long-term care insurance and administered through a combination of national institutions, Centres for Social Work, registered providers and the Health Insurance Institute of Slovenia, ZZZS.

E-care occupies a distinctive position within this architecture. People entitled to long-term care at home, a family caregiver or the cash benefit can also receive e-care, subject to the applicable arrangements. It is also available as an independent right for people meeting its specific conditions. People receiving institutional long-term care do not receive e-care as an additional entitlement in the same way, reflecting the presence of continuous support within the institution.

Applications for the independent e-care right are made through the competent Centre for Social Work, which is part of the long-term care entry-point structure.

The service itself can include a range of connected technologies:

• personal alarm devices through which a person can request assistance;
• environmental sensors capable of detecting risks such as smoke or gas;
• mobility-related technology, including fall detection;
• GPS-based location technology where this is appropriate;
• connection to a continuously available assistance centre or another agreed response route.

The important word is service. Equipment is only one component. E-care combines technology with monitoring, communication and response. Treating it purely as a hardware procurement exercise would miss the operational purpose of the entitlement.

Technology can extend support between human contacts

Traditional home-based care is organised substantially around human presence. A worker visits, assists with defined activities and leaves. Family members may provide additional support. Primary healthcare, community nursing and other services enter the home for their own purposes.

Risk, however, does not follow the timetable of scheduled visits.

An older person may fall at 02:00. Someone may become disorientated while walking outside. Smoke may develop while a person with reduced mobility is unable to leave the home quickly. A family caregiver may be away temporarily when assistance is required.

E-care can narrow this gap between scheduled support and unpredictable events. This is particularly relevant to technology-enabled support for older people, where the objective is not continuous technological observation but proportionate assistance that increases the possibility of living safely outside an institution.

The distinction matters because e-care should not be evaluated simply by counting devices installed. Its value lies in whether it improves a meaningful outcome: faster assistance after a fall, greater confidence to remain alone for part of the day, reduced anxiety for a family caregiver, or earlier recognition of a defined environmental danger.

This creates an operational discipline. The starting question should not be “What technology can we install?” It should be “What outcome or risk are we trying to address?”

A fall detector may be valuable for one person and irrelevant for another. GPS functionality may support somebody whose circumstances create a genuine location risk, while being intrusive and unnecessary for somebody else. A personal alarm is useful only if the person can activate it when required or the system can detect the relevant event automatically.

Good e-care therefore begins with the person rather than the catalogue of available equipment.

A personal alarm changes little unless the response pathway works

Consider an 84-year-old woman living alone in a village in northeastern Slovenia. She remains largely independent but has reduced balance and has fallen twice during the previous year. Her daughter lives 40 kilometres away and telephones daily, but cannot provide immediate assistance.

E-care could allow the woman to use a personal alarm and fall-detection technology connected to a continuously available assistance service. The benefit is not that the technology prevents every fall. It is that a serious event is less likely to remain undiscovered for hours.

The operational design still matters. The service needs accurate contact information, an agreed response sequence and an understanding of who can enter the home if she cannot reach the door. False alarms need proportionate management rather than creating pressure to disable the system. Equipment needs to remain functional, and the woman needs to understand what it does and does not do.

If she falls repeatedly, the answer should not simply be to record that the alarm worked each time. Recurrence should trigger wider consideration of her needs: medication, vision, mobility, home hazards, rehabilitation and whether her long-term care plan remains appropriate.

Technology has then performed two functions. It has supported immediate safety and generated information that may reveal a changing pattern.

This illustrates the connection between e-care and frailty, falls and everyday safety. The strongest digital response does not isolate an incident from the person’s wider health and care circumstances.

E-care is particularly relevant to Slovenia’s ageing-at-home ambition

Slovenia’s long-term care reform has strengthened the formal basis for support at home. This is significant in a system where families have historically carried substantial caring responsibility and institutional provision has remained an important component of long-term support.

E-care can contribute to a more diverse home-based offer. It can support people who require reassurance or defined safety mechanisms but do not need another person physically present at every moment.

That can make care more proportionate. An older person should not receive unnecessary human supervision simply because no alternative method exists for managing a specific risk. Equally, technology should not be used to reduce human contact where companionship, observation, personal care or professional intervention is genuinely required.

The principle is close to providing just enough support: assistance should be sufficient to achieve safety and independence without unnecessarily taking over functions that the person can still manage.

This matters for dignity as well as capacity. If technology allows somebody to shower, move around the home or spend part of the day independently with an appropriate route to assistance, it can increase control over everyday life.

But e-care cannot solve the structural limitations of home-based long-term care. It cannot prepare food, help somebody dress, provide complex nursing care or replace meaningful social relationships. Nor can it compensate indefinitely for an unavailable workforce.

Technology is most credible when positioned as one layer of support rather than a substitute for the rest of the system.

Assessment should connect technology to the personal plan

The wider Slovenian long-term care model is built around assessment, recognised categories of need and personal planning. E-care works best when it is connected to that logic.

A person’s needs can change. Someone who initially requires only a personal alarm may later experience cognitive deterioration. Another person may regain confidence and mobility after rehabilitation, reducing the value of some monitoring. A family caregiver may become unavailable, changing the response arrangements around existing technology.

Technology therefore needs review alongside the care plan rather than existing as a permanent installation that becomes invisible once commissioned.

Several questions are particularly important:

• What specific need, outcome or foreseeable risk does the technology address?
• Can the person use it reliably and do they understand its purpose?
• Who receives an alert, and what action is expected?
• What happens if the technology, network or response route is unavailable?
• How will changes in health, cognition, living arrangements or family support trigger review?

These questions also prevent a common digital-care mistake: confusing availability with suitability.

Organisations examining comparable decisions can use the Positive Risk-Taking Planner to structure discussion around outcomes, risks, safeguards and personal choice. It is not a Slovenian eligibility or legal tool, but its underlying method can help keep technology connected to an identified purpose rather than becoming a default response to uncertainty.

That approach also supports person-centred use of technology, in which digital support adapts to the individual rather than requiring the individual to adapt to the technology.

E-care creates a chain of responsibility

Digital support can create an illusion of automatic safety. A sensor detects an event, therefore the risk appears controlled. In practice, detection is only the first stage in a chain.

An alert has to be transmitted. The receiving system must identify it. Someone must decide what it means. A response must be initiated. The person providing that response needs enough information to act appropriately. If the event is serious, further healthcare or emergency assistance may be required.

Each link introduces responsibility.

This is why Slovenia’s decision to recognise e-care providers within the formal long-term care provider architecture matters. The National Institute of Public Health, NIJZ, maintains the Register of Long-Term Care Providers, RIDO. The register includes providers of e-care services as a defined type of long-term care provider, alongside institutional, day and home-based provision.

The Ministry responsible for long-term care oversees entry of providers into the register, while NIJZ manages the register infrastructure and ZZZS uses relevant provider information in connection with long-term care administration and payment.

Registration does not by itself guarantee that every individual response pathway will work perfectly. It does, however, place e-care within a recognisable system of provider accountability rather than treating technology suppliers as peripheral to long-term care.

The governance question then becomes operational: where does responsibility pass from equipment to monitoring service, from monitoring service to family or professional response, and from routine response to emergency escalation?

Providers need clarity about these boundaries before an incident rather than discovering them during one.

A family caregiver needs support, not permanent digital surveillance duties

Consider a man in his late seventies who receives extensive support from his wife, recognised within Slovenia’s long-term care system as his family caregiver. He has impaired mobility and needs assistance with several daily activities, but his wife also needs time away from caring.

E-care provides additional reassurance. A personal alarm and selected sensors mean that some periods of separation can be managed with greater confidence.

The arrangement could nevertheless become counterproductive if every alert is routed directly to his wife regardless of circumstances. Technology intended to create respite could instead make her continuously responsible through her telephone.

The personal plan should therefore make the response architecture explicit. Which alerts can an assistance centre resolve? When should the caregiver be contacted? What happens during her planned absence? Which situations require professional or emergency response?

The husband’s privacy also matters. The fact that his wife provides substantial care does not automatically justify unrestricted monitoring of his movements or routines.

This illustrates why family partnership and carer support must remain part of digital design. E-care can reduce uncertainty for relatives, but only if responsibilities are distributed sensibly.

It also demonstrates a broader workforce lesson. Digital technology often shifts work rather than eliminating it. Somebody must receive alerts, maintain equipment, explain systems, review patterns and respond when intervention is required. If those functions are transferred invisibly to relatives, apparent system efficiency may simply represent additional unpaid care.

Consent and privacy become more complex as technology becomes less visible

A pendant alarm is relatively easy to understand. The person presses a button when help is required. Passive sensors, location technology and more sophisticated monitoring create different ethical questions because information can be collected without deliberate action each time.

This does not make such technology inappropriate. Passive detection can be especially valuable when somebody is unable to activate an alarm after a fall or another event. But proportionality becomes increasingly important.

People should understand, as far as possible, what the system monitors, what information it generates, who can access that information and what will happen when defined events occur.

The issue becomes more difficult where cognitive impairment is present. Dementia does not make all technology inherently restrictive, nor does it automatically remove the person’s ability to express preferences. A location device may increase freedom for somebody who enjoys walking by reducing the pressure for continuous physical supervision. The same technology could become intrusive if used primarily for organisational convenience without sufficient regard to the person’s wishes and circumstances.

This is where safeguarding, consent and human rights in older-age support intersect with digital care.

Good governance asks not only whether monitoring is technically possible but whether it is necessary, proportionate and understandable.

Organisations examining these wider questions can use the Digital Transformation Readiness Assessment to test strategy, governance, workforce capability and digital resilience. The framework does not replace Slovenian data-protection or long-term care requirements, but it can help expose the organisational dependencies that sit behind apparently simple technology decisions.

Digital inclusion is part of access, not an optional extra

E-care is unusual among digital services because the person using it does not necessarily need to be digitally confident. A well-designed personal alarm can be simpler than using a smartphone application. Automated sensors may require little day-to-day interaction.

Nevertheless, digital exclusion still matters.

An older person needs to understand enough about the service to participate meaningfully. Family members may need accessible instructions. Installation may require connectivity and suitable infrastructure. Equipment has to work within the physical characteristics of the home. Language, hearing, vision, dexterity and cognitive needs can all affect usability.

There is also a difference between technical coverage and practical confidence. A device can be installed correctly while the person remains frightened of using it or misunderstands what will happen when it activates.

This creates a role for demonstration, testing and follow-up. Installation should include more than switching on equipment. The person should experience how an alert works and know what response to expect.

Accessible alternatives remain important too. Digitalisation should not make long-term care harder to navigate for people who do not use online services. Slovenia’s long-term care entry points through Centres for Social Work and its wider information infrastructure therefore remain important alongside technological development.

The broader digital inclusion principle is that technology should widen practical options rather than creating a new threshold people must cross before support becomes accessible.

Rural Slovenia shows both the value and limits of remote support

Slovenia is geographically compact, but population distribution, mountainous terrain and dispersed settlements can still affect access to services. Rural areas make the promise of e-care particularly attractive because technology can bridge distance instantaneously.

Response cannot.

Imagine an older man living alone in a dispersed settlement where his nearest relative is some distance away. A fall detector sends an alert immediately. The assistance service establishes that he is conscious but unable to stand.

The technology has worked exactly as intended. The outcome now depends on the physical response network.

If an agreed local contact can reach him quickly, the alert has translated into practical assistance. If professional help must travel a substantial distance, geography remains relevant. Where the event may involve injury, an appropriate emergency response may be necessary rather than informal lifting assistance.

This means rural e-care design needs to consider response time and local networks rather than assuming that rapid detection equals rapid resolution.

The same principle applies to infrastructure resilience. Connectivity, power supply and equipment reliability become safety considerations where a person relies significantly on digital support. Contingency arrangements should reflect the consequences of failure rather than simply the likelihood of it.

E-care can therefore mitigate some geographic inequalities without abolishing geography. Its greatest value may be earlier knowledge that somebody needs help, allowing the available response system to begin acting sooner.

Technology generates information that can improve care if it is interpreted carefully

E-care systems can produce more than individual alarms. Over time, digital information may reveal patterns.

Repeated fall alerts, increasing requests for assistance or changes in routine can indicate that a person’s circumstances are changing. Used carefully, such information can support review of the personal plan and wider assessment.

But more data does not automatically create better care.

A pattern requires interpretation. Increased night-time movement could have several explanations. Repeated alarm activation might indicate deteriorating health, anxiety, misunderstanding of the equipment or a legitimate increase in need. Digital data should inform professional judgement rather than replace it.

Slovenia’s long-term care reform already creates important national information flows involving registered providers, NIJZ, ZZZS and the Ministry responsible for long-term care. As e-care develops, the quality and interoperability of information will become increasingly significant.

The quality of digital data and performance metrics matters at two levels. At individual level, inaccurate information can produce poor decisions. At system level, inconsistent definitions can make it difficult to understand whether e-care is actually improving outcomes.

Measures therefore need to move beyond installation volumes. Useful questions include whether alerts were successfully handled, whether response arrangements worked, whether technology remained suitable after review and whether people experienced greater confidence or independence.

Organisations developing comparable oversight can use the Quality Dashboard Builder to connect digital activity with safety, experience, workforce and outcome evidence rather than treating device numbers as evidence of success.

A changing need should trigger more than another device

Consider a 79-year-old woman receiving long-term care at home who also uses e-care. Initially, the arrangement consists of a personal alarm and fall detection because she has reduced mobility but manages much of her daily routine independently.

Several months later, the assistance service records an increase in night-time alerts. Workers visiting during the day also notice that she sometimes appears confused about medication and has started leaving food uneaten.

There is a risk that each part of the system responds separately. The e-care provider could adjust technology. Home-care workers could increase prompting. Her family could install additional private monitoring. None of those actions necessarily explains why her functioning has changed.

The stronger response is to connect the information. The long-term care provider can notify the relevant pathway where a significant change in health or functional status suggests reassessment is required. Healthcare assessment may also be necessary to identify possible physical, medication-related or cognitive causes.

Technology remains useful during this process, but it becomes evidence within a broader review rather than the solution itself.

This distinction is particularly relevant during Slovenia’s early implementation of the new system. Temporary measures adopted in September 2026 strengthen the ability to respond when a user’s health or functional condition changes significantly, including routes for priority reassessment following information from a long-term care provider.

The scenario shows how e-care can contribute to a more responsive system when digital information, professional observation and formal reassessment are connected. If the same signals simply generate additional equipment, the system may become technologically richer while remaining clinically and socially fragmented.

Transition from earlier e-care arrangements requires continuity

Slovenia did not begin using remote e-care when ZDOsk-1 came into force. Earlier publicly supported arrangements had already enabled people to use remote e-care, creating an existing user population as the new statutory system developed.

Transition therefore matters.

People who already depend on an alarm or monitoring arrangement should not experience an avoidable gap simply because the legal or administrative basis for the service changes. Slovenia has used transitional provisions to maintain continuity while the new long-term care arrangements become fully operational.

In September 2026, additional temporary measures were adopted to support implementation of the long-term care system, including continuation arrangements for existing e-care users while the conditions for transition into the ZDOsk-1 framework are established.

This is a useful reminder that digital transformation has a legacy dimension. A new statutory entitlement does not start with an empty system. Existing contracts, equipment, users, response centres, data and operational routines have to be migrated safely.

For the individual, the legal transition may be largely invisible. That is often a sign of successful implementation. The person primarily needs the alarm to continue working and the response route to remain clear.

At system level, however, continuity requires active management. Provider status, payment arrangements, eligibility decisions and technical interfaces all need to align without creating a service interruption.

Financing should encourage useful support rather than technology volume

E-care also illustrates how financing shapes digital behaviour.

Under Slovenia’s long-term care arrangements, e-care receives public financial support. The statutory framework provides for a daily contribution towards the service and support for the one-off cost of installing equipment and establishing the connection. Transitional arrangements provide a higher daily amount through the end of 2027 before the planned rate changes from 2028.

This gives e-care a more stable position than a temporary innovation grant. It becomes part of the financing architecture of long-term care.

The policy advantage is predictability. People and providers can understand e-care as a recognised service rather than a short-lived pilot.

The governance challenge is ensuring that financing remains connected to value. If payment rewards only the presence of a connection, the system could expand technologically without knowing whether people are safer or more independent. If payment is too restrictive, providers may struggle to sustain responsive infrastructure and maintain equipment.

The strongest evidence set therefore combines financial, operational and human measures: uptake, availability, response performance, continuity, user experience, changing needs and outcomes.

For policymakers, the question is not whether e-care is cheaper than human care in the abstract. They perform different functions. The more useful question is whether the right combination of technology and human support achieves better independence, safety and sustainability than either could achieve alone.

The workforce still determines whether digital care becomes good care

E-care changes the long-term care workforce rather than making it less important.

Installation staff need to understand the home environment and user requirements. Assistance-centre workers need competence in interpreting alerts and communicating with people who may be frightened, injured or confused. Long-term care coordinators and frontline workers need to understand what the technology can do. Managers need oversight of failures, patterns and response arrangements.

Digital skills therefore extend beyond operating software.

Workers need to know when technology is inappropriate, how to explain it accessibly, how to record consent and preferences, how to respond to technical failure and when digital information suggests a wider change in need.

This creates a strong connection with digital skills and workforce adoption. Successful implementation depends partly on whether workers see e-care as integrated into practice rather than as equipment managed by somebody else.

Training also needs to guard against false confidence. A worker who sees a sensor on the wall may assume that somebody else is monitoring a risk continuously. Unless the service specification and response pathway are understood, technology can blur responsibility rather than clarify it.

The workforce implication is therefore both technical and cultural. Digital care needs staff who can combine human observation with technological information and recognise the limitations of both.

Digital safeguarding needs to develop alongside digital access

As e-care expands, the safety agenda must include harms created or amplified by technology itself.

Equipment can fail. Accounts can be accessed inappropriately. Location information can reveal sensitive movements. Family members may seek more monitoring than the older person wants. Poorly configured alerts can create false reassurance. Cyber incidents can affect availability.

These are not arguments against e-care. They are reasons to treat digital safeguarding as part of normal care governance.

The digital safeguarding and technology-enabled harm perspective becomes increasingly relevant as long-term care moves beyond simple alarm buttons towards more connected systems.

A proportionate governance framework should be able to answer who has access to information, how permissions are controlled, what happens when technology fails, how incidents are reported and how the person can raise concerns about the way monitoring is being used.

Cybersecurity also becomes a continuity issue. Where technology contributes directly to safety, digital resilience belongs within service resilience rather than being treated solely as an information-technology function.

Organisations examining this wider assurance chain can use the Governance Maturity Assessment to explore whether responsibility, risk ownership, escalation and learning remain clear as technology becomes more embedded in care delivery.

Slovenia can judge e-care by what changes in people’s lives

The next phase of e-care implementation should create enough evidence to distinguish technological activity from meaningful impact.

National oversight can examine coverage and expenditure, but the more important questions concern experience and outcomes. Are people able to remain at home with greater confidence? Are serious events identified earlier? Do family caregivers experience greater reassurance without becoming permanently on call? Are avoidable institutional transitions reduced for people whose needs can safely be met at home? Does technology remain appropriate as dependency changes?

Not all outcomes will be attributable to e-care alone. A person receiving an alarm may simultaneously receive long-term care at home, rehabilitation, healthcare and substantial family support. Evaluation therefore needs to avoid claiming causation that the evidence cannot support.

Patterns still matter.

If particular devices generate repeated false alarms, that should influence service design. If rural response times remain problematic, technology procurement alone will not solve the issue. If certain groups rarely take up e-care, accessibility and information may require review. If users report feeling monitored rather than supported, the model needs adjustment even if technical performance is excellent.

This is where feedback and participation from people using services become part of digital governance. People should help define what successful e-care feels like, not merely confirm whether equipment was installed.

The international lesson is that telecare becomes infrastructure when accountability follows it

Many countries have used personal alarms and telecare for years. Slovenia’s experience is noteworthy for a different reason: e-care is being incorporated explicitly into a new national long-term care entitlement architecture.

The Slovenian mechanism cannot simply be transferred elsewhere. Its compulsory long-term care insurance, Centres for Social Work, provider registration arrangements and wider social protection system reflect national institutions.

The transferable principle lies in treating technology as a care service rather than a collection of devices.

That requires several connections: between assessment and technology selection; between an alert and a response; between digital information and care review; between provider activity and national oversight; and between innovation and rights.

It also changes the question countries ask about technology. Instead of asking whether telecare can save staff time, the more useful question is where technology can perform a function better or more continuously than human presence while preserving human intervention where judgement, relationships and physical assistance remain essential.

This is particularly important as artificial intelligence and more predictive forms of monitoring develop. Future systems may identify increasingly complex patterns, but greater analytical capability will increase rather than remove the need for governance. Prediction creates value only when there is a legitimate purpose, reliable data and an appropriate response.

Slovenia’s current e-care model is more bounded than that future possibility. Its significance lies precisely in building the service foundations first.

Conclusion

E-care is becoming a meaningful part of Slovenia’s long-term care settlement because it connects digital technology with a statutory system of entitlement, provider responsibility and public financing. Personal alarms, environmental sensors, fall detection and location technologies can strengthen support outside institutions, particularly where people need reassurance and rapid access to help between scheduled human contacts.

The central strategic challenge is to ensure that expansion does not confuse technology with care. A device cannot decide why somebody keeps falling, provide companionship to an isolated older person or replace assistance with daily living. Nor does an alert improve safety unless a reliable response follows it.

Slovenia therefore has an opportunity to build e-care around outcomes rather than equipment volumes. Assessment should establish purpose. Personal planning should define how technology fits with wider support. Providers need clear responsibilities. Workers require digital competence. Families need reassurance without inheriting permanent monitoring duties. Data should inform review while privacy, consent and autonomy remain visible.

Implementation is still evolving, including transitional arrangements for existing e-care users as the new long-term care system stabilises. That makes evidence from practice particularly important.

If Slovenia can connect technology, human response and governance successfully, e-care can become more than an additional benefit. It can form part of the infrastructure for ageing at home: extending support without unnecessarily replacing independence, and demonstrating that digital long-term care is strongest when technology remains accountable to the life of the person using it.