Informal and Family Care in Belgium: The Hidden Foundation of Long-Term Support

Much of Belgium's long-term care takes place outside institutions and outside paid working hours. An adult daughter checks whether her mother's medication has been taken, a husband helps his wife dress after a stroke, a neighbour drives an older friend to appointments, or a son coordinates home nursing, practical assistance and specialist consultations while trying to remain in employment. These activities rarely appear as a single service, yet they can determine whether someone continues living at home, whether professional care remains manageable and whether a period of declining health becomes a crisis.

Within the wider Belgium Ageing, Long-Term Care & Community Support Knowledge Hub, informal and family care needs to be understood as part of the system itself rather than as background support. Belgium formally recognises the role of aidants proches in French and mantelzorgers in Dutch, while Flanders, Wallonia, Brussels and the German-speaking Community operate different combinations of home support, respite, cash benefits, advice and community services around them.

The central policy challenge is that informal care is both invaluable and inherently limited. Families offer continuity, emotional knowledge and flexibility that professional services cannot reproduce. They can also absorb large amounts of hidden labour, lost income, interrupted sleep, coordination work and psychological responsibility. A long-term care system that ignores this contribution is unrealistic. A system that simply assumes it will always be available is equally unsustainable.

Informal care is part of Belgium's care infrastructure

Belgian policy increasingly recognises carers as identifiable participants in care rather than treating support within families as an entirely private matter. At federal level, an informal carer can seek formal recognition through their sickness fund. Recognition is not restricted to close relatives. A friend, neighbour or other person with a sufficiently close personal relationship can potentially qualify where support is regular, unpaid and connected with a person whose age, illness or disability creates a genuine need for assistance.

This matters because contemporary long-term care rarely divides neatly into professional and non-professional domains. A home nurse may manage clinical treatment, while a spouse notices overnight deterioration. A family-care worker may assist with washing and meals, while an adult child arranges appointments and manages correspondence. A general practitioner may make clinical decisions, but a relative often holds the most detailed knowledge about how the person is functioning between consultations.

Good family partnership and carer support therefore depends on recognising carers without making them substitute employees. Their role should strengthen continuity and person-centred decision-making, not compensate indefinitely for gaps in professional capacity.

The distinction becomes especially important as Belgium tries to support more people at home for longer. Community-based care generally increases the need for coordination across households, professionals and organisations. Unless formal capacity grows alongside demand, rebalancing away from residential provision can unintentionally increase the amount of care absorbed by relatives.

Federal recognition gives carers a formal status

Belgium's federal framework distinguishes between general recognition as an informal carer and recognition linked to social rights. Applications are made through the carer's sickness fund. The general model acknowledges that the person provides regular and continuing unpaid support within a relationship of trust and in cooperation with at least one professional healthcare practitioner.

Recognition linked to social rights applies additional conditions. These include a substantial level of caring activity and evidence that the person receiving care meets specified dependency requirements. The federal framework uses thresholds including at least 50 hours of support each month or 600 hours over a year, and limits the number of carers who can receive recognition with social rights for the same person.

The significance is not bureaucratic recognition alone. It gives caring a visible place within social protection. Someone who is recognised is no longer institutionally invisible simply because they are not a paid professional.

However, recognition should not be confused with full compensation for caring. Informal care remains unpaid care. Recognition can unlock defined social rights, but it does not convert caring into employment, create a salary or reimburse every financial consequence. That distinction matters when considering the real economic contribution made by families.

Carer leave changed significantly in 2026

Belgium strengthened its federal leave arrangements for recognised informal carers from 1 July 2026. For eligible workers, the thematic leave can now provide the equivalent of up to six months of full-time interruption for a person requiring care. Depending on the form selected, this can be taken as full-time leave, a half-time reduction or a one-fifth reduction in working time, subject to the applicable rules.

The headline durations need to be understood carefully. The maximum career entitlement remains calculated as the equivalent of six months of full-time interruption. The longer headline periods for reduced working hours reflect conversion of that same entitlement rather than an unlimited additional right. Since July 2026, parts of the leave have also become more flexible, including the possibility of shorter periods in specified circumstances where employer agreement is required.

This reform is operationally important because long-term caring rarely follows a simple linear pattern. A worker may need an intensive period after a hospital discharge, return to work, then require further time when dementia progresses or a partner undergoes treatment. Greater flexibility makes the leave more compatible with the episodic nature of care.

Yet employment protection alone cannot make caring sustainable. A household still has to manage income, career development, pension implications, workplace relationships and the physical demands of care. Carer policy therefore intersects with fair work and responsible employment as well as health and social support.

Scenario: combining employment and care after a Flemish hospital discharge

A woman in her late forties works full time in Antwerp and lives twenty minutes from her 79-year-old father. Before a hospital admission he was largely independent. After surgery, he returns home weaker, needs help preparing food and dressing, and temporarily requires home nursing. His daughter begins visiting before work, telephoning at lunchtime and returning most evenings.

At first, both assume this arrangement will last only a few days. Several weeks later, she is exhausted and her father is still unable to manage safely alone. A stronger response does not begin by deciding that the daughter should simply do more. His support needs have changed and need to be considered across the whole home environment.

A recognised family-care service can assess the practical support required and combine personal care, household help and psychosocial assistance with the nursing already in place. If the father's dependency meets the relevant conditions, Flemish Social Protection may provide access to the care budget for people with heavy care needs. The money is paid to the person requiring care and can be used flexibly; it is not a wage automatically payable to his daughter.

The daughter may also consider recognition as a mantelzorger and, if she meets the additional conditions for social rights, use carer leave to reduce her working time temporarily. This gives the family space to stabilise the arrangement rather than allowing a short-term recovery period to become an unsustainable permanent routine.

The outcome to monitor is not merely whether her father remains at home. It is whether his independence improves, whether formal services are sufficient, whether the daughter can continue her employment and whether the package can reduce as he recovers. That is the difference between involving a family and designing a care model around unpaid availability.

Flanders combines formal home care with recognition of mantelzorg

Flanders has a particularly developed infrastructure around home and informal care. Its home-care system includes family-care services, home nursing, sitting services, local service centres, social-work services associated with sickness funds, short-stay provision and recognised associations for informal carers and service users.

At the beginning of 2026, family-care services represented the largest component of Flemish home-care provision, with more than one hundred organisations and almost 27 million programmed hours. That formal infrastructure matters to carers because the sustainability of informal care is closely related to what can be delegated to professionals.

Flemish Social Protection also provides a care budget for people with heavy care needs. In a home-care context, eligibility is linked to substantial and long-lasting loss of self-reliance, increasingly assessed through instruments including the BelRAI Screener. The budget belongs to the person needing support and can be used flexibly.

Some Flemish municipalities additionally operate their own local mantelzorgpremie arrangements, but these are not a uniform Flemish entitlement. Local conditions and amounts vary. That variation illustrates a recurring feature of Belgian care: a carer may be affected simultaneously by federal recognition rules, Flemish social protection and municipal support.

For families, the challenge is therefore often navigation as much as entitlement. The existence of several support mechanisms does not guarantee that people know which one applies, how they interact or what evidence is needed to access them.

Supporting carers requires more than a payment

Financial recognition matters because care has real costs. Relatives may reduce working hours, pay for transport, increase household energy use, purchase equipment or absorb expenses that would otherwise sit within formal services. Yet money alone does not address the full burden.

A sustainable carer-support system generally needs several functions:

• clear information and navigation before the family reaches crisis;
• formal home-care capacity that can take responsibility for defined tasks;
• respite that provides genuine relief rather than additional coordination work;
• workplace flexibility and income protection where caring affects employment;
• assessment of the carer's own wellbeing as circumstances change;
• recognition of carers as partners while maintaining the cared-for person's autonomy and privacy.

The final point is particularly important. Family involvement should not erase the voice of the person receiving support. Strong involvement of family and advocates works alongside, rather than instead of, the individual's own preferences, consent and decision-making rights.

Wallonia places respite alongside practical support at home

In Wallonia, the Agence pour une Vie de Qualité, AVIQ, sits at the centre of important parts of the older-person, disability and home-support landscape. Services d'aide aux familles et aux aînés, known as SAFA, provide family and older-person assistance in the home. A social worker assesses the person's needs and circumstances and establishes a social record before appropriate services are organised. User contributions are linked to income and family circumstances within the applicable Walloon framework.

For carers, the significance of SAFA lies not only in the tasks performed but in workload substitution. Help with washing, meals, household activity or supervision can turn a family arrangement from an almost continuous obligation into one that relatives can sustain alongside other responsibilities.

Wallonia also recognises the importance of respite. AVIQ-supported respite services can provide different forms of temporary support, including activities and residential respite in relevant disability-support contexts. The strategic principle extends beyond any one service category: carers need periods in which responsibility is genuinely transferred to someone else.

Respite is often misunderstood as leisure. For a person providing high-intensity care, it may instead mean sleeping through a night, attending their own medical appointment, spending time with another child, completing paid work or simply having several hours without remaining continuously alert to another person's needs.

This is why access to respite should be interpreted through prevention and early intervention. Supporting a carer before exhaustion becomes acute may prevent avoidable breakdown, emergency admission or a permanent move that neither person originally wanted.

Scenario: dementia care and carer exhaustion in Wallonia

An older man with dementia lives with his wife in a town in Wallonia. She has supported him progressively for several years. At first, caring involved reminders, transport and managing appointments. It now includes helping him dress, supervising meals, preventing him from leaving the house unsafely and responding when he wakes confused during the night.

Professional services visit, but his wife remains the constant presence between those contacts. When asked whether she can continue, she says yes because the alternative she imagines is immediate residential placement. Her answer therefore reflects fear of losing their shared home rather than evidence that the current arrangement is sustainable.

A stronger assessment looks beyond the husband's dependency. It asks what the wife is doing, how often she sleeps uninterrupted, whether she can leave the house, what happens if she becomes ill and which parts of care could be transferred to SAFA, day support, respite or other professional services.

The important decision is not whether she qualifies as a "good" carer. It is how to protect both members of the household. Structured day activity may reduce supervision demands and offer the husband meaningful engagement. Additional home support can take over predictable tasks. Planned respite can give the wife recovery time and provide an opportunity to test how her husband responds to care from others before an emergency occurs.

If his needs later become too intensive for home care, residential care may still be appropriate. The value of earlier carer support is that the decision can then be made deliberately, with evidence about his needs and his wife's capacity, rather than during a crisis caused by exhaustion.

Brussels adds urban, financial and cultural complexity

Informal care in Brussels operates within a distinctive environment. The region is dense, multilingual and socially diverse, with substantial differences in income, housing conditions, family structure and access to informal networks. Some older residents live near several generations of family. Others are isolated despite living physically close to thousands of people.

Iriscare subsidises recognised home-help services that assist older people, disabled people, people with long-term illness and families in difficulty. These services coordinate, where possible, with relatives and professional carers around the person. Since January 2026, Iriscare has increased the financing forfaits for its recognised home-help services following financial pressures in the sector.

That policy decision has direct consequences for informal carers. Provider viability is carer policy. If a home-help service reduces capacity, relatives may absorb the missing hours even though no formal decision has been made to increase their responsibilities.

Financial protection also matters. Brussels administers the allocation for assistance to older people, the APA, for older residents with reduced autonomy and limited resources. Applications can be supported by relatives, sickness funds, CPAS services and other actors. Although the allowance is paid because of the older person's dependency rather than because a relative provides care, such benefits can influence the resources available to sustain life at home.

In a culturally diverse city, support also needs to recognise cultural and identity needs without assuming that particular communities will automatically provide family care. Strong intergenerational expectations can be valuable, but they can also conceal pressure on individual carers, especially women. Cultural sensitivity means understanding the family's values while still asking whether the arrangement is chosen, equitable and sustainable.

Family care is strongly shaped by gender and employment

Long-term care systems often describe informal carers collectively, but caring is not distributed evenly. Women remain disproportionately represented in unpaid care, particularly when support becomes intensive and long-lasting. Working-age daughters may be expected to coordinate parents' care even when sons or other relatives are present. Spouses can find themselves providing substantial physical assistance despite having their own age-related health conditions.

This matters economically as well as socially. Reducing working hours affects current earnings, career progression and potentially longer-term financial security. Someone who leaves employment completely may find it difficult to return several years later. The cost of unpaid care therefore cannot be measured only by whether a formal payment is made.

Belgium's expanded 2026 carer leave is important because it acknowledges that employment and care sometimes need to be reconciled institutionally rather than privately. But leave remains a time-limited mechanism. Long-duration caring requires employers, social protection systems and services to think beyond temporary absence.

The stronger workforce question is not only how Belgium recruits more professional carers. It is also how the labour market retains people who provide care outside work. If increasing numbers of middle-aged workers reduce employment because formal support is unavailable, the country experiences two workforce pressures at once: shortages in care and reduced participation elsewhere in the economy.

Organisations examining these dependencies can use the Predictive Workforce Risk Module to structure thinking around workforce availability, turnover and continuity. In an international long-term care context, the wider lesson is to include unpaid-care capacity in workforce assumptions rather than modelling the formal workforce in isolation.

Carers often become the system's unofficial care coordinators

Belgium's decentralised architecture creates an additional role for many families: navigating organisations. A carer may contact a sickness fund, general practitioner, hospital, home nurse, home-help service, regional administration, municipality and residential or day-care provider within the same period.

Each organisation can act appropriately within its own remit while the family still experiences fragmentation. Appointment letters, assessments and eligibility processes may not align. One professional may assume that another organisation has explained the next step. Information may be available but distributed across several languages, platforms or administrative levels.

This creates hidden coordination work. Relatives keep medication lists, repeat the person's history, chase referrals and notice when two services have made incompatible assumptions. Where the person has cognitive impairment, the carer's organisational role may become almost as demanding as the hands-on care itself.

Better multi-agency working should reduce that burden rather than formalise dependence on it. The aim is not to exclude the carer from coordination but to prevent the system from functioning only because a relative is capable of joining the pieces together.

Scenario: caring alone in multilingual Brussels

An older woman in Brussels speaks limited French and Dutch and has developed mobility problems alongside diabetes. Her adult son, who is bilingual and lives elsewhere in the city, becomes the main point of contact for almost every professional interaction. He books appointments, explains letters, speaks with the sickness fund, organises practical help and visits several evenings each week.

The arrangement appears effective because his mother rarely misses an appointment. In reality, the pathway depends heavily on one person's language skills, digital access and availability. If he travels for work, important communication can stall.

A more resilient arrangement starts by identifying what information the mother herself can receive in an accessible form and which decisions require her direct involvement. Home-help and healthcare professionals need an agreed understanding of the son's role, including what information can appropriately be shared and where his mother's consent remains central.

The system should also identify tasks that do not need to sit with him. Administrative assistance, professional care and accessible communication can reduce dependence on a single relative. If his mother's needs increase, day support or other community services may provide both social contact and structured relief from his coordinating role.

The governance lesson is that a family member who makes a fragmented pathway work can inadvertently conceal its weaknesses. A service may report good attendance and continuity while overlooking how much unpaid labour was required to achieve them. Understanding the real pathway means seeing the contribution behind the outcome.

The German-speaking Community shows the value of local navigation

The German-speaking Community operates at a very different scale from Belgium's larger federated entities. Its smaller population enables a more concentrated network of institutions but also creates particular capacity challenges, especially where specialist support or workforce supply is limited.

The Dienststelle für Selbstbestimmtes Leben, DSL, plays an important navigation and assessment role for people with support needs. Older people and families can also receive advice through the Community's care-allowance arrangements. Assessment increasingly uses BelRAI-based approaches, while home support is delivered through locally organised family and older-person assistance.

In 2026, the German-speaking Community continued substantial funding for home-support provision and explicitly recognised the need to strengthen support for caring relatives and develop further relief options. The policy direction reflects the same demographic reality seen elsewhere in Belgium: people want to remain at home, but smaller families and population ageing can reduce the amount of informal support available.

This matters because close-knit local systems should not be assumed to have unlimited community capacity. Geographic familiarity and social connection can improve navigation, but rural distance, ageing carers and limited specialist provision can place significant pressure on individual households.

Informal care needs its own evidence, not just gratitude

Care systems often acknowledge carers rhetorically while collecting limited operational evidence about their actual contribution. Yet carer sustainability can be measured and governed. Services can record whether a family member is providing night support, personal care, medication prompts, transport or continuous supervision; whether the intensity has increased; whether the carer wants to continue; and what would happen if they became unavailable.

This information matters for risk as well as wellbeing. A home-care package may appear stable because professional visits are completed reliably, while the household is becoming progressively less sustainable between visits. Without visibility of the carer's workload, organisations can underestimate the true level of dependency.

Useful evidence includes changes in caring hours, sleep disruption, employment impact, cancelled appointments, respite use, emergency episodes, the cared-for person's own wishes and whether formal services are replacing or merely adding to family work. Carer feedback should also inform service redesign through feedback and co-production rather than being gathered only after problems arise.

For organisations seeking a more structured approach to outcome and risk information, the Quality Dashboard Builder can help organise indicators around service stability, continuity, outcomes and emerging pressure. It is not a Belgian reporting framework, but the underlying discipline is relevant: hidden care becomes governable only when decision-makers can see its contribution and its limits.

Technology can reduce coordination burden, but it can also transfer work

Digital tools have considerable potential to support informal carers. Shared care information, remote monitoring, medication reminders, video contact and digital appointment systems can reduce duplication and help families remain informed. For carers living at a distance, technology can make some forms of support possible that would otherwise require travel.

However, digitalisation can also relocate administrative labour to the household. A relative may become the person expected to operate multiple portals, install devices, interpret alerts and update information because the older person is not digitally confident. A system can therefore become more efficient for organisations while becoming more demanding for carers.

The relevant test is whether person-centred technology increases autonomy and reduces unnecessary workload. Consent, privacy and proportionality remain important, particularly where monitoring technologies are used in someone's home. The fact that a family member wants reassurance does not automatically justify surveillance of an older person who does not want it.

Digital support should also have a clear response pathway. An alert that someone has not opened a refrigerator or moved around the home has little value if responsibility for checking repeatedly falls to an already exhausted daughter. Technology can strengthen care relationships, but it cannot resolve an underlying shortage of human capacity.

Scenario: when the main carer suddenly becomes unavailable

An 84-year-old man lives at home in the German-speaking Community and receives some professional home support, but his wife provides most daily assistance. She manages meals, helps him move safely around the house and accompanies him to appointments. The arrangement has been stable enough that formal services have gradually come to regard her contribution as part of the normal household context.

She is then admitted to hospital unexpectedly. Nothing about her husband's underlying care needs has changed overnight, but the effective care package has lost its largest component.

A resilient system needs to recognise this as a predictable risk rather than an exceptional family problem. The relevant services need a current understanding of what the wife usually does, which activities can be covered by home support, whether temporary additional hours are possible, whether other relatives can help voluntarily, and whether short-stay provision is required while the household stabilises.

If the only recorded information describes the professional visits, the scale of the gap may initially be missed. Staff may discover task by task that the wife was providing essential support that had never been formally documented.

The longer-term response should therefore include contingency planning for high-dependency home arrangements. It does not require families to promise backup care. It requires the formal system to know where it depends heavily on one individual and what alternatives exist if that person becomes unavailable.

This is a governance issue as much as a care-planning issue. Organisations can use the Governance Maturity Assessment to examine whether responsibility, escalation and risk visibility are sufficiently clear. In Belgium, the actual response still depends on the relevant local and federated arrangements, but the governance principle is universal: critical dependencies should not remain invisible merely because they sit inside families.

Supporting carers also protects the rights of the person receiving care

Carer wellbeing and the rights of the person receiving support should not be treated as competing interests. In most circumstances they are closely connected. Exhaustion can reduce patience, increase conflict and make restrictive responses more likely. A family member who has had no meaningful break for months may struggle to support choice and independence even when they are deeply committed to the person.

At the same time, concern for the carer cannot justify overriding the cared-for person's wishes without appropriate legal or professional basis. Adults retain rights to privacy, autonomy and participation in decisions about their lives. Professionals need to distinguish between listening carefully to a relative and allowing that relative to become the automatic decision-maker.

This is especially important in dementia, where families may gradually assume increasing responsibility as cognition changes. Strong care planning should record what the person can still decide, how communication can be supported and how relatives contribute without unnecessarily removing control.

Good informal-care policy therefore protects both sides of the relationship. It reduces unsustainable pressure on carers while strengthening choice and control for the person receiving support.

Carer support is also an equity question

Not every person has a family member who can provide care. Some people have no children. Others live far from relatives, have experienced family breakdown or belong to households in which everyone is already balancing insecure employment and financial pressure. Migrant families may provide substantial intergenerational support but face language, housing or employment barriers of their own.

If access to living at home depends heavily on informal care, two people with similar needs can experience very different options simply because one has an available family network and the other does not. This makes informal care an important dimension of health inequalities and prevention.

Equity does not require eliminating family involvement. It requires avoiding service designs in which formal entitlement assumes a level of unpaid support that some households cannot provide. Assessment should therefore identify existing informal care without treating its absence as a deficiency in the individual or family.

This is particularly important when resources are constrained. Eligibility decisions or service planning should not reward households for presenting as unable to cope while effectively penalising those that have been struggling quietly for years. Systems need ways to see accumulated carer pressure before families reach the point of complete withdrawal.

The policy challenge is to move from dependence on carers to partnership with carers

Belgium's recognition framework, regional home-care systems, care benefits, respite arrangements and 2026 expansion of carer leave show a significant institutional acknowledgement of informal care. The stronger future opportunity is to connect those mechanisms more coherently.

That means treating carer support as part of long-term care capacity planning. When authorities project future home-care demand, they also need to consider whether the pool of family members able to provide extensive unpaid support is likely to expand or contract. Smaller households, longer working lives, geographic mobility and the ageing of carers themselves can all alter that capacity.

It also means improving navigation. A family should not need specialist knowledge of federal and federated competencies to understand where to seek recognition, respite, home assistance or financial support. Belgium's decentralised system allows regionally tailored responses, but complexity should be absorbed as far as possible by services rather than transferred to households.

Finally, partnership requires reciprocity. If public policy expects carers to contribute, systems need to respond when carers say the arrangement is no longer manageable. Recognition without practical relief risks becoming symbolic.

What other countries can learn from Belgium

Belgium's institutional arrangements are shaped by its own federal structure, sickness-fund system, social protection traditions and linguistic communities, so its mechanisms cannot simply be copied elsewhere. Its experience nevertheless offers several useful principles.

• Informal carers can be formally recognised without turning family care into paid professional employment.
• Carer leave works best when it reflects the changing and episodic nature of dependency rather than assuming one continuous period of need.
• Home-care funding and carer support are interdependent because gaps in formal capacity are often absorbed inside households.
• Respite should be treated as preventive infrastructure, not as an optional benefit after exhaustion has occurred.
• Assessment should consider the sustainability of the household, not just the dependency of the person receiving care.
• Carer involvement must remain compatible with the autonomy, privacy and rights of the person being supported.

The transferable lesson lies less in Belgium's specific benefit structures than in recognising unpaid care as a material part of system capacity. Long-term care planning that models beds, professional workers and public expenditure while ignoring millions of hours provided by families will always describe only part of the system.

The future of family care will depend on how much support surrounds it

Population ageing will increase the number of Belgians living with frailty, dementia and multiple long-term conditions. At the same time, demographic and labour-market changes mean that the traditional assumption of readily available family care will become harder to sustain in some households.

The response is not to replace families with professional services. That would ignore both people's preferences and the distinctive value of close relationships. Nor is it realistic to expect families to absorb every increase in demand. The stronger model combines professional care, income protection, flexible employment, respite, accessible housing, technology and community infrastructure around relationships that people already value.

Flanders, Wallonia, Brussels and the German-speaking Community will continue to develop different mechanisms within their own competencies. Federal social rights will remain part of that landscape. What matters increasingly is whether those layers form a comprehensible and responsive pathway when viewed from the household rather than from the administration.

As home and community care expands, Belgium will need to know not only how many people receive formal services but how much care remains outside them, who is providing it and whether those arrangements are sustainable. Carers should become more visible in system intelligence without becoming a resource to be exploited simply because they are visible.

Conclusion

Informal and family carers are one of the foundations of Belgian long-term care. They provide continuity between professional contacts, enable many people to remain at home, carry detailed knowledge of changing needs and frequently coordinate across a system divided between federal, federated, local and provider responsibilities. Belgium's formal recognition of aidants proches and mantelzorgers, its regional support structures and the expansion of federal carer leave in 2026 all acknowledge that contribution more explicitly.

The strategic challenge is now to ensure that recognition is matched by sustainable support. A policy preference for ageing at home cannot depend on relatives absorbing whatever professional services, housing or community infrastructure do not provide. Carer leave, respite, home assistance, financial protection and accessible navigation need to work together, while assessment must identify when a household is approaching its limit.

The strongest model is therefore partnership rather than dependence. Families should be involved because relationships, continuity and personal knowledge matter, not because unpaid care is assumed to be infinitely available. Equally, professional systems should not displace family relationships or undermine the autonomy of the person receiving support.

Belgium's long-term care sustainability will increasingly depend on maintaining that balance. The quality of a community-care system can be judged partly by how well it supports the person receiving care, but also by whether the people around them can continue to care without sacrificing their own health, rights, employment and future.