What this means
Governments worldwide are investing in ageing in place-that is, policies and programmes that enable older adults to remain in their homes and communities irrespective of income level or functional ability. However, there have been few concerted evaluation efforts to keep up with these reforms.
A plain-English summary is on its way. Until then, this is the start of the authors' own summary.
- Who it was tested in
- Earlier studies
- Kind of research
- A summary of earlier studies
The science
- Original title
- Ageing in place: how to evaluate current practices following long-term care reforms.
- Authors
- MacNeil-Vroomen JL, Wouterse B, Quesnel-Vallée A et al.
- Journal
- The lancet. Healthy longevity
- Published
- Oct 26, 2026
- Study type
- Review
- PMID
- 42933452 ↗
Abstract
Governments worldwide are investing in ageing in place-that is, policies and programmes that enable older adults to remain in their homes and communities irrespective of income level or functional ability. However, there have been few concerted evaluation efforts to keep up with these reforms. Drawing on country examples from the Netherlands, Norway, and Japan, this Personal View identifies three recurring reform tensions: decentralisation versus coordination, personal versus collective responsibility, and cost containment versus investment. Each reform tension produces unintended consequences that evaluations can detect, prompting midcourse corrections. Importantly, existing evaluation frameworks remain narrowly focused on care expenditure, missing the wider societal consequences of reforms. These frameworks also overlook structural inequities that shape who can and cannot age in place with dignity. We therefore propose an integrated, equity-stratified framework to assess whether ageing in place reforms achieve their stated goals or instead widen the disparities they purport to address.
MacNeil-Vroomen JL, Wouterse B, Quesnel-Vallée A et al. Ageing in place: how to evaluate current practices following long-term care reforms. The lancet. Healthy longevity. 2026. doi:10.1016/j.lanhl.2026.100929. PMID: 42933452. https://pubmed.ncbi.nlm.nih.gov/42933452/