The transition towards person-centred and community-based care in Spain: insights for European long-term care policy

Abstract

Demographic aging poses one of the greatest social challenges in Europe, and Spain is projected to be one of the oldest countries in the world by 2050, with more than 30% of its population over the age of 65. This context is expected to increase the demand for long-term care and pressure on the social and long-term care system. This study therefore analyses the evolution of models of care for older people in Spain through a narrative review of the literature and historical and regulatory documentation, covering sources from the nineteenth century to 2025. It compares the traditional residential model, person-centred care (PCC) and the 2024–2030 State Strategy for Deinstitutionalisation, placing them in the European context. The results show that the traditional model has documented limitations in terms of autonomy and well-being; PCC emerges as an ethical and operational alternative, but its implementation is uneven; and the State Strategy proposes a transition towards community care based on rights, technology and local networks. The analysis suggests that even highly institutionalised systems can move towards more personalised and community-based models, offering lessons that are relevant to the European context.