Dr. Kontopoulou Konstantina A.
One of the greatest gaps in social policy of the Greek state is the lack of geriatric care and especially chronic illnesses. Despite the constant demographic challenges and the climax of the phenomenon of an aging population, Greece remains significantly underprepared to provide public long-term care facilities for the geriatric population with chronic illnesses and challenging conditions as mid-stage dementia.
Unlike most Western nations, Greece is still underdeveloped in the recognition of geriatrics as independent medical specialty, despite the alarmingly rising number of its ageing population after 65, which is found to be almost 21.8% of its total population, a percentage which is similar to Portugal’s [1](Soulis et al, 2021) The Medical School of Aristotle University has begun a post-graduate program in geriatrics for medical professionals, nurses, psychologists, social workers and other healthcare scientists, however, after graduation the potential professional development of geriatrics is limited since the specific specialty both in medicine and mental health, is extremely underestimated. According to the World Health Organization’s 2024 assessment of long-term care in Greece, the system of geriatric care remains fragmented, underfunded, and heavily dependent on informal caregiving. The report highlights the absence of a unified legal framework and the inadequate support offered to families who shoulder the burden of care (World Health Organization, 2024). This fact, except from the implication that Greece is careless for its geriatric population reveals another underlying problem: the systemic failure to implement preventive measures for the psychological and social well-being of the caregiving population. In the region of Central Macedonia with 1,795,669 inhabitants, the situation is shocking given the context of a country that has emerged from an economic crisis while it is simultaneously grappling with a demographic crisis and still spending millions on warfare equipment. There are only two public geriatric care facilities when the population aged over 65 reaches 21% in the region. [2]
This area, one of the most affected by unemployment, has consequently seen potential informal caregivers seek employment abroad or in Athens leading to an even more significant gap in geriatric care even at an informal scale. If the family cannot assist as family caregiver informal care is provided by “immigrant women without any specific training.”(Soulis et al, 2021). In case of non 24hour need for care there are “community-based resources across the country but limited to the extremely poor older persons without solid family support mainly for delivery of meals, help in hygiene and home care and social support” (Soulis et al, 2021).
This was only an example of a region in Greece and it is not the only one. For Attica’s population, reaching 4.000.000, the public facilities are also extremely limited demonstrating a generalized pattern of neglect in chronic-illness geriatric care.
The consequences are detrimental. Older adults with dementia, depression, or other psychiatric conditions face long waiting times, poor access to specialized treatment, and even stigmatization. Areas like Thessaloniki do not even have a single short-term facility for geriatric patients with challenging conditions. There is only one public long-term facility of care for geriatric patients and the waiting time is almost two years. A study published in the Journal of Neurosciences in Rural Practice observed that specialized mental-health services for older adults in remote Greek communities are “underdeveloped and inconsistently delivered,” leaving significant unmet needs (Peritogiannis & Lixouriotis, 2019). Yet, the problem goes even further. Informal family caregiving is the only free of charge solution. Yet, is it really a solution?
Around Thessaloniki, in the area of Halkidiki, 40% of caregivers of elderly patients have reported mild to severe burden, while one in ten have reported increased symptoms of anxiety (Koutsampasopoulos et al., 2008). These caregivers—often women in midlife or old age themselves—dedicate up to 70 hours a week to caregiving, frequently without respite or professional guidance. Many experience depression, isolation, and physical exhaustion. Other research has found that Greek caregivers aged 50 years or older were more likely to report depressive symptoms compared to non-caregivers (Papastavrou et al., 2013). What happens however with younger caregivers? The problem is even higher. Younger caregivers aged 18-35 do not receive any privilege from the National Authorities leading to a major destruction of their educational needs and professional advancements. Their abilities and dynamics are being constantly ignored leading to a contemporary Keadas of these young population. These young people do not receive credit for joining university despite the burden of care for an older individual with health problems or other disability. This is extremely problematic as it shows lack of social care.
These realities reveal that the problem is not only medical but moral and structural. Family is invited to the Greek social policy gaps. The consequence is a growing gap between the ethical aspect of responsibility and the practical capacity to provide appropriate care while maintaining the mental health balance of the caregiver.
To find a solution to this contemporary Keadas, Greece needs a comprehensive national strategy that integrates geriatric and psychogeriatric care across settings. Creating short and long – term facilities for elderly care and special facilities for mid-stage dementia, employing young scientists with scientific expertise and caregiving records while assisting caregivers’ burden with specific professional and educational measurements such as life and professional insurance, accredited educational and academic opportunities, mental health assistance are only small steps to a basic strategy of healthcare and social policies.
Additionally, the recognition of geriatrics as a specialty is a necessary second step. Equally vital is the creation of community-based multidisciplinary teams that bridge hospital, primary care, and home support, along with telehealth programs for remote regions (Xiarchi et al., 2024).
The gaps in Greece’s elder care are a consequence of political and social choices. Greece could transform its “Keadas” from a symbol of exclusion into one of renewal—a system where old age is not a burden and informal family caregivers – young or elder- are not unseen citizens
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Selected Bibliography (Open Access)
Hellenic Statistical Authority. (2023). Central Macedonia: 2021 Population-Housing Census Results. ELSTAT. Retrieved from https://census2021results.statistics.gr/perifereies/kentriki-makedonia
Hellenic Statistical Authority. (2025) https://www.statistics.gr/documents/20181/0a4fb776-1abc-2cd9-3545-b5ab70ac6c0a
Koutsampasopoulos, K., Ralli, F., Gavana, M., & Benos, A. (2008). Psychiatric morbidity and burden among caregivers: A cross-sectional study in rural north Halkidiki (Greece). Annals of General Psychiatry, 7(S1), S124. Open-access PDF
Peritogiannis, V., & Lixouriotis, C. (2019). Mental health care delivery for older adults in rural Greece: Unmet needs. Journal of Neurosciences in Rural Practice, 10(4), 721–724. Open access
Soulis G, Kotovskaya Y, Bahat G, Duque S, Gouiaa R, Ekdahl AW, Sieber C, Petrovic M, Benetos A. Geriatric care in European countries where geriatric medicine is still emerging. Eur Geriatr Med. 2021 Feb;12(1):205-211. doi: 10.1007/s41999-020-00419-7. Epub 2020 Nov 25. PMID: 33237564; PMCID: PMC7685957.
World Health Organization, Regional Office for Europe. (2024). State of long-term care in Greece: Technical assessment. Copenhagen: WHO Regional Office for Europe. PDF
Xiarchi, L. M., Nässén, K., Palmér, L., Cowdell, F., & Lindberg, E. (2024). Unveiling the dynamics of older person care: A qualitative exploration of the intersection between formal and informal caregiving from the perspectives of registered nurses in Greece. BMC Health Services Research, 24, 966. Open access PDF
[1] Data from OECD (2019) Health at a glance 2019: OECD indicators (summary). OECD Publishing, Paris, 10.1787/e88a7402-en. Accessed 19 May 2020, Université de Sherbrooke, Faculté des lettres et sciences humaines. Perspective Monde. https://perspective.usherbrooke.ca/bilan/tend/TUN/fr/SH.MED.PHYS.ZS.html. Accessed 19 May 2020 as cited in the work of Soulis et al, 2021.
[2] https://census2021results.statistics.gr/perifereies/kentriki-makedonia
