By 2050, there may be nearly 12 million elderly people in Poland, making up 40 percent of the population. This ongoing aging of the population presents a challenge in the context of developing geriatric and long-term care. Even now, the biggest problem in these areas is a lack of staff. In the coming years, a significant portion of the workforce currently employed in long-term care will reach retirement age. Without proper actions taken now, the shortage of medical and caregiving staff in long-term care could soon reach a critical level.
“Long-term care faces many challenges. The first pillar that secures long-term care is staff, and we have a problem with that,” evaluates Magdalena Osińska-Kurzywilk, president of the coalition “Help for the helpless,” in conversation with Newseria agency. “We have a difficult demographic situation related to an aging population. As a result, we need more staff for long-term care.”
The elderly make up a steadily increasing proportion of Poland’s population. In 2023, Poland’s population was 37.6 million, with nearly 9.9 million people aged 60 and over. According to GUS forecasts, the population of people aged 65+ will increase to 11.8 million by 2060, making up nearly 40 percent of the population.
In old age, the risk of diseases increases, as well as the loss of ability to function daily. The GUS report “Population aged 60+. Demographic structure and health” states that every third person aged 65+ has difficulty performing activities related to basic self-service. In the case of more complex tasks, the need for assistance is much greater. From the “Health Needs Map for 2022-2026” of the Ministry of Health, it appears that in 2019, about 110,000 patients benefited from nursing and caregiving services as part of long-term care financed from NFZ funds. That’s only a small percentage of those actually needing help. In many cases, families take care of the elderly, but they are not always able to meet this challenge.
“Working in long-term care is not very popular for several reasons, one of them is salaries, or financial matters. There are many professions in long-term care, starting from doctors with a specialty in geriatrics, through nurses, also with a specialty in geriatrics, but also in behavioral specialization and others, to auxiliary staff. Here, medical carers, who can work and have education suitable for long-term care, deserve great credit,” says Magdalena Osińska-Kurzywilk. “Unfortunately, there is a decline in long-term care personnel. This is not solely due to financial matters, although they are undoubtedly a very important factor, but also due to the aging of medical staff, including doctors, nurses, but also medical carers who choose this profession.”
The Ministry of Health’s review “Comprehensive review of possibilities for creating long-term care centers and geriatric departments in county hospitals in Poland” indicates that the average age of a nurse in long-term care is 50, and over 14 percent are of retirement age. There is also a strong dynamic of aging among nurses in geriatric wards – the average age of nurses is 48, almost 9 percent are of retirement age.
The Supreme Audit Office (NIK) in the report “Functioning of medical geriatric care” draws attention to the age structure of the nursing staff in the context of a large disproportion in the number of nurses with qualifications in geriatrics, long-term care, palliative care, internal nursing, and behavioral nursing, and especially on a large percentage of personnel over 40 years of age. This may cause a lack of nurses in the future, and as a result, a problem with providing elderly patients with care at the appropriate level.
“Long-term nursing care is very difficult. Nurses often have to make decisions independently, be specialists in various fields: cardiology, internal medicine, pulmonology, and others. Therefore, few people take jobs in long-term care. As it is very poorly paid in this system, nurses treat it rather as an additional source of income, and the main job is a department of inpatient treatment. If they give up an additional source of employment, it is this long-term care, which is why this system is currently so poorly staffed,” explains the president of the Coalition “Help for the helpless.”
NIK believes that a key problem in the development of geriatrics in Poland that remains unsolved is the too small number of medical personnel with qualifications in this area. In 2021, 532 doctors were specialized in the field of geriatrics. According to Professor Tomasz Kostka, former national consultant, the target number of geriatrics in Poland should be 3,000 doctors. Qualifications in geriatrics, long-term care, or palliative care at the same time were held by slightly over 11.1 thousand nurses.
“Fortunately, older nurses, because that’s what we should say, are currently securing long-term care. But the gaps are significant,” emphasizes Magdalena Osińska-Kurzywilk.
In November 2024, several thousand nurses and midwives supported by medical rescuers and medical diagnosticians protested in front of the Chancellery of the Prime Minister. Representatives of nurses and midwives from all over Poland talked about daily problems they face. The lack of staff was a recurring issue in all statements, contributed to by difficult working conditions, non-observance or violation of employment norms, non-recognition of competences, and the inability to plan a career path as a result.
“The nursing and midwifery community is currently very divided. Some services provided by a nurse are financed from the Ministry of Health and these are all services provided in facilities or medical entities financed by the National Health Fund, these are LTCs, OZPs, hospital wards, geriatric wards or long-term nursing care. The other services are performed, among others, in social welfare homes. These nurses are no longer covered by the increases received by all those employed in medical entities. This has caused a division of nurses and protests,” says the president of the Coalition “Help for the helpless.”
