Care Under Constraint: Unmet Care Needs Among Older Adults in Romania

Abstract

Population ageing is a common trend across Europe, yet its social consequences vary significantly between countries. In Romania, older adults face heightened risks of social exclusion and vulnerability, shaped by the legacy of post-communist welfare transformations and large-scale emigration. The shift from a state-socialist model of social protection to a fragmented, residual system has led to a growing reliance on families and informal networks. At the same time, outmigration of the care workforce abroad has generated a domestic care drain. As a result, access to care in later life is characterised by significant inequalities, which depend on family resources, material conditions, and geographic location. Drawing on a 2025 national survey of over 900 persons aged 65 and older, this study examines the relationship between the care needs of older people and the support they receive, with the aim of identifying the most vulnerable groups. Anchored in the care poverty framework, the analysis considers individual characteristics (age, gender, health status, socioeconomic position), family context (living arrangements, presence of migrant children), and structural dimensions (urban-rural divides). Findings reveal that older adults living in rural areas, those residing alone, individuals with migrant close family members, weak social networks, material deprivation, or poor health are more likely to experience care poverty. These results highlight the uneven distribution of care resources and point to the urgent need for targeted policy interventions to mitigate inequalities in later-life care provision.