For many older people in Uruguay, remaining at home is not simply a preference about accommodation. Home can mean familiar neighbours, routines, possessions, relationships and a continuing sense of control over everyday life. Yet remaining there safely as dependency increases may require far more than the absence of a decision to enter residential care.
Someone may need help with personal care, another person to respond after a fall, transport to community activities, adjustments to their home, support for the relative who provides most of their care and a reliable route back into health services when their condition changes. If those elements are fragmented or unavailable, ageing at home can gradually become ageing alone with an increasing burden transferred to the household.
The wider Uruguay Aging, Long-Term Care & Community Support Knowledge Hub examines how the country’s Sistema Nacional Integrado de Cuidados (SNIC) is developing around precisely these questions. Uruguay already has Personal Assistants, teleassistance and Day Centres alongside health, housing, family and residential services. Its National Care Plan 2026–2030 now proposes a more integrated route into that system and further community-based models.
The central policy challenge is therefore not whether ageing at home is desirable. It is whether Uruguay can build enough coordinated capacity around the home for it to remain a realistic choice as its population ages and care needs become more complex.
Ageing at home depends on a system, not a single home-care service
Community-based long-term care is sometimes discussed as though it were synonymous with workers visiting people in their homes. Direct personal support is important, but sustainable ageing at home requires a broader ecosystem.
Uruguay illustrates this clearly because its existing SNIC services address different dimensions and levels of dependency. Personal Assistants provide support with activities of daily living for specified groups experiencing severe dependency. Teleassistance offers a means of requesting help after an incident for people aged 70 or over with mild or moderate dependency. Day Centres provide structured daytime care for people aged 65 or over with mild or moderate dependency who live at home.
None is a complete ageing-at-home system on its own.
An older person may use teleassistance but still need help shopping. Someone may receive personal assistance but have poor housing accessibility. A Day Centre may provide stimulation and respite while transport determines whether the person can attend. A daughter may provide the majority of care but eventually become unable to combine that role with employment.
The effectiveness of home- and community-based services therefore depends on how the pieces connect around a person rather than simply on how many separate programmes exist.
Demographic change makes the question increasingly structural
Uruguay is already an ageing society. The 2023 Census recorded approximately 545,300 people aged 65 and over, representing 16% of the population. The age structure has changed substantially over the longer term as longevity has increased and younger age groups have become a smaller share of the population.
This does not mean that 16% of Uruguayans require long-term care. Most older people remain independent, and chronological age is a poor substitute for understanding functional ability.
It does mean that the population from which age-related care needs emerge is substantial and likely to place increasing importance on services that can respond before institutional care becomes necessary.
The operational issue is also cumulative. An ageing population affects demand for direct care workers, primary healthcare, rehabilitation, accessible housing, transport, dementia support and assistance for unpaid carers simultaneously. Expanding one programme without considering those dependencies can move pressure rather than resolve it.
This is why Uruguay’s policy direction increasingly treats care as infrastructure. The National Care Plan 2026–2030 links the right to care not only with services but with housing, habitat, mobility, workforce, community and information.
Ageing at home is consequently a system-design question: what combination of formal and informal resources allows people with changing levels of autonomy to continue living in ordinary communities?
Uruguay already has the foundations of a community care pathway
The existing SNIC gives Uruguay several building blocks on which to develop that pathway.
Teleassistance can provide reassurance and emergency contact for someone whose dependency remains mild or moderate. Day Centres can add structured activity, social participation and respite. Personal Assistants provide more direct support with daily life for eligible people with severe dependency. Beyond these programmes sit primary and specialist healthcare, family support, long-stay establishments, housing policies and local community organizations.
The challenge is that eligibility and programme boundaries do not necessarily mirror the way dependency develops.
A person does not move neatly from independent to mildly dependent, then moderately dependent and finally severely dependent according to administrative timetables. Needs can fluctuate. A hospital admission may produce a sudden reduction in function. Rehabilitation may restore some capability. Cognitive decline can alter risk without immediately producing major physical dependency. The death of a spouse can transform an apparently sustainable home arrangement overnight.
A strong long-term care pathway therefore needs both differentiated services and mechanisms for moving between them.
Uruguay’s 2026–2030 Plan recognizes this directly. It proposes moving away from applications made primarily to individual programmes towards a single route into the care system based on more comprehensive assessment, with periodic reassessment and referral between benefits as people’s circumstances change.
That shift could be more consequential than simply increasing the capacity of an individual programme.
Scenario: one assessment should open a pathway rather than one service
An 82-year-old woman lives alone in Montevideo. Until recently she managed independently, supported informally by a son who visits at weekends. Following a fall, she becomes less confident bathing and going outside. She is not seeking residential care and strongly wants to remain in her apartment.
A programme-led system can fragment her circumstances into separate questions. Does she qualify for teleassistance? Is she sufficiently dependent for another service? Should her son contact health services separately about mobility? Who considers whether the apartment itself is becoming difficult to use?
A person-centered access model begins with her situation instead.
An integral assessment can identify functional need, personal preferences, available family support, environmental risks and the services that may currently be appropriate. Teleassistance could provide a route to assistance after an incident. Rehabilitation or primary healthcare may need to address the consequences of the fall. Community activity could help rebuild confidence and reduce isolation.
Crucially, the assessment should not become a permanent classification.
If her mobility improves, support may reduce. If dependency increases, the care pathway should be able to respond without requiring the family to rediscover the system from the beginning.
The governance test is whether the SNIC can maintain that continuity across programmes. Ageing at home becomes substantially more secure when the person enters a system rather than repeatedly applying to disconnected services.
Personal assistance can sustain autonomy, but coverage and design matter
For people experiencing severe dependency, support inside the home becomes more intensive. Uruguay’s Personal Assistants programme provides help with activities of daily living and is an important part of the country’s response to dependency.
The National Care Plan reported approximately 5,900 Personal Assistant users in 2025 and acknowledged that coverage of community services remained limited. It also identified expansion and changes in provision as part of the next phase of SNIC development.
Personal assistance has particular value because support can be organized around the individual’s everyday environment rather than requiring the person to move into a care institution simply to obtain help.
But hours of assistance do not automatically create independence.
Practice matters. Support that routinely takes over tasks a person can still perform may unintentionally accelerate dependence. Conversely, insufficient support can leave people or relatives managing unsafe levels of need. Continuity also matters because intimate personal care depends heavily on trust, communication and familiarity.
This creates a workforce requirement as well as a funding requirement. Workers need practical competence, clear employment arrangements, supervision and an understanding that the purpose of assistance is not simply task completion but support for autonomy.
The Plan’s proposed development of collective provision through cooperatives, social enterprises and other organizational forms is therefore significant. It could potentially create stronger structures around workers who might otherwise operate more individually, although implementation and outcomes will need to be assessed as these models develop.
Teleassistance extends the home, but technology cannot become the care plan
Uruguay’s teleassistance programme provides another layer of support. People aged 70 or over with mild or moderate dependency can use the service to alert family, neighbours or medical services when an incident occurs at home.
The National Care Plan reported approximately 1,100 users in 2025 and sets a goal of reaching 1,500 people. It also proposes incorporating innovative technologies and developing a service catalogue with multiple teleassistance alternatives.
Technology can strengthen ageing at home because it changes the relationship between being alone and being unreachable. A person may retain privacy and independence while knowing that assistance can be summoned when necessary.
Its limits are equally important.
An alarm cannot help someone wash, prepare food or overcome loneliness. Sensors do not repair inaccessible housing. Digital monitoring cannot substitute for a relationship with someone who recognizes that a person is becoming withdrawn or confused.
Technology can also create new forms of exclusion where devices are difficult to operate, connectivity is unreliable or people do not understand how their information is being used.
Organizations examining similar developments can use the Digital Transformation, AI and Cybersecurity Readiness Assessment to structure questions about digital capability, governance and risk. It is not a Uruguayan assessment instrument, but the underlying discipline is relevant: technology-enabled care needs to be judged through accessibility, privacy, resilience and service outcomes rather than novelty.
Uruguay’s opportunity lies in treating teleassistance as one component of technology-enabled care, connected with human support rather than positioned as a substitute for it.
Family care remains essential, but should not become the hidden funding model
Much of the practical work that allows older people to remain at home takes place outside formal programmes.
Relatives shop, cook, accompany people to appointments, manage paperwork, provide emotional reassurance, monitor medication, respond at night and notice when something has changed. Those contributions can be deeply valued by everyone involved.
They can also become unsustainable.
Care responsibilities may reduce employment, income and retirement savings. A spouse who is also ageing may be physically unable to continue lifting or providing personal care. A daughter may coordinate several services while raising children and working. Geographic distance can leave one family member carrying most of the responsibility.
Uruguay’s concept of corresponsabilidad is therefore fundamental to ageing at home. The objective is not to displace families from care but to prevent care from being treated as an essentially private responsibility, disproportionately absorbed by women.
This is where family care and caregiver burden become system issues. If a home-care model works only because an unpaid relative silently contributes dozens of hours each week, its apparent public cost understates its real resource requirement.
Scenario: caregiver capacity can change before the older person’s dependency does
An 86-year-old man lives with his 78-year-old wife. He has significant mobility limitations, while she provides meals, household support and much of his supervision. Their daughter lives nearby and helps several evenings each week.
His assessed dependency remains broadly stable, so a service system focused only on his functional condition may see little reason to change the care arrangement.
Then his wife develops her own health problems.
The household’s care capacity changes immediately even though his dependency score does not. Their daughter increases her involvement, but this begins affecting her employment. What had looked like a sustainable ageing-at-home arrangement becomes fragile.
A responsive pathway needs to recognize family capacity as dynamic. Reassessment should consider not only what the older person cannot do, but whether the network on which the existing arrangement depends remains available and willing to provide support.
That may lead to a different combination of formal assistance, community support or respite. It may also require planning for the possibility that living arrangements eventually need to change.
The important principle is that family care should be visible without being presumed. Relatives are partners in care where the person wants their involvement; they are not an unlimited substitute for public provision.
Day Centres add the community dimension that home visits cannot provide
Ageing at home should not mean receiving every service behind the front door.
Uruguay’s Day Centres demonstrate the importance of community-based spaces where people with mild or moderate dependency can participate in physical, cognitive, cultural and social activities while continuing to live at home.
The model has already been examined separately within this series because its operational design deserves detailed attention. Within the wider ageing-at-home pathway, its significance is different: Day Centres show how community infrastructure can complement support delivered inside the home.
A worker may help someone dress and prepare breakfast, but that alone does not create social participation. Teleassistance can improve emergency response, but it does not create relationships. A family member may provide companionship, but relying exclusively on relatives can narrow a person’s social world.
Community provision helps maintain ordinary life beyond care tasks.
That makes social participation part of independence rather than an optional enhancement after physical needs have been met.
Housing can determine whether community care succeeds
The home itself is sometimes the limiting factor.
Stairs, narrow bathrooms, poor accessibility or an unsuitable location can turn manageable dependency into a much greater need for human assistance. Conversely, appropriate housing can allow relatively modest support to sustain independence.
Uruguay’s 2026–2030 Plan explicitly connects care with housing and proposes a new viviendas con apoyos, or supported-housing, programme. The model envisages small-scale housing embedded in ordinary communities for people who need support with daily life but do not need—or do not wish—to live in a long-stay institution.
The Plan describes flexible support including assistance with daily activities, help with administrative tasks, strengthening community networks and cultural, recreational or work-related participation. It sets a goal of at least four pilot experiences during the five-year period.
The distinction between established and emerging provision matters here. Supported housing is a planned development rather than a mature national alternative currently available across Uruguay.
Its significance nevertheless extends beyond the pilots. It recognizes that the choice between an unsupported private home and an institutional setting is unnecessarily narrow.
Housing with flexible support can create a third space: ordinary community living with enough assistance around the person to make independence sustainable.
Community care could make support less dependent on individual programmes
One of the most interesting directions in Uruguay’s National Care Plan is the development of Comunidades que cuidan—communities that care.
The Plan proposes introducing a community-carer role in at least ten departments, using the potential of Day Centres and collective Personal Assistant provision. It also describes innovation around a care-manager function capable of coordinating local resources around a care and life plan.
These are commitments for development during 2026–2030, not evidence that Uruguay already has a standardized community-care workforce operating nationally.
They nevertheless address an important weakness in programme-based systems. People frequently need help that sits between formal entitlements.
An older person may need someone to reconnect them with a local activity after bereavement, help coordinate several supports or notice that the family arrangement on which their care depends is deteriorating. These needs can be too significant to ignore but not always neatly matched to a specialist programme.
A community role can potentially work across those boundaries, provided responsibilities are clear and workers are not expected to compensate indefinitely for unavailable formal services.
The stronger opportunity lies in creating local connective capacity: people who understand both the individual and the resources surrounding them.
Scenario: community coordination prevents a series of small problems becoming one large crisis
A 79-year-old man in a smaller urban community has mild dependency and uses teleassistance. Following the death of his partner, he begins missing health appointments and stops attending a local social group. His home is becoming poorly maintained, but no single issue appears severe enough to trigger an urgent intervention.
His daughter lives in another department and becomes increasingly worried. She makes telephone calls to several organizations but is unsure who is responsible for coordinating the overall situation.
A mature community-care model would recognize the pattern rather than waiting for one problem to cross a crisis threshold.
A local care coordinator or community worker could help reconnect him with social activity, identify practical support, ensure relevant health concerns reach the appropriate service and clarify whether his care needs should be reassessed. Teleassistance remains useful, but it sits within a wider network rather than becoming his only formal support.
If similar cases repeatedly reveal the same gaps, that information should also move upwards. Local experience might show that transport is the main barrier, that particular communities lack daytime support or that people discharged from hospital are routinely losing contact with existing networks.
This is where community care becomes more than individual problem-solving. It generates intelligence about how the system is functioning territorially.
Territorial variation is one of the central tests of ageing at home
Uruguay’s relatively small national population does not remove geographical inequality.
Services concentrated in Montevideo or larger departmental centres are not equally usable by someone living in a smaller town or rural area. Travel time affects Day Centre attendance, access to rehabilitation and the practicality of workforce deployment. Specialist workers may be harder to recruit outside larger population centres.
Digital support can reduce some distance but cannot remove the physical dimensions of care.
This means that national entitlement and local service availability need to be analysed separately. A person can satisfy eligibility criteria yet have fewer realistic options because of where they live.
The challenge is unlikely to be solved by reproducing exactly the same service configuration everywhere. Lower-density areas may need more flexible workforce models, mobile or shared provision, transport solutions and stronger coordination between existing community assets.
That makes rural and underserved communities a planning issue rather than simply an equity statement.
National governance should be capable of identifying persistent territorial differences while allowing local models to adapt to population density and available infrastructure.
Health and long-term care have to meet around the person
Ageing at home also depends on what happens when health changes.
An older person may be stable with community support until pneumonia, a fracture, medication problems or worsening chronic disease leads to hospital treatment. The discharge home then becomes a critical transition.
Clinical stability does not necessarily mean that the previous living arrangement remains workable. Someone may temporarily need more help walking, bathing or preparing food. A family carer may not have been trained or prepared for those changes. Existing social support may need to be restarted or adjusted quickly.
This makes hospital-to-community transition relevant to long-term care even though hospital treatment and SNIC provision sit within different parts of Uruguay’s institutional landscape.
The strongest pathway is not one in which health services absorb social care responsibilities or vice versa. It is one in which each can recognize when the other is required.
Primary healthcare is particularly important because it can provide continuity around chronic conditions, functional change and prevention. Community care services, meanwhile, may observe everyday changes that are invisible during occasional clinical appointments.
Integration becomes practical when those observations can lead to proportionate action without requiring families to act as the sole information bridge.
Prevention has to begin before severe dependency
A long-term care system that concentrates most resources after severe dependency develops will struggle to make ageing at home sustainable.
Prevention in this context does not mean promising to prevent ageing or eliminate disability. It means protecting functional ability where possible and reducing avoidable causes of deterioration.
Falls prevention, physical activity, nutrition, medication review, social connection, accessible housing and timely rehabilitation can all influence how people function. So can confidence: after a fall or hospitalization, fear may lead someone to move less, which can itself contribute to further loss of strength and independence.
Uruguay’s Day Centres and teleassistance already operate among populations with mild or moderate dependency, creating opportunities to act before needs become more intensive.
The wider system can strengthen that approach by connecting preventive value and early intervention with assessment and care planning rather than treating prevention as a separate public-health message.
The financial value of prevention also needs careful interpretation. Not every intervention produces an immediate cash saving, and longer life at home may still require substantial formal support. The relevant value may include maintained autonomy, reduced family strain, delayed escalation and better quality of life as well as avoided expenditure.
Workforce capacity will set the practical ceiling on expansion
Policy can establish entitlement and funding, but community care ultimately depends on people being available to deliver it.
Uruguay’s National Care Plan identifies professionalization and decent working conditions as a strategic objective. That is particularly important for ageing at home because community provision distributes workers across many individual households rather than concentrating them within one facility.
Travel time, scheduling, fragmented hours and geographic distribution can therefore affect productive capacity. Continuity also becomes harder when turnover is high.
The workforce challenge is not simply to recruit more people. Uruguay needs enough workers with the right competencies, employment conditions and organizational support to provide reliable care while the number of people requiring assistance grows.
Collective provision models may create opportunities for stronger supervision and coordination. Training can support consistent practice. Career development may improve the status and attractiveness of care work. Technology can reduce administrative burden or improve scheduling, but it cannot remove the relational and physical work at the centre of personal support.
Organizations examining comparable capacity pressures can use the Predictive Workforce Risk Module to structure analysis of vacancies, turnover and continuity risk. It is not an SNIC workforce tool, but it illustrates why workforce data and capacity planning need to sit alongside service-expansion targets.
Scenario: expanding entitlement without workforce capacity creates a different kind of waiting
A department experiences growing demand for community support among older residents. Assessment capacity improves and more people are identified as needing formal assistance. Policy has therefore succeeded in making need more visible.
But the local care workforce does not expand at the same rate.
Families may technically have an entitlement or approved service while struggling to find stable provision. Workers may travel long distances between households, reducing the amount of time available for direct support. Frequent changes of worker can weaken continuity for people receiving intimate personal care.
The immediate temptation is to treat this as an operational scheduling problem. At scale, however, it is a strategic capacity issue.
Local information about vacancies, travel, unmet hours and turnover needs to reach national decision-makers alongside headline figures on eligibility and programme coverage. Training places may need adjustment. Collective provision could be tested where it improves deployment and supervision. Service models may need to reflect population density rather than assuming that one configuration works everywhere.
The scenario illustrates a wider principle: universalization involves more than expanding formal access. A right becomes meaningful only when the workforce and infrastructure exist to deliver it with reasonable continuity and quality.
Quality at home is less visible than quality inside an institution
Community care creates a particular assurance challenge because services are delivered behind thousands of separate front doors.
A residential establishment has a fixed location, management structure and concentrated workforce. Home-based care is dispersed. Supervisors cannot observe every interaction, and family members may have very different levels of involvement.
This makes clear standards, training, records, complaints routes and follow-up important. It also makes the person receiving support a crucial source of quality information.
Quality should not be reduced to whether a worker arrived and completed assigned tasks. Relevant outcomes include dignity, continuity, reliability, autonomy, communication and whether support helps the person live the life they have chosen.
Safeguarding requires similar balance. Older people living at home can experience abuse, neglect, financial exploitation or coercion, including within family relationships. At the same time, excessive risk aversion can restrict ordinary autonomy.
Community care therefore requires a mature approach to quality, safety and safeguarding in ageing services: risks should be recognized and acted upon without treating every person with dependency as incapable of making decisions.
Organizations considering comparable assurance systems can use the Quality Dashboard Builder to structure service, quality and outcome indicators. The wider principle is that dispersed care needs governance capable of seeing patterns across individual households without losing the person behind the data.
Information should reveal whether community living is genuinely sustainable
Uruguay’s planned move towards integrated assessment creates an opportunity to build better intelligence about care trajectories.
Instead of knowing only how many people use each programme, the system can increasingly ask how people move between them. How many people with mild dependency later require more intensive support? Which factors are associated with successful continuation at home? Where do family arrangements break down? Which territories experience long waits or limited options?
Those questions require appropriate data governance and should not lead to intrusive surveillance of older people.
They do, however, allow policy to move beyond activity measures.
Useful national intelligence could bring together:
- dependency and reassessment patterns;
- service availability and waiting times by territory;
- continuity and workforce capacity;
- carer circumstances where appropriately captured;
- health and care transitions; and
- outcomes such as autonomy, participation and satisfaction.
The aim is not to create a single algorithm deciding where someone should live. Housing and care choices involve rights, relationships and personal preferences that cannot be reduced to predictive scores.
Data should instead help the SNIC identify where policy intent and practical experience diverge.
Financing has to recognize the real cost of community living
Ageing at home is sometimes assumed to be inherently cheaper than residential care. That may be true in some circumstances, particularly where relatively modest support prevents the need for continuous institutional provision. It should not be treated as a universal rule.
A person with severe dependency living alone may require substantial paid support. Adaptations, transport, technology and health services also carry costs. Where families provide large amounts of unpaid care, some of the apparent saving reflects costs transferred outside public budgets.
Uruguay’s own policy debate therefore has to connect expansion with sustainability.
The National Care Plan acknowledges resource constraints and the need for progressive development towards universality. This requires choices about which services expand, how quickly capacity can grow and how different forms of support are financed.
A mature approach to budget impact and affordability should consider the whole pathway rather than evaluating programmes in isolation.
A community service that appears expensive within one budget may reduce pressure elsewhere, but such effects should be demonstrated rather than assumed. Equally, underfunding community care can create hidden expenditure through avoidable crises, hospital use, caregiver withdrawal or premature institutional placement.
Sustainability therefore involves matching resources to outcomes while being transparent about who is actually carrying the cost of care.
Ageing at home must remain a choice rather than a policy instruction
There is an important rights distinction between enabling people to remain at home and assuming that remaining at home is always preferable.
Many older people strongly want to stay where they live. Others may feel unsafe, isolated or overwhelmed. Some may prefer a supported housing arrangement or residential community. Severe dependency can make continuous support difficult to provide safely in a particular home, especially where housing is unsuitable or the person has no reliable support network.
A person-centered system should therefore expand alternatives without creating a new orthodoxy.
The objective is not to minimize residential care at any cost. It is to avoid institutionalization occurring merely because community alternatives were unavailable.
This distinction becomes increasingly important as Uruguay develops supported housing and community-care models. More options should create more meaningful choice, not another predetermined pathway.
Uruguay’s next opportunity is to connect community services into local care ecosystems
The most significant direction in the 2026–2030 Plan may ultimately be the attempt to move beyond separate programmes.
Supported-housing pilots, community carers, proposed care coordination, Day Centres, collective Personal Assistant provision and expanded teleassistance all point towards a more networked model. The Plan also proposes community care centres for older people in housing complexes, linking accommodation, shared spaces, services, active ageing and community support.
These developments are at different stages and should not be interpreted as one established nationwide model. Their strategic logic is nevertheless coherent.
Ageing at home works best when the person is surrounded by an ecosystem rather than a collection of isolated transactions.
Housing affects care. Transport affects participation. Workforce capacity affects entitlement. Health services affect recovery and stability. Technology affects responsiveness. Families affect continuity. Community relationships affect isolation and wellbeing.
National policy therefore has to create standards, funding and accountability while territorial delivery connects those components around real lives.
This is also where governance becomes most demanding. Multiple institutions can contribute to a good outcome while no single programme controls all the factors determining it.
International learning lies in the architecture around the home
Uruguay’s institutional arrangements cannot simply be transferred to another country. The SNIC was created within Uruguay’s particular welfare state, legal framework, demographic profile and tradition of national social policy. Its eligibility rules, administrative institutions and workforce arrangements are locally specific.
The transferable lesson lies less in those structures than in the recognition that community living requires infrastructure.
Countries seeking to reduce unnecessary institutional care cannot rely only on declaring a preference for home-based support. They need multiple levels of assistance, mechanisms for reassessment, support for unpaid carers, accessible housing, community participation, workforce capacity and connections with healthcare.
They also need to understand that these elements interact. Weakness in one can destabilize the others.
Uruguay’s planned shift from programme-specific applications towards an integrated care-system trajectory is particularly relevant. The principle is that people should not have to redesign their own pathway each time dependency changes.
Other systems could adapt that principle without replicating Uruguay’s exact eligibility or administrative mechanisms.
Conclusion
Uruguay has already established several of the components needed to support ageing at home: Personal Assistants, teleassistance, Day Centres and a national care system that recognizes care as a social right rather than solely a private family responsibility. The challenge now is to connect and expand those components as demographic change increases the importance of long-term support.
The National Care Plan 2026–2030 points towards a more coherent model. Integrated assessment and service trajectories could reduce fragmentation. Community carers and care coordination could strengthen local connections. Supported-housing pilots could widen the choices between an unsupported home and residential care. Technology can improve responsiveness, while workforce professionalization and stronger information can improve reliability and oversight.
None of these developments removes the central implementation test. Community living requires enough real capacity in the places where people live. Formal entitlement is weakened when workers are unavailable, transport is inaccessible, family carers are exhausted or housing makes ordinary tasks unnecessarily difficult.
The future of ageing at home in Uruguay will therefore depend less on any single programme than on the architecture built around the person. If national policy can connect care, health, housing, technology, family support and community resources while preserving genuine choice, remaining at home can become a sustainable pathway across changing levels of need. If those connections remain fragmented, households will continue to absorb the gaps. Uruguay’s next phase is about turning a collection of community supports into a care system capable of accompanying people as their lives change.