An older Indonesian recovering from a stroke may need help with mobility, personal care, medication routines and rehabilitation. Another person living with dementia may need supervision and support that changes gradually over several years. A family may be willing to provide much of that care but still need somebody with the right skills to visit the home, assess changing needs, provide practical assistance or recognize when specialist intervention is required.
Indonesia’s aging transition is therefore becoming a workforce question as much as a demographic one. As explored across the Indonesia Aging, Long-Term Care & Community Support Knowledge Hub, the country is developing community-based and integrated approaches while families continue to provide a substantial share of everyday support. The next challenge is ensuring that sufficient human capability exists around those arrangements.
This does not mean importing a mature long-term care labor model from another country. Indonesia already has nurses, doctors, rehabilitation professionals, social-welfare personnel, community cadres, family caregivers and emerging care roles. The strategic task is to build a more coherent workforce from those assets while identifying functions for which capacity remains insufficient.
That requires more than recruitment. Indonesia needs to consider what care work is, which tasks require professional qualifications, which can be performed by appropriately trained care workers, how community roles connect with formal services, how workers are supervised and protected, and how a country of more than 17,000 islands can distribute capability more equitably.
The workforce question ultimately determines whether policy ambitions such as healthy aging, aging in place and integrated long-term care become practical services or remain largely dependent on what individual families can provide.
Population Aging Is Creating a New Labor-Market Requirement
Indonesia’s older population reached approximately 34.7 million people, or 12.33% of the population, in 2025 according to the Ministry of National Development Planning/Bappenas. Bappenas projects that the proportion could reach 20.31% by 2045.
Those figures do not translate directly into an equivalent increase in long-term care workers. Many older people remain independent, and effective prevention can extend healthy and active life. Yet a larger older population inevitably increases the absolute number of people living with functional limitations, frailty, dementia, stroke-related disability and multiple long-term conditions.
The resulting labor requirement extends beyond healthcare.
A doctor can diagnose disease but does not provide several hours of assistance with everyday activities. A physiotherapist can design a rehabilitation program but cannot necessarily ensure exercises are incorporated safely into daily life. A family member may provide companionship and personal support but may need training, respite or assistance when needs become more complex.
Long-term care therefore occupies a space between healthcare, social support, rehabilitation and ordinary household life.
Indonesia’s 2025–2045 Care Economy Roadmap is important in this context. Bappenas has linked development of the care economy with social protection, financing, capacity development and protection for formal and informal workers. More recent national planning discussions have also identified the care economy as a potential source of new formal employment as Indonesia’s demographic structure changes.
This reframes care workforce development. Care is not simply a cost generated by population aging. Properly designed, it can become an employment sector that supports economic participation elsewhere by reducing the amount of intensive care that families—particularly women—must absorb without assistance.
Indonesia Is Not Starting Without a Workforce
It would be misleading to describe Indonesia as needing to create an eldercare workforce from nothing.
The country already has substantial human infrastructure. Puskesmas provide primary healthcare at local level. Nurses, doctors and other health professionals support older people with clinical needs. Rehabilitation professionals contribute to functional recovery. Social-welfare structures address aspects of vulnerability and social support. Posyandu and community cadres extend preventive and promotional activity into neighborhoods and villages. Families provide the largest layer of everyday assistance.
Community-based long-term care pilots supported by the Asian Development Bank have added another source of practical learning. The Indonesian pilot undertaken from 2022 to 2024 developed community care hubs and included training programs intended to strengthen long-term care capability. Its significance lies less in establishing a finished national workforce model than in demonstrating that care functions can be organized around existing local assets.
The workforce problem is therefore partly one of fragmentation.
Different people can see different parts of an older person’s needs without anyone necessarily being equipped or responsible for supporting the complete daily-care arrangement. Clinical staff may identify disease. A cadre may notice that someone has become less mobile. A family member may know that bathing has become difficult. A social-welfare actor may understand the household’s financial vulnerability.
Workforce design needs to connect these perspectives while preserving appropriate professional boundaries.
The strongest opportunity is not to make every worker capable of doing everything. It is to establish complementary roles and reliable escalation.
Long-Term Care Needs Its Own Occupational Identity
One of the central questions for Indonesia is whether long-term care work becomes recognized as skilled work in its own right.
Where care remains largely inside families or informal employment, its complexity can be underestimated. Helping somebody dress may appear straightforward until that person has hemiplegia after a stroke, pain, cognitive impairment or a high falls risk. Supporting eating can involve nutrition, swallowing concerns, dignity and cultural preferences. Assisting a person with dementia requires communication and judgment as well as physical presence.
Care workers do not need to become nurses to perform these functions effectively. But neither should the work be defined as unskilled simply because it takes place in a home rather than a hospital.
A developing occupational framework could distinguish several levels of capability:
- community and volunteer roles focused on outreach, connection, health promotion and identifying changing needs;
- direct-care roles providing appropriate assistance with everyday living, independence and social participation;
- more advanced care roles able to support people with greater functional or cognitive complexity under appropriate supervision;
- health and rehabilitation professionals responsible for clinical assessment, treatment and professionally regulated interventions; and
- coordination and leadership roles responsible for assessment, care planning, supervision, quality and service development.
The boundaries would need to reflect Indonesian regulation, labor conditions and service models rather than an imported occupational hierarchy.
The underlying principle is nevertheless important. Clearer roles make training more meaningful, help employers understand what competence they are purchasing, make delegation safer and allow workers to see a route from entry-level care into more advanced responsibilities.
Competence Must Be Designed Around What Older People Actually Need
A national workforce strategy can easily become dominated by qualifications rather than capability.
Qualifications matter, but long-term care quality is ultimately determined by what workers can do consistently in real settings.
Core capability may include understanding aging and functional change; supporting mobility and independence; communicating with people with sensory or cognitive impairment; recognizing deterioration; supporting nutrition and hydration; understanding basic medication-related risks; maintaining dignity and privacy; identifying possible abuse or neglect; and knowing when to seek professional help.
Person-centered capability is equally important.
A worker who completes tasks efficiently but removes every opportunity for an older person to do things independently can unintentionally accelerate dependency. Someone supporting a person after illness should understand the difference between helping and taking over.
This connects workforce development with Indonesia’s broader policy emphasis on healthy aging and aging in place. Care workers should not merely maintain people in a passive state of dependency. Where possible, their practice should support function, confidence and participation.
Training therefore needs practical validation. Completing a classroom session does not demonstrate that a worker can assist somebody safely, communicate respectfully with a person with dementia or respond appropriately to a change in condition.
Organizations examining comparable workforce systems can use structured approaches to competence, supervision and assurance when deciding how learning becomes observable practice. The wider principle is that training inputs should eventually be connected to service outcomes, not counted as an end in themselves.
A new worker learns why doing more can produce a worse outcome
A community-based service recruits a worker to support a 72-year-old woman in Yogyakarta after hospitalization for a fractured hip. Her daughter lives with her but works during the day. The worker’s initial instinct is to be helpful: prepare meals, fetch everything the woman needs and complete household tasks quickly.
Yet the rehabilitation plan emphasizes rebuilding mobility and confidence. If the worker performs every activity for her, the home becomes comfortable but increasingly disabling.
Supervision changes the approach. The worker learns how to support safe movement, encourage the woman to perform tasks she can manage, recognize pain or deterioration that requires professional review and communicate progress to the family and relevant health professionals.
Over several weeks, assistance reduces as function improves.
The important workforce outcome is not simply that a worker attended the home. It is that the worker understood the purpose of the support.
If local monitoring repeatedly showed that people receiving post-illness assistance became more dependent despite clinical recovery, that would indicate a practice-development issue rather than automatically a need for more staffing. Workforce quality therefore depends on competence, supervision and service philosophy as much as headcount.
Community Cadres Are Valuable but Should Not Become an Invisible Substitute for Paid Care
Indonesia’s extensive community networks are a major advantage in responding to population aging. Cadres associated with community health activity can identify needs, maintain local relationships and help connect households with services.
The expansion of life-course approaches within Posyandu also increases opportunities for older people to remain visible within community health infrastructure.
However, the existence of volunteers and community cadres creates an important boundary question.
Community participation can complement a formal care workforce, but it should not become a mechanism for transferring increasingly intensive long-term care tasks to unpaid or lightly supported local actors.
A cadre who notices that an older person has become unsteady and encourages assessment performs a valuable function. Expecting that cadre to provide ongoing personal care, manage complex dementia-related behavior or undertake clinical responsibilities without appropriate training and oversight is different.
Role clarity protects older people and workers alike.
It also protects the sustainability of community participation. Volunteers who are gradually given more complex responsibilities because no formal alternative exists can experience workload, anxiety and disengagement.
Indonesia can therefore build on community infrastructure without confusing community reach with professional care capacity.
The distinction will become increasingly important as demand rises. What works when a cadre is helping identify a relatively small number of vulnerable older people may become unmanageable if the same person is expected to coordinate or deliver intensive support to many households.
Supervision Is the Infrastructure Behind Safe Delegation
Expanding the workforce through new care roles creates value only if workers have somewhere to take uncertainty.
Long-term care frequently involves judgment. An older person is more confused than yesterday. A pressure area is developing. A family asks the worker to change how medication is given. Someone who normally walks independently begins falling. A person refuses assistance that relatives believe is necessary.
Workers need clear boundaries around what they can decide, what requires consultation and what requires urgent escalation.
This is where supervision becomes part of system design rather than simply personnel management.
Good supervision can reinforce practice, identify training needs, support emotionally demanding work and prevent gradual role drift. It also gives managers visibility of recurring issues. If several workers repeatedly encounter the same difficulty, the problem may lie in the pathway rather than individual competence.
For Indonesia, supervision models will need to accommodate geography. A dense urban service may have supervisors physically available. An island or remote district may need a combination of local senior workers, scheduled professional outreach and digital consultation.
Technology can extend access to expertise, but accountability must remain clear. A worker sending a photograph or message to a distant professional needs to know whether advice will arrive quickly enough, what to do while waiting and how the interaction is recorded appropriately.
The Governance Maturity Assessment can help organizations examining analogous workforce models test whether responsibility, escalation and oversight are sufficiently clear. It is not an Indonesian regulatory framework; its relevance lies in making governance dependencies explicit before services scale.
Geography Makes Workforce Distribution as Important as Workforce Supply
Indonesia’s archipelagic geography means a national increase in worker numbers would not by itself guarantee access.
Jakarta, Surabaya and other major urban centers operate in fundamentally different labor markets from remote islands, mountainous communities and sparsely populated rural areas. Specialist professionals tend to be easier to sustain where populations are dense and institutions are concentrated.
Long-term care magnifies this challenge because much of the work must occur where people live.
A person requiring assistance to bathe cannot solve the problem by traveling several hours to a regional center. A caregiver needing respite requires replacement support locally. Rehabilitation can lose effectiveness if follow-up is inaccessible between specialist appointments.
Workforce planning therefore needs a geographic dimension.
Some functions can be concentrated regionally. Others require distributed local capacity. Technology can support consultation, training and supervision across distance, but direct personal care remains fundamentally place-based.
Local workforce models may consequently differ. A remote district may require broader generalist capability with strong escalation links, while an urban area can sustain more specialization. That variation can be legitimate if outcomes and safety remain protected.
The risk arises when geographic variation becomes invisible inequity: people with similar needs receive substantially different support not because local models have been thoughtfully adapted, but because one area simply lacks workers.
National and provincial planning therefore need indicators that reveal distribution rather than only total workforce numbers.
A remote district cannot recruit its way out of every capability gap
A kabupaten serving dispersed island communities identifies increasing numbers of older people with stroke-related disability and chronic disease. It would like greater rehabilitation and long-term care capacity, but recruitment of specialist professionals is difficult and turnover is high.
Attempting to replicate the workforce structure of a major city is unrealistic.
The district instead examines which functions must be locally available and which can be supported remotely or periodically. Community workers receive defined training for everyday functional support. Puskesmas teams identify people whose needs are changing. A rehabilitation professional visits on a scheduled basis and provides structured plans, while digital consultation is available between visits for appropriate questions.
The model still has limits. Remote advice cannot replace hands-on specialist assessment when this is required, and connectivity cannot be assumed everywhere. Those constraints are recorded rather than disguised.
Over time, the district monitors waiting times, deterioration, referrals requiring travel, workforce turnover and whether families are being asked to absorb tasks because formal capacity is absent.
If the evidence shows persistent unmet specialist need, the issue is escalated as a workforce-planning and funding problem rather than treated as a series of isolated family difficulties.
The scenario illustrates a wider principle for Indonesia: workforce equity does not always require identical staffing models, but it does require comparable attention to need, risk and outcomes.
Pay and Employment Conditions Will Shape Whether Care Becomes a Sustainable Occupation
Indonesia’s care economy can create employment, but only if care jobs are capable of attracting and retaining workers.
This is particularly important because care work is vulnerable to undervaluation. Tasks associated historically with unpaid household labor can be assumed to require little skill once moved into paid employment. That can produce low wages, insecure conditions and high turnover.
Such a model may initially appear affordable. In practice, unstable staffing can undermine continuity, increase recruitment costs and weaken the development of experienced workers.
Continuity matters particularly in home-based care. An older person with dementia may become distressed by constantly changing workers. Families repeatedly explaining routines to new staff lose confidence. Subtle changes in function can be missed when nobody knows the person well.
Employment design therefore affects quality.
The Care Economy Roadmap’s inclusion of protection for workers in formal and informal settings is significant because workforce expansion and decent work need to develop together. As formal care markets grow, policymakers will need to consider employment status, social protection, working time, occupational safety and routes for progression.
The objective should not be to make long-term care artificially expensive. It is to avoid constructing a system whose affordability depends on chronic workforce instability.
Organizations developing care services also need to understand the full cost of a sustainable workforce: recruitment, induction, supervision, travel, training, leave and management infrastructure, not merely hourly labor.
Career Pathways Can Turn Care Jobs Into Care Careers
Recruitment campaigns alone will not create a mature workforce if workers see no future in the sector.
Career architecture can make long-term care more attractive while improving capability.
An entry-level worker might develop expertise in dementia support, rehabilitation-oriented practice or coordination. Experienced workers could become mentors or supervisors. Some may progress into formal health or social-welfare qualifications where education pathways allow.
Progression also helps services retain tacit knowledge. Experienced care workers understand households, community resources and practical risks that are difficult to reproduce through initial training alone.
Indonesia does not need to create excessive hierarchy. Small community services require flexible workers, and too many occupational categories can increase bureaucracy.
The stronger approach is a visible relationship between competence, responsibility and progression.
That requires consistency in training standards. If every provider defines “trained care worker” differently, experience becomes difficult to transfer between employers and families cannot easily understand what competence a worker possesses.
National guidance or competency frameworks could provide a common foundation while allowing local adaptation. Professional regulation may be appropriate for some roles, whereas proportionate certification, accreditation or employer assurance may be sufficient for others.
The regulatory response should match risk rather than assuming that every care role requires the same mechanism.
Families and Paid Workers Need a Partnership, Not a Handover
Growth in formal care does not imply that Indonesian families will cease providing support. The more plausible future is a mixed care economy in which families and paid workers share responsibility in different proportions.
That creates its own workforce skills.
A worker entering somebody’s home is not simply delivering a task. They are joining an existing family system with routines, expectations, relationships and sometimes disagreement.
Families may know the older person exceptionally well but lack technical knowledge. Workers may bring training but know little about the person’s history or preferences. Strong care combines those forms of knowledge.
Conflict can arise if responsibilities are unclear. A family may assume the worker will perform tasks outside their role. A worker may expect relatives to complete activities they cannot manage. Each may believe the other is monitoring a risk.
Simple care plans and communication arrangements can prevent much of this ambiguity.
They should identify what the person wants, what family members have agreed to provide, what the paid worker is responsible for and what happens when needs change.
This also protects against replacing unpaid family labor with poorly bounded paid labor. Workers should not gradually acquire responsibilities simply because relatives are unavailable unless the service has assessed and agreed those changes.
Family partnership therefore becomes a core care-workforce competency rather than an optional interpersonal skill.
Digital Infrastructure Can Extend Workforce Capacity Without Replacing Human Care
Technology will play an increasingly important role as Indonesia attempts to extend services across a large and geographically diverse population.
Digital records can reduce duplication. Mobile tools can support workers in the field. Teleconsultation can connect local teams with specialist expertise. Scheduling systems can reduce wasted travel. Digital learning can extend training to workers who cannot regularly attend centralized courses.
Artificial intelligence may eventually support functions such as documentation, risk identification or workforce planning, but these uses should be distinguished from the human work of care.
Technology cannot help an older person transfer safely from bed, provide reassurance during distress or replace the relational knowledge developed through consistent contact.
Indeed, poorly designed digital systems can reduce productivity. Workers can spend increasing amounts of time entering duplicate information, responding to alerts or navigating systems that do not exchange data.
Digital workforce strategy should therefore ask whether technology removes work, improves decisions or simply creates another administrative layer.
The Digital Transformation, AI and Cybersecurity Readiness Assessment offers organizations considering comparable changes a way to structure questions around infrastructure, workforce readiness, information governance and implementation. It does not determine what Indonesia should adopt, but the underlying discipline is useful: technology should be matched to operational capability before scale.
Digital inclusion also matters for workers themselves. A technology-enabled care model cannot assume identical devices, connectivity or digital literacy across every locality.
A digital system reveals that a staffing problem is actually a travel problem
A community care organization in a growing urban area believes it needs substantially more workers because staff report that caseloads are becoming unmanageable.
Before expanding recruitment, managers examine how working time is actually used.
The analysis shows that direct care hours have increased, but travel between poorly grouped visits and repeated journeys to collect information are consuming a growing proportion of the day. Workers also enter similar information into separate systems after returning to the office.
The organization redesigns geographic scheduling, introduces a secure mobile workflow and clarifies which information needs to be recorded once and shared appropriately.
Capacity improves without reducing the time spent with older people.
This does not prove that recruitment is unnecessary. As demand continues to rise, more workers may still be required. It demonstrates that workforce planning should distinguish labor shortage from avoidable operational workload.
If the redesigned system subsequently shows direct-care demand exceeding available capacity, the recruitment case becomes stronger because managers understand the underlying workload rather than relying on a headline vacancy number.
For Indonesia, where travel and geography can consume substantial resources, that distinction can materially affect the affordability of community-based care.
Workforce Data Must Move Beyond Counting People
A workforce strategy needs reliable intelligence about supply, demand and capability.
Counting the number of workers is necessary but insufficient.
Two districts with the same number of workers may have very different capacity if one has higher turnover, greater travel requirements, more complex needs or weaker supervision. A workforce that appears adequate on paper may contain significant skill gaps.
Useful workforce intelligence therefore needs to examine multiple dimensions: vacancies, retention, geographic distribution, competence, caseload, continuity, supervision capacity and the amount of demand still absorbed by families.
Care needs should also be connected to workforce forecasts. Population aging alone does not specify what roles will be required. Functional dependency, dementia prevalence, disability, living arrangements and service design all affect demand.
The Digital Twin Scenario Modeler can help organizations exploring analogous planning questions test how different assumptions about workforce capacity, service demand and stability interact. It is not a forecast of Indonesia’s national workforce; rather, it illustrates the value of scenario-based planning where future demand cannot be predicted from one variable alone.
For national and regional government, the same principle applies at a larger scale. Workforce intelligence should identify where capacity is becoming fragile before shortages appear only as service failure.
Quality Assurance Must Grow With the Workforce
Rapid expansion of a new care market creates a familiar policy tension. Too little oversight can expose older people to inconsistent or unsafe support. Excessive regulation can make small community services difficult to establish and push care back into informal arrangements.
Indonesia therefore needs proportionate quality architecture as formal long-term care grows.
Some quality expectations should be universal regardless of provider size: dignity, safety, appropriate competence, clear responsibility, protection from abuse, reliable handling of concerns and respect for the person’s preferences.
Other controls can reflect the nature of the service. An organization providing complex personal care requires different assurance from a community group providing social activities and basic navigation.
Quality should also be assessed through outcomes rather than documentation alone.
Are workers helping people maintain function? Are avoidable falls decreasing? Do older people experience continuity? Are families confident about who to contact when needs change? Are workers receiving supervision? Are complaints and incidents producing learning?
The Quality Dashboard Builder can help organizations considering similar services translate broad quality expectations into a manageable set of indicators. It is not an Indonesian quality standard, but the principle is relevant: workforce expansion should be accompanied by evidence about whether additional capacity is producing better and safer support.
Indonesia also needs learning between localities. Where one community develops an effective workforce model, the objective should not be to copy every staffing detail nationally. Decision-makers need to understand which elements created the result: training, supervision, local leadership, funding, family engagement, workforce availability or community infrastructure.
Worker Wellbeing Is a Service-Continuity Issue
Long-term care can be physically and emotionally demanding.
Workers may support people through deterioration, bereavement, family conflict and distress. Home-based staff can work independently without immediate peer support. Travel can extend working days. Poorly designed schedules can create pressure to rush intimate care.
These conditions affect retention, but they also affect quality.
A workforce strategy should therefore consider occupational safety, manageable workload, rest, supervision and emotional support. Worker wellbeing is not separate from productivity; sustained exhaustion eventually reduces both.
This is particularly important if Indonesia seeks to formalize care work currently provided informally. Formalization should improve protection rather than simply make previously invisible labor visible to employers.
Gender needs to remain explicit. Care work is often feminized, whether paid or unpaid. If the emerging sector relies disproportionately on women, employment policy should examine pay, security, social protection, progression and compatibility with workers’ own family responsibilities.
Otherwise, Indonesia risks creating a paradox in which women are recruited to relieve other families’ unpaid care burden while continuing to carry substantial unpaid care within their own households.
Financing Determines Whether a Skilled Workforce Can Actually Be Deployed
Workforce strategy cannot be separated from long-term care financing.
Training thousands of workers creates little practical capacity if households cannot afford their services and public programs do not fund them. Conversely, creating a new care entitlement without a workforce able to deliver it can generate waiting, inflationary pressure or uneven access.
Indonesia’s current architecture distributes costs across healthcare financing, social programs, local budgets, household spending and unpaid family care rather than operating through a single comprehensive long-term care insurance mechanism.
That makes workforce development more complex because there is no single purchaser capable of shaping the entire market.
Different financing routes may therefore emerge for different functions. Health professionals may continue to operate largely through health-system arrangements. Local government may support community services. Households may purchase some direct care privately. Social-protection programs may support selected vulnerable groups. Future policy could develop additional financing mechanisms as long-term care becomes more explicit.
Whatever model develops, reimbursement needs to recognize the real cost of safe delivery.
If payment covers only direct contact time while ignoring travel, supervision, training and leave, providers will either become financially unstable or reduce those functions. If rates are unaffordable for government and households, coverage will remain narrow.
Workforce and financing policy therefore need to evolve together rather than sequentially.
A local service expands quickly but loses the workers it has trained
A city supports the development of a home-based care program for older people with significant functional needs. Initial recruitment is successful, and workers complete a structured training program.
Within a year, turnover begins rising.
Exit discussions reveal that the problem is not primarily dislike of care work. Workers value relationships with older people but experience unpredictable schedules, substantial unpaid travel and limited progression. Experienced workers receive little additional recognition for mentoring new colleagues.
The service could respond by recruiting another cohort and repeating the same cycle. Instead, local leaders treat turnover as performance intelligence.
Schedules are redesigned geographically. Travel expectations become explicit. A senior care-worker role is introduced for experienced staff able to support colleagues under professional supervision. Training investment is tracked alongside retention rather than reported only as the number of certificates issued.
The revised model costs more per worker but reduces repeated recruitment and protects continuity for older people.
The broader lesson is that the cheapest employment model is not necessarily the lowest-cost care model. Workforce instability has consequences for recruitment, supervision, family confidence and quality that should be visible in financing decisions.
National Stewardship and Local Adaptation Need to Work Together
Indonesia’s decentralized governance means workforce development will inevitably vary between provinces, kabupaten and cities.
That variation can support innovation. Local governments understand their geography, labor markets, community organizations and population needs in ways that central government cannot reproduce through one standardized staffing model.
But decentralization also creates a risk of unequal workforce development.
Wealthier or more administratively capable areas may establish formal services earlier, while other localities continue relying predominantly on families and community volunteers. Training standards may diverge. New job titles may emerge without consistent definitions.
National stewardship can reduce those risks without prescribing every operational detail.
Central government can help establish competency expectations, workforce data standards, broad quality principles and connections with national aging and care-economy policy. Provincial government can support planning across district boundaries where specialist capability cannot efficiently be duplicated. Kabupaten and city governments can shape delivery around local need.
Education and training institutions also need to be part of the architecture. A workforce strategy that exists only within social policy will struggle to create sufficient training capacity or recognized career routes.
The Ministry of Health, Ministry of Social Affairs, Ministry of Manpower, Bappenas, regional governments, education institutions and non-government providers all hold different parts of the workforce question. Effective stewardship depends on those responsibilities connecting rather than assuming one ministry can create the sector alone.
Workforce Expansion Should Strengthen Independence, Not Institutionalize Dependency
As formal care capacity grows, Indonesia will need to remain clear about what the workforce is trying to achieve.
More care hours are not automatically a better outcome.
For some people, intensive ongoing assistance is necessary and appropriate. For others, the stronger outcome is recovery of function, adaptation of the home, assistive technology or support that gradually reduces as independence returns.
This matters economically as well as personally.
A system that responds to every new limitation by adding permanent labor will become increasingly difficult to finance as the population ages. A system that combines appropriate care with prevention, rehabilitation, reablement and technology can direct human support toward tasks where it creates greatest value.
Workers need to understand this philosophy. Otherwise, incentives can drift toward doing more for people rather than helping people do more for themselves.
Performance measures should therefore include independence, participation and functional outcomes alongside activity.
For a person with progressive dementia, maintaining function may mean slowing decline and preserving familiar routines rather than reducing support. For someone recovering after surgery, it may mean gradually withdrawing assistance. Person-centered workforce productivity cannot be reduced to completing the maximum number of tasks in the shortest time.
The Care Economy Can Become Part of Indonesia’s Economic Strategy
Indonesia’s decision to include the care economy within longer-term development thinking creates an opportunity to connect aging policy with employment and productivity.
Care services generate jobs that cannot easily be relocated internationally because much of the work occurs physically within communities. They can also enable employment elsewhere when relatives are no longer forced to leave work to provide all care themselves.
The economic effect therefore operates in two directions: direct employment in care and increased labor-market capacity among family caregivers.
However, the value of this opportunity depends on job quality.
A rapidly expanding informal market may meet some immediate demand but provide limited training, protection or continuity. Excessively rigid formalization could make care unaffordable and exclude community organizations that are capable of providing valuable support.
The policy task is to create a graduated ecosystem in which different types of service have proportionate expectations while core worker protections and care standards become progressively stronger.
Indonesia can also learn from countries that expanded formal long-term care only after aging was more advanced. Their experience demonstrates that workforce shortages are difficult to solve quickly once demand is already high. Training pipelines, occupational identity and career structures take years to mature.
The transferable lesson is not to reproduce another country’s workforce institutions. It is to develop human capacity before demographic demand reaches its later stages.
Building the Workforce Before Demand Peaks
Indonesia still has an important strategic window.
The country is already an aging society, but the demographic shift projected toward 2045 will occur over time. That allows workforce development to be staged alongside the growth of long-term care infrastructure.
Community-based pilots can reveal which roles are useful. Local government experience can show how models need to vary geographically. Training frameworks can be tested before being scaled. Workforce data can improve gradually. Financing mechanisms can be evaluated against real delivery costs rather than theoretical assumptions.
Most importantly, Indonesia can avoid treating workforce policy as a late response to labor shortage.
The better sequence is to define the functions an aging society will need, identify which existing occupations can provide them, establish new roles where genuine gaps remain, build training and supervision, improve employment conditions and connect workforce supply to service and financing reform.
That approach also creates space to learn.
If a new role proves too broad, its competencies can be refined. If training does not improve outcomes, it can be redesigned. If rural models depend excessively on volunteers, additional paid capacity can be targeted. If technology reduces administration, those productivity gains can inform future workforce assumptions.
The aim is not to predict the exact number of workers Indonesia will need in 2045. It is to create a workforce system capable of adapting as the evidence becomes clearer.
Conclusion
Indonesia’s long-term care workforce challenge is not simply a future shortage of people. It is the larger task of turning fragmented clinical, community, family and emerging care capacity into a sustainable workforce ecosystem capable of supporting a much older population.
The country has important foundations. Puskesmas, community cadres, health and rehabilitation professionals, social-welfare structures, families and community-based care initiatives already contribute different forms of support. Indonesia’s Care Economy Roadmap and national development agenda also create a policy opportunity to treat care as both social infrastructure and a source of formal employment. The next stage is to make roles, competencies, supervision, employment conditions and career pathways more deliberate.
Implementation will vary across a country as geographically and administratively diverse as Indonesia. Remote districts cannot necessarily reproduce metropolitan workforce structures, and local adaptation should remain possible. But variation should operate within a stronger national foundation of workforce intelligence, quality expectations, worker protection and clear escalation between community support and professional care.
The decisive test will be whether workforce expansion improves the lives of older people rather than merely increasing service activity. Care should protect dignity, maintain function where possible, support families and provide continuity when dependency increases. Building that capability before demographic demand reaches its later stages gives Indonesia an opportunity to shape its care economy deliberately rather than constructing it under pressure.