Can care co-ops defuse the demographic timebomb?

Healthcare systems are coming under strain across Europe as the population ages. Here we look at how the co-op care sector is innovating to meet those challenges to ensure...

Healthcare systems are coming under strain across Europe as the population ages. Here we look at how the co-op care sector is innovating to meet those challenges to ensure a dignified quality of life …

Over the next 40 years, the number of people in Europe over the age of 65 will double.

This will pose health care systems with serious challenges of sustainability, warn researchers behind a study into the state of health care co-ops. These challenges have made dignified ageing and care-giving a pressing concern to a huge number of Europeans. In response, individuals and organisations are experimenting and developing viable and innovative solutions to the needs of elderly.

As autonomous associations of persons who voluntarily co-operate for their mutual social, economic and cultural benefit, co-operatives have a unique opportunity to play a lead role.

The iCarecoops research project – funded by the European Active and Assisted Living Programme, which has included Cooperatives Europe as a partner – has completed a two-year look at health co-ops and has gathered best practice. We look at that best practice here and, further below, three case studies from Europe.

Why health care co-ops are different

Researchers looked at health care co-ops across Europe to figure out what makes some providers stand out over others. Here are their criteria:


  • membership is open to service users (older people and/or relatives) and providers (formal and/or informal), and/or to other stakeholders
  • membership is used as a tool to stimulate care co-operative culture on a given territory
  • interactive mechanisms are implemented to ensure compliance of co-operative process and services with the needs of users and providers
  • service users feel empowered; members are better-off thanks to the elderly care co-operative.


  • decision-making processes involve service users and providers, and/or other stakeholders
  • internal rules and innovative mechanisms ensure inclusive decision-making processes based on a flat hierarchy.


  • a co-operative is the unique elderly care service provider on a given territory embedded in a tight local network and driven by user-oriented needs
  • elderly care services are delivered in an innovative way.


  • the co-operative model allows the settlement of a viable elderly care business where other models fail
  • the co-operative implements mechanisms to attract external investors and/or raise additional public funding.


  • the co-operative interacts with the local community through innovative mechanisms
  • the local community has developed a better awareness of elderly care issues thanks to co-operative action
  • intergenerational solidarity has spread in the community thanks to the co-operative’s actions.


  • Information and communications technology (ICT) tools are used to support innovative mechanisms, service delivery systems and management enhancement or simplification

A number of health care co-ops in Europe meet some of this recommended best practice, including Itaca and Aldia Cooperativa Sociale in Italy, and Zeitgut Luzern in Switzerland.



Itaca owns the Cimolais care home on the edge of the Alps
Itaca owns the Cimolais care home on the edge of the Alps

Members: 1,200
Staff: 1,600
Location: Pordenone (Italy)
Founded: 1992

Itaca was born in 1992 as a spin-off from social co-operative Noncello, which was active in the field of labour inclusion. Its creation was the result of a law that distinguished between social co-operatives that provide social health services through their members and social co-operatives that deliver labour inclusion to their members.

Itaca’s goal was to put workers at the centre of the organisation – to expand job opportunities for its members, ensure the sustainability and improvement of working conditions, and to develop its workers’ professional skills and competencies.

It is active in five main sectors: elderly residential care, elderly home care, disability,  mental health and youth policies, and early infancy. Services are provided to more than 7,000 beneficiaries across four Italian regions: Friuli-Venezia Giulia, Veneto, Trentino Alto Adige and Lombardia.

In its elderly sector, Itaca aims to enable the older person to remain an active member of their community. The co-operative mobilises all territorial resources, from volunteering to non-organised civil society. In particular, as an example of its interventions, Itaca has developed an intergenerational solidarity project with a strong local partnership, connecting older people with youngsters to encourage intergenerational interactions (project Genius Loci).


Zeitgut Luzern

Zeitgut Luzern’s Vicino Luzern project aims to ensure that elderly people in the city of Luzern can live safely and independently in their own homes for as long as possible

Members: 184
Staff: 2
Location: Luzern (Switzerland)
Founded: 2012

Community involvement is a core element of Zeitgut’s mission to fill the gap left by insufficient public services. It aims to provide elderly care services to those in need by stimulating and organising self-help and solidarity at a local level.

To fulfil this, a time-banking system has been set up, as opposed to usual money-based trading models. So the care giver earns time-units exchangeable against another service. Elderly care costs are hereby reduced for the whole community.

Zeitgut’s business model is based on time-exchange, instead of money. The co-operative model means capital can be raised through membership fees, together with a complementary external support (grants from foundations). To ensure a better financial stability, the co-operative is planning to invest in new projects, such as supporting families.

While the members’ age is currently situated between 18 and 102 years old, the co-operative is working on fostering the development of inter-generational solidarity by encouraging the involvement of younger people.

The co-operative works in close coordination with civil society organisations operating locally, such as the Red Cross and Spitex.

It has shown some best practice in its use of technology: besides basic tools (emails, website and Facebook), it has created a database to manage time credits and allow for the online booking of services. Internet tools are also used to communicate with co-operative members and to recruit new co-operators.

Finally, a mobile app is expected to be created in the near future.


Aldia Cooperativa Sociale


Members/staff: 522
Location: Pavia (Italy)
Founded: 1977

Aldia was established by a group of young women in a bid to create job opportunities around their common skills in home care services.

The organisation counts 500 employees (all co-operative members), providing services to 11,000 beneficiaries, mainly in three fields: child care (nursery, outdoor centres, home schooling), elderly care and general services (janitor service, canteen, school bus assistance).

It is active in three regions (seven provinces) in northern Italy.

Aldia is owned and managed by its 500 employees, together with two supporting organisations, in accordance with the principle of one member, one vote. To ensure an inclusive and participative governance despite a wide geographical coverage, two general assemblies are organised every year: one at the headquarters, another at a different location each year.

For daily matters, co-ordinators are in charge of facilitating internal communication between workers and elected bodies.

The co-operative considers the elderly years as a time of life when the person has the opportunity to exploit his/her physical, social and mental potentials, hereby maturing his/her own personality.

Based on this, Aldia provides a range of elderly care services, including integrated home care services, design and experimentation of ICT projects (e.g. active ageing online platforms), health-related emergency management projects, active ageing training sessions (e.g. memory training) and day care centres.

The human resources management process is based on ICT tools – software such as Zucchetti is used on a daily basis. This especially allows for a centralised coordination of employees active in the field, covering a wide geographical area.

Aldia has also taken part in other sector-wide projects, such as:

  • SoMedAll, an online platform offering social media to elderly persons with a variety of handy interfaces, promoting content adapted to this specific targeted population. It allows people to stay in touch with relatives and receive support from medical staff.
  • CareInMovement (CiM) aims at providing an integrated ICT service, including IT-based encouragement for physical activity, standardised training and communication systems for formal and informal care givers, and an electronic time bank to support voluntary assistance.

This article is based upon the words and research from the iCarecoops project team. Find out more online:

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