Dysfunctions in ADL and IADL are considered to be activity limitations within the ICF framework. In the past, many documents related to functional dependency produced by European experts on ageing have used the ADL approach, while in most recent legislation and policy documents European countries and agencies have adopted the ICF model.27 The use of a classification of dependency or personal functioning is itself a means to assess the need for services, rather than part of the HC classification itself. However, it should be borne in mind that the ICF is an official classification adopted by an increasing number of countries (Salvador-Carulla and Gasca, 2010). In some countries, payments may start on day one but be restricted to certain conditions. Other country’s records would allow measurement only based on the primary purpose of the provider- that is, whether the facility is primarily a medical or social facility. In other systems, insurance protection typically covers only part of the LTC, and sometimes carer relatives receive some compensatory transfers, which may include training.