The Care-Pressure Index 2026
Switzerland is under care pressure at both ends of life. At the end, the number of people over 80 doubles by 2050 — fastest not where people are oldest today, but in the young, fast-growing cantons. At the start, the country has the most expensive childcare in the OECD. Where the state is absent and care is expensive, the grey zone takes over. A cantonal survey of both ends.
Executive Summary
The care question hits Switzerland at both ends of life at once. At the end of life, the population aged 80 and over nearly doubles by 2050 — from around 523'000 (2024) to roughly 1'006'000 (2050), a rise of 92% (BFS reference scenario). The surprise is the geography: the fastest ageing strikes not the cantons that are oldest today, but the young, high-growth ones — Thurgau (+140%), Obwalden (+139%), Fribourg (+136%). And home care is already stretched to the limit: in 2024, Spitex recorded a high of 424'000 clients — before the baby-boomer wave even reaches the 80 mark.
At the start of life, Switzerland has the most expensive childcare in the OECD: a daycare place costs a dual-earner couple around 28% of household income (2023), and parents cover roughly 70% of that themselves on average. Behind this average lies a sharp Röstigraben — the parental share ranges from 89% in Thurgau to 30% in Valais — and several cantons leave funding entirely to the municipalities.
Both ends lead to the same consequence. Where institutional care is missing, too expensive or too scarce, informal care takes over: grandparents, and above all nannies and care helpers who are often employed off the books — the same grey zone that already shapes cleaning. This is exactly where Clino comes in: the platform covers not only cleaning, but also nanny and senior care — turning informal undeclared work into legal, insured employment. This study is non-partisan, scientifically grounded, and transparent in its methodology and sources.
The end of life: the ageing wave that has already begun
The number of people over 80 grows by 92% nationwide by 2050 — practically a doubling. But this average masks a highly uneven geography. The fastest ageing hits Thurgau (+140%), followed by Obwalden (+139%), Fribourg (+136%), Aargau (+125%) and Valais (+124%). These are not the cantons that are oldest today, but the growth cantons whose large middle-aged cohorts move into old age over the next 25 years.
| # | Growth 80+ | |
|---|---|---|
| 1 | Thurgau5.2 % 80+ today | +140 % |
| 2 | Obwalden5.6 % 80+ today | +139 % |
| 3 | Fribourg4.5 % 80+ today | +136 % |
| 4 | Aargau5.2 % 80+ today | +125 % |
| 5 | Valais5.8 % 80+ today | +124 % |
| 6 | Appenzell Inner Rhodes6.1 % 80+ today | +122 % |
| 7 | Nidwalden6.3 % 80+ today | +121 % |
| 8 | St. Gallen5.6 % 80+ today | +116 % |
| 9 | Zug5.4 % 80+ today | +110 % |
| 10 | Schwyz5.2 % 80+ today | +108 % |
| 11 | Solothurn6.0 % 80+ today | +108 % |
| 12 | Lucerne5.4 % 80+ today | +107 % |
| 13 | Grisons6.6 % 80+ today | +101 % |
| 14 | Glarus6.0 % 80+ today | +95 % |
| 15 | Uri6.3 % 80+ today | +92 % |
| 16 | Appenzell Outer Rhodes5.9 % 80+ today | +90 % |
| 17 | Vaud5.2 % 80+ today | +89 % |
| 18 | Schaffhausen6.7 % 80+ today | +88 % |
| 19 | Ticino8.0 % 80+ today | +85 % |
| 20 | Bern6.6 % 80+ today | +82 % |
| 21 | Jura6.5 % 80+ today | +74 % |
| 22 | Basel-Country7.4 % 80+ today | +72 % |
| 23 | Geneva5.5 % 80+ today | +71 % |
| 24 | Zurich5.4 % 80+ today | +68 % |
| 25 | Neuchâtel6.3 % 80+ today | +66 % |
| 26 | Basel-City6.7 % 80+ today | +43 % |
Projected growth of the population aged 80+, 2024–2050 (BFS reference scenario AR-00-2025). Subline: today's 80+ share of the resident population (2024, observed). Highlighted: Thurgau (fastest) and Basel-City (slowest).
The map shows the same pattern spatially: the darkest areas — the strongest growth — lie in eastern and central Switzerland and the Mittelland, not in the cities. Where many young adults live today, the greatest need for care will arise tomorrow.
Projected growth of the 80+ population 2024–2050 (BFS reference scenario). Darker = stronger growth. The fastest ageing hits today's young, high-growth cantons (Thurgau, Obwalden, Fribourg, Aargau), not the oldest ones today.
And home care provision is already strained today. In 2024, Spitex cared for more people than ever before — 424'000 clients and 25.6 million hours of care. The largest increases were recorded in Aargau and Zurich, each at around +20%. This record is reached before the actual 80+ wave arrives — so outpatient care is already running at its limit, while demand is only just building.
Who is old today, and who will be
Plotting today's 80+ share against future growth reveals a weak negative relationship (r = -0.52): cantons that are old today tend to age more slowly in future — and vice versa. There are, then, two profiles.
Each dot a canton. X: today's 80+ share (2024, observed). Y: projected 80+ growth to 2050 (BFS reference scenario). Weak negative relationship (r = −0.52): cantons old today age more slowly in future — and vice versa. Basel-City is relatively old yet grows slowest (in-migration renews the city); Fribourg and Thurgau are young today but age fastest.
The first profile is the cantons that are already old today: Ticino (65+ share 24.0%, 80+ share 8.0%), Graubünden (23.6%) and Basel-Landschaft (23.3%) already bear the burden now — but will grow below average in future, because ageing there is far advanced.
The second profile is the young cantons that age the fastest: Thurgau, Obwalden and Fribourg look demographically young today, but experience the steepest rise by 2050. For them the ageing wave is not an extension of the present but an abrupt shift — with correspondingly little established care infrastructure.
The clearest counter-example is Basel-City: with an 80+ share of 6.7% the canton is relatively old, yet ages by far the slowest in future (+43%). The Basel-City paradox is explained by immigration: cities continuously attract young adults and thereby rejuvenate demographically — Neuchâtel (+66%), Zurich (+68%) and Geneva (+71%) follow the same pattern. Urban Switzerland ages the slowest, the rural and small-town hinterland the fastest.
The start of life: Europe's most expensive childcare
At the other end of life stands the most expensive childcare in the OECD. A daycare place costs a dual-earner couple around 28% of household income (2023) — the highest figure in the OECD comparison. Unlike in most European countries, parents bear the lion's share of it: on average around 70% of the cost, while the state covers only the remainder.
On top of the high cost comes uneven availability. There is no nationwide, uniformly collected series on daycare coverage per canton; only individual anchor values are robust. But these anchors show an enormous range: Basel-City around 50%, Zug 43% — and Appenzell Innerrhoden only about 6%. That is an eightfold difference between the best- and worst-served canton. Depending on where you live, a daycare place is therefore not only differently priced, but differently reachable in the first place.
Who ultimately pays how much depends crucially on cantonal funding — and here a sharp Röstigraben runs through. The parental share ranges from 89% in Thurgau to 30% in Valais: in some cantons families bear almost the entire cost themselves, in others less than a third.
| Canton | Public spend/child | Parents' share | Cantonal role |
|---|---|---|---|
| Basel-City | CHF 4’669 | – | top subsidiser |
| Vaud | CHF 3’099 | 38 % | co-finances |
| Zurich | CHF 1’747 | 83 % | leaves it to municipalities |
| Bern | CHF 1’358 | – | co-finances |
| Fribourg | CHF 1’312 | – | co-finances |
| Glarus | CHF 1’195 | – | co-finances |
| Schaffhausen | CHF 884 | – | co-finances |
| Lucerne | CHF 776 | – | co-finances |
| Grisons | CHF 703 | – | co-finances |
| Ticino | CHF 701 | – | co-finances |
| St. Gallen | CHF 695 | 64 % | co-finances |
| Basel-Country | CHF 527 | – | leaves it to municipalities |
| Solothurn | CHF 278 | – | co-finances |
| Aargau | CHF 238 | – | leaves it to municipalities |
| Schwyz | CHF 172 | – | co-finances |
| Jura | – | – | top subsidiser |
| Thurgau | – | 89 % | co-finances |
| Neuchâtel | – | 42 % | co-finances |
| Valais | – | 30 % | co-finances |
Public spending per child 0–12 (canton + municipalities), INFRAS for the BSV, October 2024 (15 cantons). A dash (–) means not published. Basel-City: over CHF 2’000/child from the canton alone, CHF 4’669 incl. municipalities; Jura: over CHF 1’500/child cantonal. Parents' share where published (Röstigraben: Thurgau 89% vs. Valais 30%). Cantonal role per CHSS/SODK 2024. Highlighted: cantons that leave funding entirely to municipalities.
Cantons that fund childcare
- •Basel-City: over CHF 2'000/child from the canton alone, CHF 4'669 including municipalities — with a legal entitlement
- •Jura: over CHF 1'500/child from the canton
- •Canton actively contributes — lower parental shares
- •Childcare understood as a public responsibility
Cantons that leave it to municipalities
- •Aargau, Basel-Landschaft and Zurich: CHF 0 from the canton
- •Funding rests entirely with the municipalities
- •Coverage and fees vary from municipality to municipality
- •High parental shares (Zurich: 83%)
Where the state is absent, the grey zone steps in
Both ends of the care pressure lead to the same response. When outpatient care runs at its limit and care-home places are scarce, when daycare is too expensive or simply unavailable, the need does not disappear — it migrates into informal care. Grandparents step in, and families hire nannies, carers and care helpers. Often this happens without a contract, without social insurance, without a wage statement: the same grey zone that already shapes cleaning.
This is not only a legal risk for households, but also a protection gap for the carers — no accident insurance, no AHV contributions, no entitlement in case of illness. With the ageing wave and the persistent pressure on childcare, this informal layer will grow over the next 25 years, not shrink.
This is exactly where Clino comes in. The platform covers not only cleaning, but also nanny and senior care: families can employ care workers legally in just a few minutes — with a contract, payroll, social insurance and accident cover — at the same flat price. The grey zone becomes a clean, proper employment, for both sides.
The ageing wave and the most expensive childcare in the OECD meet at a single point: in the households that have to organise care themselves. Whether that care is legal and insured or stays in the grey zone is not decided by need — but by how easy it is to employ someone properly.
Surprising findings
The fastest ageing hits the young cantons, not the old ones
Intuitively, you would expect the strongest ageing where people are already oldest today — in Ticino or Graubünden. In fact the opposite is true: Thurgau (+140%), Obwalden (+139%) and Fribourg (+136%) are demographically young today and will age the fastest. The weak negative correlation (r = -0.52) confirms the pattern across all cantons. It is precisely the cantons with the least established care infrastructure that face the steepest rise.
Basel-City ages the slowest — despite a high elderly share
With 6.7%, Basel-City has one of the highest 80+ shares in Switzerland, yet within this group it grows by far the slowest by 2050 (+43%). The reason is immigration: cities continuously attract young adults and rejuvenate demographically. Neuchâtel (+66%), Zurich (+68%) and Geneva (+71%) show the same urban rejuvenation effect. The ageing wave is therefore above all a phenomenon of the rural and small-town hinterland.
Spitex is already at a record — before the actual wave
With 424'000 clients and 25.6 million hours of care, Spitex recorded an all-time high in 2024. What is remarkable is the timing: this record is reached before the baby-boomer generation even hits the 80 mark. Outpatient care is thus already running at its limit, while the main demographic burden is still to come — the largest increases in 2024 were in Aargau and Zurich, each at around +20%.
Sources
- BFS — Bevölkerungsszenarien 2025–2055 (2025), Reference scenario AR-00-2025, 80+ projection to 2050; base year 2024 observed
- BFS — Spitex-Statistik (2024), 424'000 clients, 25.6 million hours of care, record
- INFRAS für das BSV (2024), Public spending per child aged 0–12 (canton + municipalities), 15 cantons
- CHSS / SODK (2024), Cantonal role in childcare funding
- OECD (2023), Childcare costs ~28% of household income, most expensive in the OECD
- Clino (2026), Consolidation and cantonal processing of the care-pressure data
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About Clino
Clino is a Swiss SaaS platform enabling households to legally employ domestic workers: payroll, contracts, social security, and accident insurance included. CHF 19.90/month. All 26 cantons. Founded 2026 in Zurich. clino.ch
