The direct dependence of the pay-as-you-go financing system on demographic developments poses significant financing challenges for social long-term care insurance in the medium and long term. Against this backdrop, the work analyzes the sustainability of social long-term care insurance using the method of generational accounting, as well as the associated intergenerational shifts in burdens. In addition to the demographic component, factors specifically related to the care sector are presented, and their financing effects are quantified. Furthermore, the sustainability consequences of different reform models, with a focus on the resulting intergenerational distribution effects, are also examined.