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Home care across Europe: current structure and future challenges
- Editors:
- GENET Nadine, ed.
- Publisher:
- World Health Organization
- Publication year:
- 2012
- Pagination:
- 156p.
- Place of publication:
- Copenhagen
Currently, for every person over the age of 65 in the European Union, there are four people of working age. But by 2050 there will only be two. Demand for long-term care, of which home care forms a significant part, will inevitably increase in the decades to come. Despite the importance of the issue, however, up-to-date and comparative information on home care in Europe is lacking. This report attempts to fill some of that gap by examining current European policy on home care services and strategies. It examines a wide range of topics including the links between social services and health-care systems, the prevailing funding mechanisms, how service providers are paid, the impact of governmental regulation, and the complex roles played by informal caregivers. Drawing on a set of Europe-wide case studies, the report provides comparable descriptive information on many aspects of the organisation, financing and provision of home care across the continent. The report is designed to help frame the coming debate about how best to serve elderly citizens as European populations age.
The future of homecare: responding to older people's needs
- Author:
- BERNARD Caroline
- Publisher:
- Counsel and Care; Ceretas
- Publication year:
- 2009
- Pagination:
- 19p.
- Place of publication:
- London
This discussion paper has been developed from Ceretas and Care and Council round table meeting held on 8 July 2009. The meeting was attended by 22 people from across the care sector, including sheltered housing and local authorities to discuss the state of home care in the wider context of community care. The paper beings by discussing the current state and quality of home care. It then discusses what a better system of care and support should look like to respond to older people's needs. Recommendations for the future are then summarised, which include listening to what older people say, undertaking a review of council homecare charging, and examine ways for home care to move seamlessly into residential care.
Still playing for time
- Author:
- VALIOS Natalie
- Journal article citation:
- Community Care, 9.9.99, 1999, p.9.
- Publisher:
- Reed Business Information
Argues that even though its own report attacks "great inconsistencies" in social services charges, the government is evading action.
Expansion of formalised in-home services for Japan's aged
- Authors:
- ADACHI Kiyoshi, LUBBEN James E., TSUKADA Noriko
- Journal article citation:
- Journal of Aging and Social Policy, 8(2/3), 1997, pp.147-159.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Analyses the social and political forces in Japan that led to the creation of the Gold Plan, a comprehensive national plan for formalised in-home services for the aged. Examines the political strategies of the Gold Plan from the perspectives of the shift from institutional to in-home services; decentralisation of in-home services policy; and needs for expanding the number of in-home service workers. New nonprofit organisations called Resident-Participation Types (RPTs) are identified, which are self-help organisations to augment the delivery of in-home services to the aged. Finally, future issues regarding RPTs and in-home services for the aged and some policy recommendations are discussed.
Methodological challenges in the implementation and evaluation of social welfare policies
- Authors:
- ANDERSSON Katarina, KALMAN Hildur
- Journal article citation:
- International Journal of Social Research Methodology, 15(1), 2012, pp.69-80.
- Publisher:
- Taylor and Francis
As social reality is quite elusive, even regarding seemingly well-recognised everyday concepts and objects, assessments and evaluations of implementation policies will always present methodological challenges. There is a need to consider such assessments and evaluations in a critical perspective to investigate whether the desired knowledge is really being acquired. The purpose of this article is to address some of the challenges that underlie assessments and evaluations of the implementation of social welfare policies by presenting a rereading and analysis of an empirical study of elderly home care services. The rereading and analysis is described in terms of 4 stages: ecological analysis of institutions; shadowing; focus on common concepts and objects; and applying the analytical concept of boundary objects. The results reveal the emergence of a dissolution of common and professional key concepts and objects in these welfare services to a degree that challenges both the implementation policy and the evaluation of policy. The article concludes that this has methodological implications for the evaluation of implementation policies in general.
Expanded, but not regulated: ambiguity in home-care policy in Ireland
- Authors:
- TIMONEN Virpi, DOYLE Martha, O’DWYER Ciara
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.310-318.
- Publisher:
- Wiley
The article examines this incompatibility between the expansion of home-care services in Ireland, and the failure to develop policies to govern access to and quality of services. It suggests that the key factors that motivated home-care expansion in the Irish case were: problems in the acute hospital sector and the perception of home care as a partial solution to these; and significant GDP growth that provided politicians with the means to fund expansion in home-care services. The key factors that inhibited the development of a policy framework to govern home-care services were: weak governance structures in health services and decision-making at national level based on short-term political gain; Ireland’s adherence to the liberal welfare state model and concern about uncontrollable care costs in the face of population ageing; until 2010, paucity of attention to home-care issues in the Irish media; and weak provider interest representation.
Norwegian home care in transition – heading for accountability, off-loading responsibilities
- Author:
- VABØ Mia
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.283-291.
- Publisher:
- Wiley
In Norway, home care was traditionally characterised by collegiality and flexible organisation. Over the past two decades, this framework has been challenged by new modes of governance introduced under the banner of transparency and accountability. This paper focuses on how this new trend in governance has been justified and put into practice. It demonstrates how accountability arrangements became entangled with ongoing effort of local authorities to control costs. Drawing on existing case studies conducted at different points in time, the paper reveals how these arrangements have reshaped home care organisations in a way that also contributes to splitting up and curtailing responsibilities. It is argued that steps taken to make home care services more transparent and reliable have made them less sensitive to the particular needs of individual service recipients. The paper concludes by arguing that accountability arrangements in home care have enhanced the predictability and reliability of service delivery. However, as off-loading responsibilities may be disempowering for those who do not have additional coping resources, institutional changes may also serve to undermine the enabling role of home care services.
Home health care policy and recommendations for change: a social work perspective
- Authors:
- WEBER Peggy C., LUGAR Robyn
- Journal article citation:
- Social Policy Journal, 3(2), 2004, pp.5-17.
- Publisher:
- Haworth Press
- Place of publication:
- Binghamton, New York
Home health care has changed dramatically over the years. Recent federal policy changes have made a drastic impact on the home health care industry, including home health social work. It is imperative social workers strive to affect policy changes rather than adjust to policy changes. The following article will provide a brief review of the history of home health care and home health care social work, and will offer possible strategies to affect policy. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Our turn next: a fresh look at home support services for older people
- Editor:
- HENWOOD Melanie
- Publisher:
- Nuffield Institute for Health
- Publication year:
- 1998
- Pagination:
- 11p.,bibliog.
- Place of publication:
- Leeds
Looks at shortcomings in community care provision, focusing particularly on home care services and at issues that need to be urgently addressed concerning their provision.
The effectiveness of paid services in supporting unpaid carers’ employment in England
- Authors:
- PICKARD Linda, et al
- Journal article citation:
- Journal of Social Policy, 44(3), 2015, pp.567-590.
- Publisher:
- Cambridge University Press
- Place of publication:
- Cambridge
This paper explores the effectiveness of paid services in supporting unpaid carers’ employment in England. There is currently a new emphasis in England on ‘replacement care’, or paid services for the cared-for person, as a means of supporting working carers. The international evidence on the effectiveness of paid services as a means of supporting carers’ employment is inconclusive and does not relate specifically to England. The study reported here explores this issue using the 2009/10 Personal Social Services Survey of Adult Carers in England. The study finds a positive association between carers’ employment and receipt of paid services by the cared-for person, controlling for covariates. It therefore gives support to the hypothesis that services for the cared-for person are effective in supporting carers’ employment. Use of home care and a personal assistant are associated on their own with the employment of both men and women carers, while use of day care and meals-on-wheels are associated specifically with women's employment. Use of short-term breaks are associated with carers’ employment when combined with other services. The paper supports the emphasis in English social policy on paid services as a means of supporting working carers, but questions the use of the term ‘replacement care’ and the emphasis on ‘the market’. (Publisher abstract)