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From subsidiarity to ‘free choice’: child- and elder-care policy reforms in France, Belgium, Germany and the Netherlands
- Author:
- MOREL Nathalie
- Journal article citation:
- Social Policy and Administration, 41(6), December 2007, pp.618-637.
- Publisher:
- Wiley
This article analyses the patterns of reform in care policies in Bismarckian welfare systems since the early 1980s. Based on a comparison of France, Germany, Belgium and the Netherlands, the article shows that these reforms share similar logics and trajectories, which can be explained by the shared conservative and corporatist traits of Bismarckian labour markets and welfare state institutions and their impact on labour market adjustment possibilities and preferences. Indeed, we argue that care policy reforms have been very closely linked to specific employment strategies, and the politics of welfare without work and subsequent attempts to shift away from such a labour-shedding strategy go a long way in explaining both the nature and the timing of child- and elder-care policy reforms in Bismarckian welfare systems. The article also shows how a focus on promoting ‘free choice’ in all four countries has justified the introduction of measures that have simultaneously reinforced social stratification in terms of access to the labour market – meaning that some women have much more ‘free choice’ than others – and weakened certain labour market rigidities. To conclude, we argue that care policy reforms have provided a backdoor for the introduction of labour-cheapening measures and for increasing employment flexibility in otherwise very rigid labour markets.
Elderly suicide attempters: characteristics and outcome
- Authors:
- LEBRET Stephane, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(11), November 2006, pp.1052-1059.
- Publisher:
- Wiley
The authors made a descriptive survey to assess the outcome of elderly patients discharged from a hospital psychiatric service after a suicide attempt (rates of overall mortality and repeat attempts), to identify the factors that had a significant impact on their survival and to determine patient characteristics. Fifty-nine suicide attempters over 60 years of age admitted to hospital between 1993 and 2000 were included in the study. Their outcome was assessed by questioning their attending physicians over the telephone. We traced 51 of the 59 patients; 8 were lost to follow-up. Statistical analysis (Log Rank tests, Cox model) was computed to determine which factors altered the overall survival and the survival without further attempt. The patients sociodemographic, medical and psychiatric characteristics were recorded from hospital patient files. Elderly suicide attempters showed an increased mortality from suicide and natural causes and the risk of a repeat attempt increased in female patients with memory disorders. The factors altering survival were advanced age, pre-existing physical disability, several co-existing physical illnesses, severe physical consequences of the suicide attempt, history of psychiatric illness other than depression, memory disorders and one previous suicide attempt. The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression. Elderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which it is essential to detect.
Major depression as a risk factor for early institutionalization of dementia patients living in the community
- Authors:
- DORENLOT Pascale, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.471-478.
- Publisher:
- Wiley
Although depression is known to be frequently associated with dementia, it is nonetheless under-diagnosed and under-treated among this patient population. Its effect on outcome for dementia patients is thought to be substantial, because depression appears to induce higher than normal rates of disability as well as supplementary cognitive decline. The aim of this study was to measure the impact of major depression on the institutionalization rate of community-dwelling dementia patients. Three-hundred forty-eight consecutive dementia outpatients of a geriatric clinic (mean age: 81 years, 69.8% women, 65.5% dementia of Alzheimer's type, mean baseline MMSE score: 20.5), followed between 1997 and 2002 (mean follow-up: 20.5 months). Twenty-five percent of the patients met the criteria of major depression at baseline, and only 30.3% of these received antidepressant medication. Major depression at baseline was independently associated with nursing home admission within one year of the baseline assessment. Antidepressant medication tended to protect against this outcome, but not to a statistically significant extent. Major depression at baseline is an independent risk factor for early institutionalization of dementia sufferers. Early institutionalization is defined in this study as nursing home placement within a year of diagnosis with dementia at our specialized outpatient center. The study highlights the need for better management of depression among dementia outpatients. Further investigation is needed to evaluate the protective effect of antidepressant medication (and/or non-pharmacological therapies) on the institutionalization rate.
Dementia and minority ethnic older people: managing care in the UK, Denmark and France
- Authors:
- PATEL Naina, et al
- Publisher:
- Russell House
- Publication year:
- 1998
- Pagination:
- 183p.,tables,bibliog.
- Place of publication:
- Lyme Regis
Report from a project looking at the care needs of black and minority ethnic elders with dementia in the UK, Denmark and France. Designed to be both a guide and a starting point for service developments and improvements throughout Europe.
Incomes and living standards of older people: a comparative analysis
- Authors:
- WHITEFORD Peter, KENNEDY Steven
- Publisher:
- HMSO
- Publication year:
- 1995
- Pagination:
- 173p.,diags.,bibliog.
- Place of publication:
- London
Research study providing an empirical analysis of the incomes of older people in 11 countries. Also presents the results, for a narrower range of countries, of an analysis of living standards, defined to include the value of government provided health and education services, as well as disposable cash income. In addition, looks at the role of owner-occupied housing and liquid wealth.
Growing older in the community: European projects in housing and planning
- Authors:
- BRECH Joachim, POTTER Philip
- Publisher:
- Anchor Housing Trust/Wohnbund
- Publication year:
- 1994
- Pagination:
- 197p.,tables,illus.,bibliogs.
- Place of publication:
- Oxford
Research report looking at how meeting the care and housing needs of older people, to enable them to live in the community for as long as possible, is being tackled by European countries.
The economics of care of the elderly
- Authors:
- PACOLET Jozef, WILDERCOM Celeste
- Publisher:
- Avebury
- Publication year:
- 1991
- Pagination:
- 241p.,tables,bibliogs.
- Place of publication:
- Aldershot
Set of papers given at a colloquium in March 1990 in Brussels, where a group of economists presented their theoretical and empirical progress on an EC initiated project on the care of elderly people. Divided into 4 parts: part 1: the ageing population and the organisation of the welfare state: macro economic analysis; part 2: significance of informal care of elderly people; part 3: how to meet the needs of elderly people: relevance of micro-economic analysis; and part 4: policy formation for older people. This section includes comparative studies of Belgium, Denmark, Spain, France, West Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, and the United Kingdom.
Ageing populations: spreading the costs
- Author:
- GILLION Colin
- Journal article citation:
- Journal of European Social Policy, 1(2), 1991, pp.107-128.
- Publisher:
- Sage
Over the next 50 years almost all the countries of the OECD are will experience a dramatic ageing of their population structures. This process will affect the burden, in terms of taxes or social security contributions, placed on active members of the population. If no changes occur in the (relative) level of benefits, the age of retirement, female participation rates, the level of unemployment, or the level of immigration: then the total burden of support by the active members of the population for the inactive and dependent will rise very considerably. This paper attempts to place broad magnitudes on the amount of the potential increase. The analysis goes on to ask: what if changes should occur in the underlying parameters such as benefits rates, retirement age, female participation, unemployment rates, immigration?
Privatisation by default?: old age homes in Britain and France
- Authors:
- ESTRIN Saul, PEROTIN Virginie
- Publisher:
- London School of Economics. Suntory Toyota Centre for Economics and Related Disc
- Publication year:
- 1988
- Pagination:
- 22p., tables, bibliog.
- Place of publication:
- London
Examines the growth in private residential care for elderly people in the UK and provides statistics from France by comparison.
Elderly sexual abuse: an examination of the criminal event
- Authors:
- CHOPIN Julien, BEAUREGARD Eric
- Journal article citation:
- Sexual Abuse a Journal of Research and Treatment, 32(6), 2020, pp.706-726.
- Publisher:
- Sage
The current study investigates the modus operandi specificities for the sexual abuse against the elderly. A comparison between sex crimes against adult and elderly victims is conducted following the criminal event approach. The comparison is based on the precrime, crime, and postcrime phases of the modus operandi, operationalized through 53 variables. The sample comes from a French national police database including a total of 1,829 cases - including 130 cases of elderly sexual abuse and 1,699 cases of sexual abuse against victims aged between 18 and 45 years. Bivariate and multivariate analyses are performed to examine the differences in the two groups. Several differences are observed between the two modus operandi. Findings indicate that the precrime phase is the most important to explain these differences, and this phase of the criminal event affects the rest of the decisions taken during the crime and postcrime phases. Specifically, the authors have highlighted that sexual crimes against the elderly are more violent and occur more often in the victim’s residence. This study suggests that offenders targeting the elderly use specific crime characteristics, and this allows to highlight practical implications in terms of investigation and offender management. (Edited publisher abstract)