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Diversification of old-age care services for older people: trade-offs between coverage, diversification and targeting in European countries
- Authors:
- SUNDSTRÖM Gerdt, et al
- Journal article citation:
- Journal of Care Services Management, 5(1), January 2011, pp.35-42.
- Publisher:
- Taylor and Francis
The two major public services for older people are institutional care and home care. In addition to these, a number of other low-level support services have also developed including transportation, meals-on-wheels, alarm systems, and day care. Using secondary analysis of a number of earlier surveys, this paper provides information on the way in which all of these types of support are allocated and who uses them in six different countries: Denmark, Norway, Sweden, Germany, England, Spain, and Israel. It also provides a closer scrutiny of Swedish service profiles. When all types of support are considered, service coverage in these countries is approximately 50% to 100% higher than for the two major types alone. The results suggest that countries with higher service levels target all their services more strictly by needs than countries with lower service levels. In countries with lower user rates, users may get what is available with little differentiation between their needs. The article suggests that a range of services, major and minor, may suit the varying needs of older people, and that minor services may also be used as an inexpensive substitute for full support.
The effects of rationing home-help services in Spain and Sweden: a comparative analysis
- Authors:
- SUNDSTRÖM Gerdt, TORTOSA Maria Angeles
- Journal article citation:
- Ageing and Society, 19(3), 1999, pp.343-361.
- Publisher:
- Cambridge University Press
Compares Spain and Sweden, two countries with different experiences of providing home-help services for older people, and to consider how they ration these services when there is a short supply. Spain provides relatively few hours of help with household tasks, primarily to poor old people. Sweden focuses on the oldest and frailest people of all social classes who live alone. Spain uses strict needs assessment and eligibility criteria to target clients and Sweden has sharpened its needs assessment and raised fees to discourage users with lesser needs.