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How European nations care for their elderly: a new typology of long-term care systems
- Authors:
- KRAUS Markus, et al
- Publisher:
- European Network of Economic Policy Research Institutes
- Publication year:
- 2011
- Pagination:
- 6p.
- Place of publication:
- Brussels
Expected future demographic and societal shifts have put the improvement of quality and efficiency of long-term-care (LTC) systems on the agenda of virtually every EU member state. ANCIEN (Assessing Needs for Care in European Nations) is a research project that concerns the future of long-term care (LTC) for the elderly in Europe. It aims to investigate how needs, demand, supply and use of LTC develop, and how different systems of LTC perform. This policy brief summarises findings from Work Package 1 of the ANCIEN project. This research comprised the collection of comprehensive information on national LTC systems in a number of EU member states, and the production of national reports describing the structure of these systems. Two typologies of LTC systems were developed. The first approach focused on the organisation and financing of care, relied on qualitative information, and included 21 EU member states. The second approach focused on use and financing of care, used quantitative variables, and included 14 EU member states. The typologies resulting from the 2 approaches were ordered according to attractiveness of their systems for elderly in need of care, yielding the same result for 10 out of the 14 countries. Implications for policy and recommendations are discussed.
Gone for good?: prefunded insurance for long-term care
- Author:
- LLOYD James
- Publisher:
- Strategic Society Centre
- Publication year:
- 2011
- Pagination:
- 65p.
- Place of publication:
- London
In the debate on how to fund long-term care in England and Wales, some stakeholders have advocated a central role for financial services, and pre-funded consumer insurance in particular. This report examines this approach by considering: the potential role that pre-funded insurance could take in funding long-term care; and the extent to which the pre-funded long-term care insurance market can help policymakers achieve key strategic policy objectives for social care. It examines the demand and supply-side barriers to the use of pre-funded long-term care insurance, noting the last UK provider exited the market in 2010 citing a lack of demand. No country has achieved an effective market in pre-funded long-term care insurance, with France having the highest rate at 15%. The report argues that even if the UK were in the future to achieve a take-up of 15% this would still result in outcomes that failed to meet many policy objectives for long-term care funding, particularly associated with ‘catastrophic costs’, fiscal pressures and the incidence of means-testing. It concludes by outlining some of the multiple other roles that the financial services industry could take in funding social care, particularly around delivering and servicing a state-sponsored insurance scheme for long-term care, akin to the schemes found in countries such as Singapore and the Netherlands.
Politics and the care conundrum: why does England have a problem funding social care?
- Author:
- LLOYD James
- Publisher:
- Strategic Society Centre
- Publication year:
- 2011
- Pagination:
- 29p.
- Place of publication:
- London
This discussion paper explores the underlying causes of England's long-term care funding problem. It argues that the state, the older population and wider society have sufficient wealth to finance a properly funded social care system. The persistent problem of funding care in England therefore poses what can be termed the ‘care conundrum’. This paper seeks to explain this 'care conundrum', and its root causes in issues of politics and governance. Using ideas and theories drawn from political science, the paper identifies multiple factors that may explain the 'care conundrum'. These factors include: the varied, ‘indefinable’ nature of social care; the illogical, complex ‘mess’ of institutions overseeing social care policy; public ignorance of what social care is and what outcomes represent quality; and the interests of politicians in avoiding unpopular measures. The paper calls for the creation of an Office for Care and Living which would undertake a number of strategic functions, such as public education and data provision, in order to address the failure of democratic accountability alone to ensure a properly funded social care system. It argues that, even in the face of voter disinterest toward social care, the government does have an opportunity to reposition public and political discourse on care funding to create the conditions for sustainable long-term reform.
Financing long-term care in Europe: institutions, markets and models
- Editors:
- COSTA-FONT Joan, COURBAGE Christophe, (eds.)
- Publisher:
- Palgrave Macmillan
- Publication year:
- 2011
- Pagination:
- 360p.
- Place of publication:
- Basingstoke
The editors offer an understanding of the institutional, economic, cultural and behavioural constraints that explain the development of models of long-term care throughout Europe. The ageing of the European population brings new financial risks that call for state, market and societal responses. Forecasts predict that the size of the old-age population in need of long-term care will double in the next 50 years in Europe. Different countries are responding to the challenge of financing long-term care in different ways. The issues discussed here include the role of market development, changing intergenerational contracts and the constraints of state intervention. This book examines different forms of partnership and the potential cooperation of state, market and societal stakeholders. It considers the institutional responses and mechanisms in place for financing old age as well as providing a deep analysis of both the demand and supply factors underpinning the development of financial instruments to cover long-term care needs in Europe.
Independent ageing: council support for care self-funders
- Authors:
- CARR-WEST Jonathan, THRAVES Laurie
- Publisher:
- Local Government Information Unit
- Publication year:
- 2011
- Pagination:
- 20p.
- Place of publication:
- London
The cost of providing residential care for the elderly is substantial and rising, but would be even more stretched were it not for the contributions that individuals make to their own care. This report investigates the cost to councils of those who begin by funding their own care but fall back on state funding when their own means run out. It draws upon a survey of chief executives, leaders, finance directors, adult services directors and cabinet portfolio holders in all 174 upper tier authorities in England and Wales. The report demonstrates that the cost of people falling back on state funding for residential care is substantial and immediate. This is already costing councils significant amounts of money. Over 60% of key decision makers in councils do not have a detailed picture of the problem. Those that do recognise the problem significantly underestimate the cost. The report sets out some practical recommendations for how councils can help ensure that fewer self-funders deplete their resources and fall back on the state. For the most part these interventions are low cost and capable of realising cost reductions. This will lead to cost savings for councils, but it will also allow individuals to make better informed choices and improved provision for their old age.
Goal of choice for all at risk as cuts start to bite
- Author:
- DUNNING Jeremy
- Journal article citation:
- Community Care, 31.3.11, 2011, pp.22-23.
- Publisher:
- Reed Business Information
Take up of personal budgets still low in older people and those with mental health problems. The coalition government wants all users on personal budgets by 2013. The author looks at the challenges facing local authorities in achieving this goal with current cut-backs in resources.
Viewpoint on downsizing for older people into specialist accommodation
- Author:
- SUTHERLAND Janet
- Publisher:
- DH Care Networks. Housing Learning and Improvement Network
- Publication year:
- 2011
- Pagination:
- 18p.
- Place of publication:
- London
This viewpoint makes the case for encouraging more housing providers to create attractive specialist schemes for older people, and for encouraging more people to move into them. This is the second of 2 viewpoints on downsizing; the first one provides a more general outline of the advantages both to individuals and society if more people were to downsize, and considers how to encourage and help people to do so. This viewpoint considers the challenges and the opportunities faced currently in delivering a programme of specialist accommodation, providing a wider range of new schemes to meet current and future needs, and of funding improvements to existing schemes. It particularly considers the following models of specialist housing: sheltered accommodation; Extra Care housing; and retirement villages. Issues regarding the affordability of care and support are also discussed, including the releasing of assets to fund care. The document concludes that the under provision of suitable housing for older people must be tackled urgently. Developers and house builders must be engaged with to ensure that they are fully aware of the market opportunity that 50% household growth in the retirement housing sector brings, and particularly to attract more in to provide for the middle and lower equity market.
Delivering public services in the mixed economy of welfare: perspectives from the voluntary and community sector in rural England
- Authors:
- HARDILL Irene, DWYER Peter
- Journal article citation:
- Journal of Social Policy, 40(1), January 2011, pp.157-172.
- Publisher:
- Cambridge University Press
- Place of publication:
- Cambridge
The voluntary and community sector in England is playing an increasingly important role in the delivery of public services to older adults and in doing so they rely on unpaid volunteers. This article draws on the findings of a recent qualitative study of the impact on the voluntary and community sector of delivering ‘low-level’ public services that promote independent living and wellbeing in old age. The fieldwork focused on 6 services which provide lunch clubs, welfare rights information and advice, befriending and community warden services for older adults living in remote rural communities across 3 English regions (the East Midlands, West Midlands, and the East of England). A total of 69 participants were interviewed; 25 of whom were key informants (paid staff, volunteers, and funders), and 44 of whom were older people who made use of one of the services. The results highlight two key challenges faced by the voluntary and community sector in delivering public services: managing precarious funding regimes from the public purse; and a reliance on an unpaid, volunteer workforce for the frontline delivery of many services.
Investing in prevention for older people at the health and social care interface
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2011
- Pagination:
- 17
- Place of publication:
- Oxford
Describes a new investment model designed to stimulate improved and more cost-effective outcomes for older people at the interface of health and social care. Its emphasis is on reducing demand by providing targeted preventative services as a mainstream intervention – rather than as add-on or pilot-based service – and integrating provision so that it straddles health and social care. The paper begins with an assessment of the demographic and other drivers of rising demand on services, before assessing the shortcomings of demand-reduction strategies to date. Among these, it identifies primarily a lack of clarity on the relationship between funding and outcomes, noting the potential failure of coordination between multiple separate funders and the danger that prevention strategies run alongside the mainstream interventions they are supposed to replace, and show up as an additional cost. Drawing on earlier interview and case file audit research conducted by IPC among care home populations, the paper then identifies key characteristics and conditions found among those admitted, including continence problems, dementia, stroke and falls. The limitations of existing care approaches to these conditions are outlined and a new investment-based model described, based on: assessment of resources available, outcomes desired, evidence base available, likelihood of benefits occurring, the extent of savings they would offer, and the timescale over which those benefits would accrue. The merits of this framework are then demonstrated by applying it to falls to illustrate the potential savings from reduced demand and the better outcomes for users. The paper concludes with implications for local commissioning strategies. (Edited publisher abstract)
The current coordinates of the Korean care regime
- Authors:
- BAEK Sun-Hee, SUNG Eunsoo, LEE Sung Hee
- Journal article citation:
- Journal of Comparative Social Welfare, 27(2), June 2011, pp.143-154.
- Publisher:
- Taylor and Francis
During the past decade, growing attention has been paid to caregiving policies in Korea because of the low fertility rate, the ageing population, and work-life balance concerns. The necessity to address the consequences of these trends has led to political changes which have had major financial and operational impacts on the Korean care regime. This article describes how the state has increased its involvement in and financing of care services for older people and children. However, despite the expanded role of the state and increases in government funding, the burden of care is still shouldered by families. In addition, the priorities established by government policy have created winners and losers, depending on the type of care needed. Coverage limitations in Long-Term Care Insurance elder care services have done little to improve the financial hardship of those who require services. In addition, extra fee-based programmes offered by child care services have also increased the financial demand on families.