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Care regimes on the move: comparing home care for dependent older people in Belgium, England, Germany and Italy
- Authors:
- DEGAVRE Florence, et al
- Publisher:
- Universite Catholique de Louvan. Centre Interdisciplinaire de Recherche Travail, Etat et Societe
- Publication year:
- 2012
- Pagination:
- 290p.
- Place of publication:
- Charleroi
Taking the reforms of the 1990s as its starting point, this report examines the dynamics of change experienced by Belgium, England, Germany and Italy in their home care sectors. Central to our analysis is the process of “marketisation”. This constitutes one of the major trends in all these four countries, yet its nature and impact show important national variations. The data referred to in this report relate to developments in and around various home care sectors, and cover both societal and organisational dynamics. Country-based research teams gathered the information, each team following identical methodological guidelines. This report uses official documents and grey literature from the care sector to analyse the discourses underpinning reforms in the field. The conclusions of this research will be of relevance for any country or region struggling to design a home care system for an ageing population. The coordinators of this research project have submitted a proposal for a special issue of Ageing and Society based on the main chapters of this report.
"Squeezed like a lemon": a participatory approach on the effects of innovation on the well-being of homecare workers in Belgium
- Authors:
- BENSLIMAN Rachida, CASINI Annalisa, MAHIEU Celine
- Journal article citation:
- Health and Social Care in the Community, 30(4), 2022, pp.e1013-e1024.
- Publisher:
- Wiley
Innovative programs that emerge in response to the rapidly changing care needs of older adults provide an opportunity to study the transformations in working and employment conditions within the homecare sector. This study seeks to understand how innovations introduced in the homecare sector have affected the well-being of homecare workers providing non-medical domestic support to older adults who wish to age in place. Our study is based on a participatory approach involving homecare workers exposed to two innovations in Wallonia (Belgium) that relate to flexible working hours, worker training, and technological equipment. We conducted a literature review, six semi-structured individual interviews with managers, and eight workshops based on the 'Group Analysis Method' involving 9 to 12 homecare workers. The results revealed that the innovations deteriorated working conditions, intensified occupational psychosocial risk factors, and impacted work-life balance. This gave rise to tensions that ultimately had a negative impact on the well-being of workers and on the quality of their care relationship with older adults/caregivers, while also weakening the viability of the services. The workers proposed some avenues to improve and regulate these tensions. (Edited publisher abstract)
Exploring the cost of ‘ageing in place’: expenditures of community-dwelling older adults in Belgium
- Authors:
- FRET Bram, et al
- Journal article citation:
- Ageing International, 45(3), 2020, pp.209-229.
- Publisher:
- Springer
- Place of publication:
- New York
This paper aims to give an overview of the different sources of income and the expenditures of community-dwelling older adults and to what extent they can make ends meet to explore the affordability of care and support at home. Despite research on the affordability of residential care, evidence on the cost of ‘ageing in place’ is still missing. 173 questionnaires were gathered within a non-random sample of community-dwelling older adults (60+). Both frequencies and bivariate tests (to explore whether there are certain risk groups with low incomes and high expenditures) were performed on the data. Results indicate the variety of income sources, the necessity of financial compensations to make ends meet and that especially older women and older tenants are at risk for facing financial difficulties. Also, this research indicates that ‘ageing in place’, especially for older adults with care needs, is not always affordable and can be a challenge within our ageing society. (Publisher abstract)
Analysing equity in the use of long-term care in Europe
- Authors:
- RODRIGUES Ricardo, ILINCA Stefania, SCHMIDT Andrea
- Publisher:
- European Commission
- Publication year:
- 2014
- Pagination:
- 39
- Place of publication:
- Brussels
There are significant differences across social protection systems in Europe in the scope, breadth and depth of coverage of the risk to need long-term care in old-age. Together with other factors, such as education, household structure or societal values regarding care for frail older people, these differences can have a significant impact on the use of long-term care. Using SHARE data, this Research Note compares differences between European countries in the use of long-term care across income groups, for older people living at home. It analyses not only inequalities in the use of long-term care, but also differences in use that persist after differences in need have been taken into consideration, i.e. horizontal inequity. For this purpose, concentration indices, concentration curves and horizontal inequity indices are estimated for home care services and informal care. The countries analysed here are Austria, Germany, Sweden, the Netherlands, Spain, Italy, France, Denmark, Greece, Belgium and Czech Republic. The findings suggest that differences in use of home care services across income groups mostly reflect differences in need between those same groups. For informal care, the differences in use persist even after accounting for needs, and less affluent individuals are much more likely to use informal care. Some possible causes for these differences and policy implications are considered.
Socio-economic status differences in older people's use of informal and formal help: a comparison of four European countries
- Authors:
- van GROENOU Marjolein Broese, et al
- Journal article citation:
- Ageing and Society, 26(5), September 2006, pp.745-766.
- Publisher:
- Cambridge University Press
This study investigates the variations by older people's socio-economic status (SES) (i.e. educational level and social class) in the use of informal and formal help from outside the household in Great Britain, Italy, Belgium and The Netherlands. In all these countries, it was older people in low SES groups who mostly used such help. Multinomial logistic regression analyses showed that, in each country and for both types of help, there were SES gradients in the utilisation of both formal and informal care, and that differences in age, health and marital status largely accounted for the former but not the latter. Cross-national differences in the use of both informal and formal help remained when variations in sex, age, SES, health, marital status, home ownership and the use of privately-paid help were taken into account. Significant interaction effects were found, which indicated that older people in low SES groups in Great Britain and The Netherlands had higher odds of using informal help from outside the household than their counterparts in Italy, and similarly that those in The Netherlands were more likely to use formal help than their Italian peers. The results are discussed in relation to the cultural differences and variations in the availability of formal services among the countries.
Older people
- Author:
- MANTHORPE Jill
- Journal article citation:
- Research Matters, 2005, pp.37-42.
- Publisher:
- Community Care
This article reports on studies from four continents into age discrimination in the workplace, home care support and mental health issues give valuable pointers for UK practice.
Older people in Charleroi
- Author:
- MAYENCE Serge
- Journal article citation:
- Social Policy and Administration, 27(3), September 1993, pp.221-234.
- Publisher:
- Wiley
Reports on a study of older people in Charleroi, Belgium, and their views on neighbourhood life, family, dependency and domiciliary services, health, leisure-time and voluntary action, and retirement. One of a series of companion studies.
Inter-organisational collaboration in palliative care trajectories for nursing home residents: a nation-wide mixed methods study among key persons
- Authors:
- HERMANS Sofie, et al
- Journal article citation:
- International Journal of Care Coordination, 22(2), 2019, pp.69-80.
- Publisher:
- Sage
Introduction: Multiple care organisations, such as home care services, nursing homes and hospitals, are responsible for providing an appropriate response to the palliative care needs of older people admitted into long-term care facilities. Integrated palliative care aims to provide seamless and continuous care. A possible organisational strategy to help realise integrated palliative care for this population is to create a network in which these organisations collaborate. The aim is to analyse the collaboration processes of the various organisations involved in providing palliative care to nursing home residents. Method: A sequential mixed-methods study, including a survey sent to 502 participants to evaluate the collaboration between home and residential care, and between hospital and residential care, and additionally three focus group interviews involving a purposive selection among the survey participants. Participants are key persons from the nursing homes, hospitals and home care organisations that are part of the 15 Flemish palliative care networks dispersed throughout the region of Flanders, Belgium. Results: Survey data were gathered from 308 key persons (response rate: 61%), and 16 people participated in three focus group interviews. Interpersonal dimensions of collaboration are rated higher than structural dimensions. This effect is statistically significant. Qualitative analyses identified guidelines, education, and information-transfer as structural challenges. Additionally, for further development, members should become acquainted and the network should prioritise the establishment of a communication infrastructure, shared leadership support and formalisation. Discussion: The insights of key persons suggest the need for further structuration and can serve as a guideline for interventions directed at improving inter-organisational collaboration in palliative care trajectories for nursing home residents. (Edited publisher abstract)
How do older adults experience and perceive socially assistive robots in aged care: a systematic review of qualitative evidence
- Authors:
- VANDEMEULEBROUCKE Tijs, DIERCKX De CASTERLE Bernadette, GASTMANS Chris
- Journal article citation:
- Aging and Mental Health, 22(2), 2018, pp.149-167.
- Publisher:
- Taylor and Francis
Objectives: The aim of this review was to gain a better understanding of how older adults experience, perceive, think, and feel about the use of socially assistive robots (SARs) in aged care settings. Method: The authors conducted a literature search for studies that used a qualitative or a mixed-method approach having a significant qualitative element. Pubmed, Cinahl, Embase, Scopus, and Web of Science electronic databases were queried. Candidate articles published in journals and conference proceedings were considered for review. Two independent reviewers assessed the included studies for methodological quality using the Critical Appraisal Skills Program, after which data on subjects’ self-reported opinions and perceptions were extracted and synthesised using thematic analyses. Results: Seventeen studies producing 23 publications were included. Based on the opinions of older adults, four themes emerged in relation to the use of SARS: (1) roles of a SAR; (2) interaction between the older adult and the SAR, which could be further subdivided into (a) the technical aspect of the interaction and (b) the human aspect of the interaction; (3) appearance of the SAR; and (4) normative/ethical issues regarding the use of SARs in aged care. Conclusions: Older adults have clear positive and negative opinions about different aspects of SARs in aged care. Nonetheless, some opinions can be ambiguous and need more attention if SARs are to be considered for use in aged care. Understanding older adults’ lived experiences with SARs creates the possibility of using an approach that embeds technological innovation into the care practice itself. (Edited publisher abstract)
Changes In older people's living arrangements in Flanders, 1993-98
- Author:
- AUDENAERT Veerle
- Journal article citation:
- Ageing and Society, 23(4), July 2003, pp.451-469.
- Publisher:
- Cambridge University Press
The living arrangements of older people are changing. An analysis of official registration data (1993-1998) in Flanders, Belgium, shows that while the number of single person households has been increasing, the proportion of people aged 75 or more years living alone has been falling and the proportion living with a spouse or partner increasing. No less than one third of the older people who lived alone in 1993 sustain a one-person household into very old age. It was also found that those who are widowed at a very advanced age change house or move very quickly, women to a greater extent and at younger ages than men. The principal destinations are residential care homes and, to a lesser extent, child's households. Living alone appears to be a decreasingly acceptable option. Since very old people with a disability appear to have an increasing preference for residential care and a lessening preference for co-residence with relatives, these developments have consequences for both informal family care and public social services. Particular attention needs to be paid to men who live alone as a risk-group, and residential care provision requires expansion.