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Comparative political economy of long-term care for elderly people: political logic of universalistic social care policy development
- Author:
- HIEDA Takeshi
- Journal article citation:
- Social Policy and Administration, 46(3), June 2012, pp.258-279.
- Publisher:
- Wiley
Despite there being common socio-demographic pressures across industrialised countries, the public elder care programmes tend to vary. This study explored the causal relationship between political institutions and public long-term care programmes. It examined time-series and cross-section data of advanced democracies, from 1980 until 2001. It argued that countries with fragmented party systems have difficulties in developing universalistic public elder care programmes, whereas countries with party-vote-oriented electoral systems and cohesive party systems are likely to develop better elder care programmes. For whilst the former types of political institutions prioritise patronage-based, particularistic benefits, the latter types encourage political actors to appeal to broader constituencies through universalistic welfare programmes. The empirical results suggest that politicians' reliance on personal votes obstruct the expansion of public spending for elder care.
The withdrawal of the welfare state: elderly care in Sweden in the 1990s
- Authors:
- BLOMBERG Staffan, EDEBALK Per Gunnar, PETERSSON Jan
- Journal article citation:
- European Journal of Social Work, 3(2), July 2000, pp.151-163.
- Publisher:
- Taylor and Francis
In Sweden, clear changes in the care of the elderly have occurred during the 1990s, with fewer people being provided public care, although greater efforts are now directed towards those most in need of help. Elderly people are cared for increasingly in other ways: by the family, by means of market-provided care, and by voluntary and informal means. Differences between municipalities are considerable. A comparative study was conducted in eight Swedish municipalities, four of them characterized by extensive reorganization of home-help services, and the other four constituting a reference group where such changes had not occurred. The aim was to examine processes of setting local priorities and adjustments in a period of marked structural change.
Will population ageing spell the end of the welfare state? A review of evidence and policy options
- Authors:
- CYLUS Jonathan, NORMAND Charles, FIGUERAS Josep
- Publisher:
- World Health Organization. Regional Office for Europe
- Publication year:
- 2018
- Pagination:
- 43
- Place of publication:
- London
This report reviews evidence on the health and long-term care costs associated with ageing populations in order to better understand the expected cost pressures due to changing demographics. It also explores how older populations can and do contribute meaningfully both in economic and societal terms, particularly if they are able to remain healthy and active into later life. It concludes by reviewing selected policy areas that have been shown to either support the health and activity of older people or which otherwise reinforce sustainable care systems more broadly in the context of population ageing. The report provides an overview of the Economics of Healthy and Active Ageing series which investigates key policy questions associated with population ageing. (Edited publisher abstract)
Long-term care in Denmark and Lithuania: a most dissimilar case
- Authors:
- POSKUTE Virginija, GREVE Bent
- Journal article citation:
- Social Policy and Administration, 51(4), 2017, pp.659-675.
- Publisher:
- Wiley
By comparing the systems and development in Lithuania and Denmark, the article probes into differences and similarities in two countries with very different welfare states belonging to different welfare regimes and having very diverse economic and historical development of a specific social policy area – i.e. long-term care (LTC) for the elderly. Despite differences, there are also similarities in the understanding of what LTC is and could be in the future, given the economic pressure on welfare states. So despite being a country-based case analysis of a specific social service field, at the outset, seemingly dissimilar, the analysis also shows similarities especially in the expectation of the role of the civil society, and that the elderly will want to stay as long as possible in their own home. There is also expected pressure from demography change, and, especially, a possible pressure on women as they, more often than men, provide informal care and will have a higher risk of living alone when they become elderly. Lastly, the use of rehabilitation and re-enablement is a central parameter for a possible reduction in the pressure on spending as well as improving quality of life for the elderly. (Publisher abstract)
Long term care for older people, social productivity and the 'big society': the case of dementia
- Authors:
- BAMFORD Sally-Marie, BERRY Craig
- Publisher:
- 2020 Public Services Hub
- Publication year:
- 2012
- Pagination:
- 32p.
- Place of publication:
- London
The Big Society agenda is particularly relevant to long term care for older people. The aim of this paper is to consider how or whether the Big Society can deliver care for older people with dementia. Little attempt has been made by policy-makers to relate dementia to the Big Society agenda. There seems to have been a silent assumption that Big Society applies most to those with physically disabilities and older frail people who require ‘a bit of help’ around the home or in going out. In contrast, dementia can result in a devastating loss of cognitive and intellectual functions, often accompanied by changes in psychological and emotional states, and straddles the frontier between health and social care. The first section of this paper considers the failure of the welfare state in meeting the needs of long term care. The bedrock of dementia care is provided in the form of informal care by family and friends. The paper then looks at dementia in more detail, before outlining how the Big Society and social productivity concepts may be relevant to considering how dementia is treated and managed. The paper argues that responding to the challenge of dementia will require enormous investment by the state in coming decades. Although there is certainly a role for individuals, families and communities in dementia care, it is necessary to move towards the more expansive concept of social productivity, in order to think more holistically about how to mobilise a range of public and private resources in long term care provision.
Solidarity in Italy's policies towards the frail elderly: a value at stake
- Author:
- GORI C.
- Journal article citation:
- International Journal of Social Welfare, 9(4), October 2000, pp.261-269.
- Publisher:
- Wiley
The Italian public policies towards the frail elderly are undeveloped by both quantitative and qualitative standards. The bulk of care responsibilities lies on the family and the private provision of paid care is flourishing. In such a context several questions on solidarity arise regarding the degree to which this value is actually embedded in the public policies, what are the most relevant issues and how the main actors involved are concerned. The article aims to answer some of these questions, taking into consideration the points of view of the main actors; elderly people, carers and professionals.
Beyond benevolence - solidarity and welfare state transition in Sweden
- Authors:
- BERGMARK A., THORSLUND M., LINDBERG E.
- Journal article citation:
- International Journal of Social Welfare, 9(4), October 2000, pp.238-249.
- Publisher:
- Wiley
This article discusses the development of Swedish welfare and welfare opinion. First, articulates various representations of the concept of solidarity - societal cohesion, individual support for comprehensive welfare and the amount of universality in the provision of care. Second describes some fundamental traits in the route taken by Swedish welfare during the 1990s, focusing especially on care of the elderly and the demographic challenge of an ageing population. Third summarises the evolution of public opinion regarding welfare provision and discuss the determinants of its variations. The article concludes with a discussion of how the features of universalism have been affected by development during the past decade, and the role of popular support in the route ahead for Swedish welfare.
Re-conceptualising the relationship between de-familialisation and familialisation and the implications for gender equality – the case of long-term care policies for older people
- Authors:
- EGGERS Thurid, et al
- Journal article citation:
- Ageing and Society, 40(4), 2020, pp.869-895.
- Publisher:
- Cambridge University Press
This article explores how far the concepts of de-familialisation/familialisation are adequate to the classification of long-term care (LTC) policies for older people. In the theoretical debate over LTC policies, de-familialising and familialising policies are often treated as opposites. The paper proposes re-conceptualising the relation between de-familialisation and familialisation, arguing that they represent substantially different types of policy that, in theory, can vary relatively autonomously. In order to evaluate this theoretical assumption, this article investigates the relation between the generosity level of LTC policies on extra-familial care, and the generosity level of LTC policies on paid family care, introducing a new multi-dimensional approach to measuring the generosity of LTC policy for older persons. It also explores the consequences of this for gender equality. The empirical study is based on a cross-national comparison of LTC policies in five European welfare states which show significant differences in their welfare state tradition. Data used are from document analysis of care policy law, the Mutual Information System on Social Protection, the European Quality of Life Survey and the Organisation for Economic Co-operation and Development. The findings support the argument that de-familialising and familialising LTC policies can vary relatively independently of each other in theory. It turns out that a better understanding of the relationship between LTC policy and gender equality can be gained if analysis of the role of different combinations of extra-familial and familial LTC policies for gender equality take place. The paper brings new insights into the ways welfare states act in regard to their LTC policies. It helps to clarify how the concept of de-familialisation/familialisation can be understood, and what this means for the relationship between LTC policies and gender equality. (Edited publisher abstract)
Care between work and welfare in European societies
- Editors:
- PFAU-EFFINGER Birgit, ROSTGAARD Tine, (eds.)
- Publisher:
- Palgrave Macmillan
- Publication year:
- 2011
- Pagination:
- 272p.
- Place of publication:
- Basingstoke
This book provides insights into the theoretical framework of 'tensions' related to care for children and the elderly in the context of recent welfare state reforms. It brings together experts in the field of research on welfare and work from different disciplines and from different European countries. The different chapters introduce the current debates on tensions related to care and discuss specific types of new tensions that have developed in the context of welfare state reform. Analyses relate to new tensions that are connected with different types of formal and informal child and elderly care, and with migration related to care. Also, tensions within care cultures, and between the cultural and the institutional framework of care are analysed. Moreover, it is shown if and under which conditions welfare state reforms have contributed to strengthen existing tensions or even to create new tensions, and under which conditions they have contributed to relax such tensions.
One uniform welfare state or a multitude of welfare municipalities? The evolution of local variation in Swedish elder care
- Authors:
- TRYDEGARD Gun-Britt, THORSLUND Mats
- Journal article citation:
- Social Policy and Administration, 44(4), August 2010, pp.495-511.
- Publisher:
- Wiley
The Nordic welfare states, including Sweden, have an inbuilt dilemma between 2 main principles: universalism and local autonomy. The concept of `welfare municipalities' has been used to characterise the social policy construction of independent local authorities implementing national welfare policies. This article studies the evolution of the balance between universal, centralised versus local, decentralised principles in Swedish welfare services, using elder care as a case. It follows up previous studies on the extensive diversity and the local path dependency in the distribution of elder-care services in Sweden. A predominant impression is that the pattern has changed in many aspects during the first decade of the new millennium, and in a complex way. The coverage of home help and residential care has become less generous, a sign of weaker universalism. On the other hand, the decentralisation tendencies have decreased, the earlier reported geographical disparity appears to have been reduced and the municipalities are increasingly adjusting to the national average. Also, the earlier strong local path dependency has faded out and therefore the concepts `welfare municipality' and `local social policy' appear to be less accurate than heretofore when describing the Swedish model of elder care.