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Rights-based approach to care and support for older persons
- Authors:
- SCHULMANN Katharine, ILLINCA Stefania, RODRIGUES Ricardo
- Publisher:
- European Centre
- Publication year:
- 2019
- Pagination:
- 12
- Place of publication:
- Vienna
This policy brief presents a conceptual framework for a human rights-based approach to long-term care and support for older people. The framework has been developed as part of an ongoing research project aimed at building and piloting an index of rights-based policies in the area of long-term care. The purpose of the index is to enable states to monitor and compare the extent to which their care and support policies uphold older persons’ rights. A human rights-based approach to care has the potential to empower older people to claim their rights and to hold states accountable in their role as duty bearers. The framework is composed of three levels: 1) Desired Outcomes: Fulfilment of Rights; 2) Enabling Processes: Monitoring and Enforcement; and 3) Structural Conditions: Legal Recognition. It also lays out ten main human rights domains relevant to persons with care and supports needs, and provides an in-depth description of the substantive rights that each of these ten main domains should include. (Edited 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.
Paying for long-term care
- Authors:
- RODRIGUES Ricardo, SCHMIDT Andrea
- Publisher:
- European Centre for Social Welfare Policy and Research
- Publication year:
- 2010
- Pagination:
- 21p., bibliog.
- Place of publication:
- Vienna
The aim of this policy brief is to present information on the current picture of private and public expenditure on long-term care for older people, and to discuss the challenges of financing care. It describes the background context of demographic ageing across the European Union. It discusses public funding of long-term care, including the rationale behind public funding and the current picture of public expenditure, private funding arrangements and expenditure on long-term care, possible equality considerations of long-term care benefits and whether high income groups are more likely to receive home care. The authors conclude that despite concerns over the sustainability of long-term care systems, public resources devoted to this area of social policy are much lower than what is spent in other areas such as health or pensions, and that while there are several options available to provide those in need of care with the means to secure the care they require, policymakers should be aware of the potential inequalities associated with the different ways of financing and providing long-term care.
The long-term care mix in Austria: an overview of community-based care provision by formal and informal caregivers
- Authors:
- lINCA Stefania, RODRIGUES Ricardo
- Publisher:
- European Centre for Social Welfare Policy and Research
- Publication year:
- 2019
- Pagination:
- 12
- Place of publication:
- Vienna
This Policy Brief provides insights into the individual characteristics associated with the use of formal, informal and mixed care by older Austrians living in the community. These are instrumental in understanding how care services can be structured to best complement informal care provision and respond to care users’ needs, as well as how long-term care policies can be expected to impact different care users and caregivers’ groups. The Brief shows that while informal support still accounts for the majority of provided care, the supply of formal services has been constantly increasing, serving primarily very old individuals, those with higher support needs and women. Large gender differences in care use patterns are still observed in Austria and particularly pronounced among married and co-habiting older people. (Edited publisher abstract)
From disability rights towards a rights-based approach to long-term care in Europe: building an index of rights-based policies for older people. Working paper II: conceptual framework...
- Authors:
- SCHULMANN Katharine, ILINCA Stefania, RODRIGUES Ricardo
- Publisher:
- European Centre for Social Welfare Policy and Research
- Publication year:
- 2018
- Pagination:
- 19
- Place of publication:
- Vienna
This working paper presents a conceptual framework for a human rights-based approach to care and support services, and attempts to detail what the fulfilment of universal human rights entails when applied to the particular case of older people with care and support needs. It is from the project 'From disability rights towards a rights-based approach to long-term care in Europe: building an index of rights-based policies for older people'. (Edited publisher abstract)
Choice, competition and care: developments in English social care and the impacts on providers and older users of home care services
- Authors:
- RODRIGUES Ricardo, GLENDINNING Caroline
- Journal article citation:
- Social Policy and Administration, 49(5), 2015, p.649–664.
- Publisher:
- Wiley
This article critically examines recent changes in markets for home (domiciliary) care services in England. During the 1990s, the introduction of competition between private (for-profit and charitable) organisations and local authority providers of long-term care services aimed to create a ‘mixed economy’ of supply. More recently, care markets have undergone further reforms through the introduction of direct payments and personal budgets. Underpinned by discourses of user choice, these mechanisms aim to offer older people increased control over the public resources for their care, thereby introducing further competitive pressures within local care markets. The article presents early evidence of these changes on: a) The commissioning and contracting of home care services by local authorities and individual older people; b) The experiences and outcomes for individual older people using home care services.. Drawing on evidence from two recent empirical studies, the article describes how the new emphasis on choice and competition is being operationalised within six local care markets. There are suggestions of small increases in user agency and in opportunities for older people to receive more personalised home care, in which the quality of care-giving relationships can also be optimised. However, the article also presents early evidence of increases in risk and costs associated with the expansion of competition and choice, both for organisations providing home care services and for individual older service users. (Edited publisher abstract)
From care in homes to care at home: European experiences with (de)institutionalisation in long-term care
- Authors:
- ILINCA Stefania, LEICHSENRING Kai, RODRIGUES Ricardo
- Publisher:
- European Centre for Social Welfare Policy and Research
- Publication year:
- 2015
- Pagination:
- 15
- Place of publication:
- Vienna
Many countries across Europe have developed strategies to support community-based services in an attempt to replace traditional institutional models of care. Differences in needs, approaches and commitment levels have led to diverse results and pace of progress. However, much can be learned from their experiences and from examples of strategies and models which proved to be effective. This Policy Briefing presents a typology of long-term care regimes and proposes four case studies to illustrate the main barriers and drivers to deinstitutionalisation. Austria (Standard care mix) illustrates the importance of developing strong support systems for informal carers and strengthening home-based care provision. Sweden (UniversalNordic) has made great strides towards deinstitutionalisation by promoting coordination between care providers, but, the coverage and cost of services will soon become unsustainable unless appropriate support for family-based care is provided. Italy (Family-based) and the Czech Republic (Transition) represent situations where the rates of institutionalisation are relatively low and current policy is challenged to contain future growth. Both systems offer significant support to informal and family carers, but this historic over-reliance on household contributions to care is leading to a widening gap between supply and demand, which needs to be addressed through the strengthening of community-based services.The briefing concludes with a discussion of the core principles for reaching a sustainable balance between different long-term care settings. (Edited publisher abstract)