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The 'consumer principle' in the care of elderly people: free choice and actual choice in the German welfare state
- Authors:
- EICHLER Melanie, PFAU-EFFINGER Birgit
- Journal article citation:
- Social Policy and Administration, 43(6), December 2009, pp.617-633.
- Publisher:
- Wiley
In the mid-1990s the German welfare state introduced care markets and consumer choice between family care and different types of formal care, together with new long-term care legislation. This article examines care policy and the expansion of choice in Germany with the introduction of the Long-Term Care Insurance Act, and development of the structure of care of elderly people, showing how the actual decision on the part of those in need of care and their family members has developed, and looks at possible explanatory factors for why those in need of care and their family members continue to choose the traditional solution of care by family members despite the expansion of possibilities, arguing that cultural factors contribute significantly to this. The authors find that elderly people and their families orient their behaviour towards traditional care values in which the first priority is given to mutual support between spouses and generations, and that elderly people and care agencies have substantially different definitions of a good quality of care.