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Home care across Europe: current structure and future challenges
- Editors:
- GENET Nadine, ed.
- Publisher:
- World Health Organization
- Publication year:
- 2012
- Pagination:
- 156p.
- Place of publication:
- Copenhagen
Currently, for every person over the age of 65 in the European Union, there are four people of working age. But by 2050 there will only be two. Demand for long-term care, of which home care forms a significant part, will inevitably increase in the decades to come. Despite the importance of the issue, however, up-to-date and comparative information on home care in Europe is lacking. This report attempts to fill some of that gap by examining current European policy on home care services and strategies. It examines a wide range of topics including the links between social services and health-care systems, the prevailing funding mechanisms, how service providers are paid, the impact of governmental regulation, and the complex roles played by informal caregivers. Drawing on a set of Europe-wide case studies, the report provides comparable descriptive information on many aspects of the organisation, financing and provision of home care across the continent. The report is designed to help frame the coming debate about how best to serve elderly citizens as European populations age.
The future of homecare: responding to older people's needs
- Author:
- BERNARD Caroline
- Publisher:
- Counsel and Care; Ceretas
- Publication year:
- 2009
- Pagination:
- 19p.
- Place of publication:
- London
This discussion paper has been developed from Ceretas and Care and Council round table meeting held on 8 July 2009. The meeting was attended by 22 people from across the care sector, including sheltered housing and local authorities to discuss the state of home care in the wider context of community care. The paper beings by discussing the current state and quality of home care. It then discusses what a better system of care and support should look like to respond to older people's needs. Recommendations for the future are then summarised, which include listening to what older people say, undertaking a review of council homecare charging, and examine ways for home care to move seamlessly into residential care.
Expansion of formalised in-home services for Japan's aged
- Authors:
- ADACHI Kiyoshi, LUBBEN James E., TSUKADA Noriko
- Journal article citation:
- Journal of Aging and Social Policy, 8(2/3), 1997, pp.147-159.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Analyses the social and political forces in Japan that led to the creation of the Gold Plan, a comprehensive national plan for formalised in-home services for the aged. Examines the political strategies of the Gold Plan from the perspectives of the shift from institutional to in-home services; decentralisation of in-home services policy; and needs for expanding the number of in-home service workers. New nonprofit organisations called Resident-Participation Types (RPTs) are identified, which are self-help organisations to augment the delivery of in-home services to the aged. Finally, future issues regarding RPTs and in-home services for the aged and some policy recommendations are discussed.
Methodological challenges in the implementation and evaluation of social welfare policies
- Authors:
- ANDERSSON Katarina, KALMAN Hildur
- Journal article citation:
- International Journal of Social Research Methodology, 15(1), 2012, pp.69-80.
- Publisher:
- Taylor and Francis
As social reality is quite elusive, even regarding seemingly well-recognised everyday concepts and objects, assessments and evaluations of implementation policies will always present methodological challenges. There is a need to consider such assessments and evaluations in a critical perspective to investigate whether the desired knowledge is really being acquired. The purpose of this article is to address some of the challenges that underlie assessments and evaluations of the implementation of social welfare policies by presenting a rereading and analysis of an empirical study of elderly home care services. The rereading and analysis is described in terms of 4 stages: ecological analysis of institutions; shadowing; focus on common concepts and objects; and applying the analytical concept of boundary objects. The results reveal the emergence of a dissolution of common and professional key concepts and objects in these welfare services to a degree that challenges both the implementation policy and the evaluation of policy. The article concludes that this has methodological implications for the evaluation of implementation policies in general.
Expanded, but not regulated: ambiguity in home-care policy in Ireland
- Authors:
- TIMONEN Virpi, DOYLE Martha, O’DWYER Ciara
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.310-318.
- Publisher:
- Wiley
The article examines this incompatibility between the expansion of home-care services in Ireland, and the failure to develop policies to govern access to and quality of services. It suggests that the key factors that motivated home-care expansion in the Irish case were: problems in the acute hospital sector and the perception of home care as a partial solution to these; and significant GDP growth that provided politicians with the means to fund expansion in home-care services. The key factors that inhibited the development of a policy framework to govern home-care services were: weak governance structures in health services and decision-making at national level based on short-term political gain; Ireland’s adherence to the liberal welfare state model and concern about uncontrollable care costs in the face of population ageing; until 2010, paucity of attention to home-care issues in the Irish media; and weak provider interest representation.
Our turn next: a fresh look at home support services for older people
- Editor:
- HENWOOD Melanie
- Publisher:
- Nuffield Institute for Health
- Publication year:
- 1998
- Pagination:
- 11p.,bibliog.
- Place of publication:
- Leeds
Looks at shortcomings in community care provision, focusing particularly on home care services and at issues that need to be urgently addressed concerning their provision.
Varieties of migrant care work: comparing patterns of migrant labour in social care
- Author:
- HOOREN Franca J. van
- Journal article citation:
- Journal of European Social Policy, 22(2), May 2012, pp.133-147.
- Publisher:
- Sage
In some European countries the provision of elderly care services is highly dependent upon migrant labour. This article presents a comparative analysis of the role of migrant workers in elderly care in Italy, the Netherlands and England. The aim is to understand why the trend towards migrant workers in social care has occurred in some countries, such as Italy, more than others, such as the Netherlands. It investigates both the employment of migrant workers by care-providing organisations and by families. The data sources used included surveys (the Italian Indagine Multiscopo sulle Famiglie and the British Labour Force Survey) and expert interviews with, for example, representatives of trade unions, migrant organisations and policy makers. It is found that migrant workers work longer hours and do more night shifts than their native peers. Between country differences in the importance of migrant workers in social care can be explained primarily by differences in social care policies and care regimes, while the impact of immigration policies is more ambiguous. It is argued that a familialistic care regime induces a ‘migrant in the family’ model of care, while a liberal care regime leads to a ‘migrant in the market’ model of employment, and a social democratic care regime creates no particular demand for migrant workers.
The redefinition of the familialist home care model in France: the complex formalization of care through cash payment
- Author:
- BIHAN Blanche Le
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.238-246.
- Publisher:
- Wiley
This article examines French policy measures on the organisation of home-based care for older people, by investigating the balance between formal and informal care. It specifically focuses on the cash for care scheme which is at the core of the French home-based care policy. A detailed analysis was made of different policy documents and public reports, together with a systematic review of existing studies. Findings highlighted the complexity of the process related to the introduction of care allowance and demonstrate. It outlined the diversity of the resources available: heterogeneous professional care, semi-formal forms of care work with the possibility to employ a relative and informal family care. Finally, the analysis revealed the importance of the regulation of cash payments on the reshaping of formal and informal care.
Home care in Italy: a system on the move, in the opposite direction to what we expect
- Author:
- GORI Cristiano
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.255-264.
- Publisher:
- Wiley
In Italy, the public system of home care for older people is underfunded and mostly cash-oriented; a system, thus, relying almost entirely on informal care provided by the family. This article analyses how the provision of home care in Italy has changed in the last decade. It discusses the reasons behind the increased uptake of the Indennità di Accompagnamento (IA), a “companion payment”. It examines an increase in the needs and demands of older people; the traits of the Italian welfare system; and the peculiar features of the companion payment itself. The article then looks at why services in kind rose to a lesser degree, pinpoints the main reason as being based on the politics of social care at national level, and finally focuses on the challenges that the Italian home-care system has to face within the changed policy environment with respect to quality of care, carers’ conditions and support for older people with high-level needs.
Home care for older people in Sweden: a universal model in transition
- Authors:
- SZEBEHELY Marta, TRYDEGÅRD Gun-Britt
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.300-309.
- Publisher:
- Wiley
This article explores two trends in home care for older people in Sweden: a decline in the coverage of publicly funded services, and their increasing marketisation. It examines consequences of the changes by analysing two data sets from Statistics Sweden: the Swedish Level of Living surveys from 1988/1989 and 2004/2005. Analysis reveals that the decline of tax-funded home care is not the result of changing eldercare legislation. However, it was caused by a complex interplay of decision-making at central and local levels, resulting in stricter municipal targeting. Legislative changes have opened up tax-funded services to private provision, and a customer-choice model and a tax deduction for household- and care services have been introduced. As a result of declining tax-funded home-care services, older persons with lower education increasingly receive family care, while those with higher education are more likely to buy private services. In conclusion, the combination of income-related user fees, customer-choice models and the tax deduction has created an incentive for high-income older persons to turn to the market instead of using public home-care services.