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Transformation by stealth: the retargeting of home care services in Finland
- Authors:
- KRÖGER Teppo, LEINONEN Anu
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.319-327.
- Publisher:
- Wiley
This article explores changes that Finish home care services for older people have undergone during the last two decades. Data drawn from national social care statistics, 1990–2010, suggest, in contrast to many other European nations, the coverage levels in Finland have dropped dramatically during this period. Those with the highest needs do receive increased amounts of support, but others have become excluded from publicly funded home care provisions. Overall, the changes represent weakening defamilisation, that is, decreasing public responsibility for the needs of many older people and, correspondingly, an increasing reliance on family carers. This full-scale transformation of home care has taken place without any real policy debate or major modification of legislation. No actual decision was ever made to thoroughly alter the character of home care in Finland: the transformation happened by stealth.
Voice and choice for users and carers? Developments in patterns of care for older people in Australia, England and Finland
- Authors:
- YEANDLE Sue, KRÖGER Teppo, CASS Bettina
- Journal article citation:
- Journal of European Social Policy, 22(4), 2012, pp.432-445.
- Publisher:
- Sage
This article considers developments during the 1990s and 2000s, decades that saw considerable debate, innovation, experimentation and change in how services for older people were planned, developed, delivered and experienced in many states, including Australia, England and Finland. It identifies key trends in residential and community care for older people, investigating the extent of ‘de-institutionalisation’, ‘privatisation’ and ‘individualisation’. The concepts of collective and individual ‘voice’ and ‘choice’ are used to interrogate the roles of collective and individual actors, older people and carers, in influencing policy formulation. While these three processes have been pursued by policy-makers in each country, their implementation is illuminated by understanding how ‘voice’ and ‘choice’ have been operationalised – individually and collectively – in each context. In the reshaping of eldercare in the three states, the analysis identifies the greater influence of claims-making by family carers, in comparison with the collective and individual voices of older people as service users.