In Europe over the last two decades, marketization has become an important policy option in elder care. Comparative studies predominantly adopt an institutional perspective and analyze the politics and policies of marketization. This analysis takes a step back and examines the fundamental ideas underpinning the policies of marketization, using the 'What's the problem?' approach by Carol Bacchi. The central question is how the market was discursively framed as the solution to the perceived problems of three different systems of elder care, and how such processes are similar or different across the three countries. The analysis includes two extreme types of elder care systems, the Nordic public systems in Denmark and Finland, and the Southern European family-based model in Italy. Empirically, the analysis offers interesting insights into processes of constructing and legitimating markets at the level of discourse; this occurs by defining specific problem representations, underlying assumptions and silences. In all three countries, marketization is presented as a solution which builds on rather than challenges dominant ideas of care. Conceptually, in addition to its institutions, it is crucial to understand the ideas behind the marketization of elder care. Ideas emerge as a key leverage for making policies and practices of marketization acceptable and which decision makers and other influential political/societal actors use in policy and public debates. The importance of ideas is further underlined by the fact that they do not necessarily relate to the institutions of elder care systems in a linear way.
This thematic section of the European Journal of Ageing addresses care for older people in a number of European countries, in regards to the consequences that shifting boundaries of responsibility for financing, organising and providing care have had for older persons as care recipients and for informal and formal care workers. The initiative for this section comes from the Nordic Centre of Excellence: 'Reassessing the Nordic Welfare Model' (REASSESS) and within this from the strand 'Care in ageing and diversifying societies'. The interest in the consequences of the shifting boundaries of care stems from the major changes that European welfare states and elder care policies have been facing in recent decades. These changes and restructuring processes of care policies and service provision have changed the situation of carers considerably, both in the informal and formal sector, of older people in need of care and their members of kin. Care policies compose the structural environment of elder care and changes in it have many intended and unintended consequences for different actors; informal and formal carers, elders and their kin members. The overarching trend in elder care during recent decades seems to have been the politisation of care, meaning that care for older people has increasingly become a political matter that requires actions from decision-makers and public bodies. One evident consequence of politisation of care is the formalisation of care practices and relations.
New technologies, namely eHealth platforms, are being used more than ever before. These platforms enable older people to have a more independent lifestyle, enhance their participation, and improve their well-being. Information and communication technologies are expected to be linked to the triad of aging, social inclusion, and active participation, which is in line with the implementation of Smart Healthy and Age-Friendly Environments. This scoping review aimed to map eHealth platforms designed to promote autonomous life and active aging. The Joanna Briggs Institute methodology and the PRISMA-ScR checklist were used. A search was conducted on MEDLINE (via PubMed), CINAHL Complete (via EBSCOhost), Scopus, Cochrane Database of Systematic Reviews (via EBSCOhost), SciELO, DART-Europe, CAPES, and MedNar databases. Fourteen studies were included. This scoping review synthesized information on eHealth platforms designed to promote active living, their domains of intervention, and the outcomes assessed in those studies that have implemented and evaluated these eHealth platforms.
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